设为首页 | 加入收藏
| 欢迎光临本站!

消化内镜学分会官方网站

当前位置:文献追踪 > 国内外期刊

一项关于光学相干断层扫描和内镜超声对浅表性食管鳞状细胞癌的肿瘤分期的前瞻性比较研究

发布日期:2014-1-29 12:40:50 文章来源:ENDOSCOPY 作者次数:1514
    背景

    限于上皮细胞(EP)或黏膜固有层(LPM)浅表性食管鳞状细胞癌(SESCCs)(内镜切除术的标准适应症)的准确评估对确保内镜下切除的良好效果是重要的。关于断层成像技术,尽管实际上内镜超声检查的准确度不足,但我们之前表明,高清晰度光学相干断层扫描(OCT)可能使以非侵入性和实时方式进行的成像准备评估成为可能。

    目的

    通过采用高清晰度光学相干断层扫描(OCT)和20-MHz 的探针型内镜超声检查阐明浅表性食管鳞状细胞癌(SESCCs)的术前成像的准确性,并对二者进行比较。

    设计

    前瞻性研究。

    环境

    学术医疗中心。

    患者

    20075月至20119月共123例患者(131处浅表性食管鳞状细胞癌(SESCCs))参与研究。

    干预

    由一位专家采用OCTEUS对患者进行检查,并记录各病变典型的静止图像,而且检查后立即记录成像。由另一位事先不知情的调查者审查所记录的图像,并单独报告成像情况。组织学分期是由所切除的样本进行确定。最后,我们采用OTCEUS 计算成像的准确度。

    主要测量指标

    EP/LPM OCTEUS 的准确度。

    结果

    采用OCT EP/LPM 检测的准确性显著高于采用EUS 检查(OCT94.6%HF-EUS80.6%P < 0.05)。OCTEUS的观察者之间的一致性较好且适中。

    局限性

    患者数量少;单中心单操作者进行的非随机的交叉研究。

    结论

    我们前瞻性表明,采用OCT进行SESCC的术前成像比采用EUS更有效。

    缩写词:EP,上皮细胞;ER,内镜下切除术;HF-EUS,高频超声内镜;LPM,黏膜固有层;MM,粘膜肌层;SESCC,浅表性食管鳞状细胞癌;OCT,光学相干断层扫描;SM,粘膜下层


     

    A prospective comparative study of optical coherence tomography and EUS for tumor staging of superficial esophageal squamous cell carcinoma

    Division of Gastroenterology, Tohoku University Hospital, Sendai, Japan

    Received 17 February 2012; accepted 9 May 2012.

    Background

    The precise assessment of superficial esophageal squamous cell carcinomas (SESCCs) limited to the epithelium (EP) or lamina propria mucosa (LPM), the standard indication for endoscopic resection, is important to ensure good outcomes of endoscopic resection. With regard to tomographic imaging techniques, although the accuracy of EUS is practically insufficient, we previously demonstrated that high-resolution optical coherence tomography (OCT) might enable precise assessment for staging in a noninvasive and real-time manner.

    Objective

    To clarify the accuracy of the preoperative staging of SESCCs by using OCT compared with that by using 20-MHz probe-type EUS.

    Design

    A prospective study.

    Setting

    An academic medical center.

    Patients

    A total of 123 consecutive patients with 131 SESCCs were enrolled from May 2007 to September 2011.

    Interventions

    A specialist examined the patients, by using both OCT and EUS, recorded a representative still image for each lesion, and reported the staging immediately after each examination. Another blinded investigator reviewed the recorded images and reported the staging independently. The histological staging was confirmed by the resected specimens. Finally, we calculated the accuracy of staging by using OCT and EUS.

    Main Outcome Measurements

    The accuracy of OCT or EUS for EP/LPM.

    Result

    The accuracy for EP/LPM by using OCT was significantly higher than that by using EUS (OCT, 94.6%; HF-EUS, 80.6%; P < .05). Interobserver agreement of OCT and EUS was good and moderate, respectively.

    Limitations

    The small number of patients; a single-center, single-operator, nonrandomized, crossover study.

    Conclusions

    We prospectively demonstrated that the preoperative staging of SESCC by using OCT was more useful than that by using EUS.

    Abbreviations:  EP, epithelium, ER, endoscopic resection, HF-EUS, high-frequency EUS, LPM, lamina propria mucosa, MM, muscularis mucosa, SESCC, superficial esophageal squamous cell carcinoma, OCT, optical coherence tomography, SM, submucosa

     

    (作者:)
相关评论
用户名: 登录