Clinical Value Of Endoscopic Ultrasonography In Staging Of Esophageal Cancer

Objective:1.To explore the clinical diagnostic value of endoscopic ultrasonography in the staging of esophageal cancer,and to analyze the echo characteristics of endoscopic ultras-onography in different stages and its significance in judging the depth of lesions.2.Based on the pathological results,this study analyzed and compared the accuracy of endoscopic ultrasonography and NBI-ME in determining the depth of invasion of early esophageal cancer,and the accuracy of endoscopic ultrasonography and CT in TN staging of esophageal cancer.3.To evaluate the diagnostic value of different examinations in different stages of esophageal cancer,and to provide help for the next treatment plan of patients.Material selection and methods:1.From August 2016 to August 2018,endoscopic biopsy at the Affiliated Hospital of Taishan Medical College showed 199 patients with high-grade intraepithelial neoplasia(HGIN)or squamous cell carcinoma of the esophagus.After admission,patients comple-ted NBI-ME examination,chest CT examination and endoscopic ultrasonography,and retained pathology.2.According to the pathological results,80 cases of esophageal HGIN and early esophageal cancer were screened out,including 63 males and 17 females.A total of 80lesions were found,with an average age of 61 years.The results of NBI-ME and endos-copic ultrasonography were collected from these patients.170 patients were diagnosed as esophageal cancer(excluding 29 patients with esophageal HGIN),126 males and 44females.To collect the results of thoracic CT and endoscopic ultrasonography in these patients.3.To compare the results of NBI-ME and endoscopic ultrasonography in patients with HGIN and early esophageal cancer,and to study the diagnostic value of NBI-ME and endoscopic ultrasonography in patients with HGIN and early esophageal cancer.To analyze the diagnostic value of endoscopic ultrasonography and chest CT in patients with esophageal cancer.Result:1.There were 80 patients with esophageal HGIN and early esophageal cancer.The accuracy rates of HGIN+M1+M2,M3 and SM in EUS group were 88.52%,66.67%,71.43%,and the total accuracy rate was 83.75%.The accuracy of HGIN group,M1 group,M2 group and M3 SM group in NBI-ME group was 100.00%,100.00%,62.50%,78.95%respectively,and the total accuracy was 91.25%.It is suggested that NBI-ME is superior to EUS in diagnosing HGIN and early esophageal cancer.There is no significant difference in the accuracy of the two methods(χ~2=2.057,P>0.05).The results of consistency analysis between EUS and pathological results(K=0.620,P<0.05)indicated that EUS and pathological criteria were generally consistent;the results of consistency analysis between NBI-ME and pathological results(K=0.877,P<0.05)indicated that NBI-ME was in good agreement with pathological gold standard.2.There were 170 patients with esophageal cancer.(1)In T stage,the accuracy of T1group,T2 group,T3 group and T4 group in EUS group was 82.35%,57.14%,82.86%,71.43%,and the total accuracy was 75.88%.The accuracy rates of T1,T2,T3 and T4groups were 58.82%,57.14%,85.71%,100.00%and 71.18%respectively,suggesting that EUS was superior to thoracic CT in T staging of esophageal cancer.There was no significant difference in the accuracy of these two methods(χ~2=0.967,P>0.05).The results of consistency analysis between EUS and pathological results(K=0.643,P<0.05)indicated that EUS was generally consistent with pathological T staging,while the results of consistency analysis between CT and pathological results(K=0.578,P<0.05)indicated that the consistency between chest CT and pathological T staging was general.(2)In N phase,the accuracy of N0 group and N1 group was 93.07%and 86.96%respectively,and the total accuracy was 90.59%in EUS group.The accuracy of N0 group and N1 group was 91.09%and 88.41%respectively,and the total accuracy was 90.00%.It is suggested that EUS is superior to thoracic CT in the accuracy of N staging of esophageal cancer.There is no significant difference in the accuracy of the two methods(χ~2=0.034,P>0.05).The results of consistency analysis between EUS and pathological analysis(K=0.804,P<0.05)indicated that EUS and pathological gold standard had good consistency in N stage,while the results of consistency analysis and pathological comparison of thoracic CT(K=0.541,P<0.05)indicated that the consistency of thoracic CT with pathological standard in N stage was general.Conclusion:1.Ultrasound endoscopy has certain value in the invasive level of patients with esophageal HGIN and early esophageal cancer,but compared with NBI-ME,its diagnostic accuracy and coincidence rate are slightly lower.Therefore,NBI-ME is the preferred method to judge the invasive depth of esophageal HGIN and early esophageal cancer.2.In the T staging of esophageal cancer,the consistency of EUS and CT in comparison with pathological results is general,but the value of EUS is higher than that of chest CT.Therefore,endoscopic ultrasonography is recommended for the diagnosis of the depth of esophageal cancer lesions.3.In N staging of esophageal cancer,the consistency of EUS and pathological criteria is better than that of chest CT.Therefore,endoscopic ultrasonography is recommended for lymphatic metastasis of esophageal cancer.