The Value Of Micro-probe Endoscopic Ultrasonography In The Diagnosis Of Colorectal Eminence Lesions And The Staging Of Cancer

Background and ObjectiveIn the disease of lower digestive tract,colorectal eminence or invasion lesions is a common disease.It could be formed either by inflammation and submucosal tumor,or resulted from the extraintestinal compression.The conventional endoscopy can observe the surface of the colorectal eminence lesions,however,it can not judge the origin,circumsciption,depth of the lesions.With the peculiar instruments,the micro-probe endoscopic ultrasonography(EUS)can observe the layers under the colorectal eminence lesions and the extraintestinal compression.EUS helps to assess the layer of origin,tumor diameter,shape,border characteristics,and internal echopatterns of submucosal tumors and thus it is possible to predict histological diagnosis.It is also worth noting that the best therapy can be chosen with the help of EUS.The aim of this syudy is to assess the value of endoscopic ultrasonography(EUS)with micro-probe in the diagnosis of colorectal eminence lesions and the staging of cancer.Materials and MethodsA total of 104 patients diagnosed with colorectal eminence or invasion lesion were collected from September 2000 to August 2006,including 60 men and 44 women,with a mean age of 58.8 years(ranged from 20 to 80 years).The preliminary endoscopy and endoscopic biopsies were performed.The histological types of the eminence lesions were proved by CT,ultrasound or pathological examination after surgery.In order to assess the value of EUS,the examination was performed using a 12-MHz or 15-MHz ultrathin mechanical radial scanning probe(electronic enteroscope:Fujinon EC-450WM and SP-701,Olympus CF-240L).Statistical analyses were performed using the Statistical Package for Social Sciences software(SSPS11.0 for Windows).Differences with P＜0.05 were considered significant.ResultsThe accuracy of EUS in the diagnosis of colorectal eminence or invasion lesions was 90.38%and significantly superior to that of endoscopy(65.38 %)(P＜0.05);The accurate rate of EUS in the diagnosis of submucosal eminence lesions and extraintestinal compression(89.29%and 100.00%) was significantly higher than that of endoscopy(35.71%and 23.08%);The accurate rate of EUS in the diagnosis of colorectal carcinoma,colorectal polyp and inflammatory bowel disease(88.24%,96.00%,80.95%)was similar to that of endoscopy(76.47%,96.00%,85.71%);The accurate rate of EUS in detecting regional lymph node metastasis of colorectal carcinoma was 70.59%.Compared with the postoperative itself with external compression,but also can judge the origin,pathological Dukes staging,the accurate rate of the preoperative TNM staging with EUS was 64.71%.ConclusionsEUS can not only separate the lesions of colorectal wall with extraintestinalcompression,butalsocanjudgethe origin,circumsciption,depth of the lesions.In a word,EUS shows the particular diagnostic value for submucosal eminence lesions or extraintestinal compression,but in the term of detecting regional lymph node metastasis of colorectal carcinoma and preoperative TNM staging,EUS should be associated with other examinations to show the particular diagnostic value.