早期直腸癌におけるEUS深達度診断の有用性と問題点

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  • THE USEFULNESS AND ASSIGNMENT OF EUS DIAGNOSIS FOR MUCOSAL AND SUBMUCOSAL INVASION OF EARY RECTAL CANCER

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The usefulness and assignment of endoscopic ultrasonography (EUS) diagnosis for mucosal and submucosal invasion of eary rectal cancer were investigated in determination of operation method. We studied 18 cases of eary rectal cancer, including 10 cases of m cancer and eight cases of sm cancer, analyzed clinicopathologically after EUS invasion diagnosis and operation. Operative procedures included local resection for m and sm1 cancers, and rectum resection with lymph node dissection for sm2 and sm3 cancers. EUS diagnosis demonstrated accurate diagnosis in 15 cases out of the 18 cases (83.3%) in determination of operation method. Thus it can be evaluated as a significant modality in the invasion diagnosis of eary rectal cancer and determination of operation method. On the other hand, EUS failed to localize cancer in two cases (11.1%) and gave misdiagnosis in one case (5.6%) out of these 18 cases. The reasons of these failures might be due to echo attenuation owing to excessive height of carcinoma, handling difficulties owing to the location of carcinoma, and diagnosis difficulty in fibroplasia surrounding carcinoma. These are assigned to be improved and indicate the necessity of comprehensive diagnosis by rectal endoscopy and digital examination.

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