Submucosal Saline Injection Followed by Endoscopic Ultrasound versus Endoscopic Ultrasound Only for Distinguishing between T1a and T1b Esophageal Cancer
| Autor: | Jian Jun Li, Shuo Chun Zeng, Long Jun He, Lin Na Luo, Li Ming Chen, Zi Xian Wang, Guang Yu Luo, Guo Liang Xu, Yi Tai Xiao, Hong Bo Shan, Chuanbo Xie, Yin Li, Xiao Yan Gao, Ping Yang |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male Endoscopic ultrasound Cancer Research medicine.medical_specialty Adolescent Esophageal Neoplasms medicine.medical_treatment Population Sodium Chloride Endosonography Young Adult 03 medical and health sciences 0302 clinical medicine Intestinal mucosa Predictive Value of Tests Humans Medicine Endoscopy Digestive System Intestinal Mucosa Stage (cooking) education Early Detection of Cancer Aged Neoplasm Staging Aged 80 and over education.field_of_study medicine.diagnostic_test business.industry Middle Aged Esophageal cancer medicine.disease digestive system diseases Endoscopy Esophagectomy Oncology 030220 oncology & carcinogenesis Predictive value of tests Female 030211 gastroenterology & hepatology Esophageal Squamous Cell Carcinoma Esophagoscopy Radiology business |
| Zdroj: | Clinical Cancer Research. 26:384-390 |
| ISSN: | 1557-3265 1078-0432 |
| DOI: | 10.1158/1078-0432.ccr-19-1722 |
| Popis: | Purpose: To examine whether submucosal saline injection (SSI) can improve traditional endoscopic ultrasound (EUS) accuracy in distinguishing between T1a and T1b stage esophageal squamous cell carcinoma (ESCC). Experimental Design: Patients with T1N0M0 stage ESCC (n = 180) ages 18 to 85 years were enrolled between February 14, 2012 to June 4, 2018 at Sun Yat-sen University Cancer Center (Guangdong, China). They were randomly assigned (1:1) to receive either EUS examination after 3–5 mL SSI or EUS only examination. All the patients were referred to thoracic surgeons to receive endoscopic resection (ER) or esophagectomy 5 to 10 days after EUS examination. Standard EUS criteria were used to preoperatively stage the ESCC cases, and surgical pathology reports after referral were used to postoperatively stage the cases. The primary endpoint was the diagnostic accuracy of T1b staging [defined as the sum of the true positive (T1b) and true negative (T1a) cases divided by the total number of cases]. Results: Among the per-protocol population, the SSI+EUS group (n = 81) was superior to the EUS-only group (n = 85) in terms of the diagnostic accuracy for T1b staging [93.8% (95% confidence interval (CI), 88.6–99.1) vs. 65.9% (95% CI, 55.8–76.0); P < 0.001]. The positive predictive value of SSI+EUS for diagnosing T1b ESCC reached 90.9% (95% CI, 81.1–100), which was significantly superior to that of EUS only [0.576 (0.450-0.702), P = 0.001]. Conclusions: SSI significantly improves the diagnostic accuracy of EUS in distinguishing between T1a and T1b ESCC, which might help avoid unnecessary esophagectomy and diagnostic ER. |
| Databáze: | OpenAIRE |
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