| [ Summary ] |
Accurate diagnosis of invasion depth and lymph node metastasis in the 3 fields, the neck, the mediastinum and the abdomen, is important in making decisions on endoscopic mucosal resection (EMR) or EMR + α applications for superficial cancer, and in selecting the type of operation or chemo-radiotherapy for advanced cases. High frequency miniature ultrasonographic (US) probes were used to evaluate the depth of superficial esophageal cancer. With the cancers deeper than sm, it is necessary to use conventional endoscopic ultrasonography (EUS) equipment, which provides better ultrasound penetration. In the diagnosis of invasion depth, EUS has a higher accuracy rate than CTs. This is also true in diagnosis of invasion of surrounding organs. Since systematic check ups for lymph node metastasis are evaluated with an eye on surrounding organs or vessels, it is necessary to use conventional EUS equipment. Although its diagnostic capability for minute metastasis is limited, 2 or 3 times more lymph node metastases have been found this way than that with CT or US examinations. However, since the diagnostic capability of EUS is also limited, we are performing EUS-guided fine needle aspiration biopsy (EUS-FNAB) if the images of lymph nodes are difficult to judge for a definite diagnosis, leading directly to decisions on therapeutic strategies. |