维普中文期刊产品整合服务

Mediastinal node staging by positron emission tomographycomputed tomography and selective endoscopic ultrasound with fine needle aspiration for patients with upper gastrointestinal cancer:Results from a regional centre

查看全文 作　　者：Chris [1,2]Harrington;Lyn [1]Smith;Jennifer [1]Bisland;Elisabet López [1,4]González;Neil [1,3]Jamieson;Stuart [1,2]Paterson;Adrian John [1]Stanley 高影响力作者 机构地区：[1]Glasgow Royal Infirmary,Glasgow G4 0ET,United Kingdom;[2]Forth Valley Royal Hospital,Larbert FK5 4WR,United Kingdom;[3]Raigmore Hospital,Inverness IV2 3UJ,United Kingdom;[4]Hospital Vega Baja,Orihuela 03314,Spain高影响力机构 出　　处：《World Journal of Gastrointestinal Endoscopy》索引2018年第10卷第1期,共8页高影响力期刊 摘　　要：AIM To investigate the impact of endoscopic ultrasound-guided fine-needle aspiration(EUS-FNA) and positron emission tomography-computed tomography(PET-CT) in the nodal staging of upper gastrointestinal(GI) cancer in a tertiary referral centre.METHODS We performed a retrospective review of prospectively recorded data held on all patients with a diagnosis of upper GI cancer made between January 2009 and December 2015. Only those patients who had both a PET-CT and EUS with FNA sampling of a mediastinal node distant from the primary tumour were included. Using a positive EUS-FNA result as the gold standard for lymph node involvement, the sensitivity, specificity, positive and negative predictive values(PPV and NPV) and accuracy of PET-CT in the staging of mediastinal lymph nodes were calculated. The impact on therapeutic strategy of adding EUS-FNA to PET-CT was assessed.RESULTS One hundred and twenty one patients were included. Sixty nine patients had a diagnosis of oesophageal adenocarcinoma(Thirty one of whom were junctional), forty eight had oesophageal squamous cell carcinoma and four had gastric adenocarcinoma. The FNA results were inadequate in eleven cases and the PET-CT findings were indeterminate in two cases, therefore thirteen patients(10.7%) were excluded from further analysis. There was concordance between PET-CT and EUS-FNA findings in seventy one of the remaining one hundred and eight patients(65.7%). The sensitivity, specificity, PPV and NPV values of PET-CT were 92.5%, 50%, 52.1% and 91.9% respectively. There was discordance between PET-CT and EUS-FNA findings in thirty seven out of one hundred and eight patients(34.3%). MDT discussion led to a radical treatment pathway in twenty seven of these cases, after the final tumour stage was altered as a direct consequence of the EUS-FNA findings. Of these patients, fourteen(51.9%) experienced clinical remission of a median of nine months(range three to forty two months). CONCLUSION EUS-FNA leads to altered staging of upper GI cancer, resulting in more patients receiving radical treatment that would have been the case using PET-CT staging alone. 关 键 词：Endoscopic ultrasound Oesophago-gastric CANCER STAGING OESOPHAGEAL CANCER POSITRON emission tomography-computed TOMOGRAPHY MEDIASTINAL nodes
相关文献

参考文献(35)

引证文献(5)

耦合文献(9)

网站首页 | 关于我们 | 联系我们 | 产品服务 | 客服中心 | 广告服务 | 版权声明 | 网站联盟 | 友情链接 | 售卡网点

版权所有© 渝B2-20050021-1　渝公网安备 50019002500403号　违法和不良信息举报中心

互联网出版许可证 新出网证(渝)字10号 全国400电话 - 免长途话费