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RISS 인기검색어
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- 저자 : 손진휘(Jin Hwe Son) (검색결과 1 건)
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위장관 ( 胃腸管 ) : 위암환자에서 내시경적 초음파단층법 ( EUS ) 에 의한 TNM분류의 평가
조성원(Sung Won Cho),심찬섭(Chan Sup Shim),김진홍(Jin Hong Kim),이문성(Moon Sung Lee),조영덕(Young Deok Cho),손진휘(Jin Hwe Son),김홍수(Hong Su Kim) 대한소화기학회 1991 대한소화기학회지 Vol.23 No.3
N/A EUS-a combination of endoscopy and ultrasonography was developed to improve the diagnostic accuracy of ultrasound by direct image of the target lesion via the gastrointestinal lumen. This new technique will prove to be accurate in the staging of gastric malignant tumors because of the clear visualization of the tumor infiltration and of involvement of adjacent lymph nodes. EUS was performed preoperatively for assessing the clinical TNM classification in 54 patients with a gastric carcinoma confirmed by endoscopic biopsy. The results were correlated with those obtained with the histology of resected specimens according to the pathological TNM classification. 1) In 54 patients with a gastric carcinoma, the mean age of the patients was 55.9 years with a male to female ratio of 1.84 : l 2) Early gastric cancer was diagnosed with the histology of resected specimens in 7 patients, and advanced gastric cancer in 47 patients. In 4 cases of advanced gastric cancer, only exploratory laparotomy was performed, so that the extent of tumor infiltration could not be assessed histologically. 3) In assessing the depth of tumor invasion, the stage accuracy rate of EUS was 85.6%. for T1 tumors, 83.3% for T2 tumors, 76.5% for T3 tumors, and 85.7% for T4 tumors. The overall accuracy rate was 82.0% (41/50). 4) In staging lymph nodes, the accuracy rate of EUS was 57.9% for NO, 75.0%. for Nl, and 54.5% for N2. The overall accuracy rate was 64.8% (35/54). A rate of false-positive diagnosis was 42.1% and a rate of false-negative diagnosis was 14.3%. 5) In assessing distant metastases, the accuracy rate of EUS was 100% for MO, 57.1% for Ml. In 2 patients with metastases in the right lobe of the liver and 1 patient with metastasis in the ovary, metastases were not visualized with EUS due to its limited depth of the penetration of ultrasound. 6) In stage grouping of stomach cancer, the overall accuracy rate of EUS was 57.4% (31/54). In conclusion, EUS will become an important diagnostic procedure for clinical TNM classification with the combined use of transcutaneous abdominal ultrasonography or abdomimal computed tomo-graphy.
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