Endoscopic Ultrasonography for Preoperative Diagnosis of the Mediastinal Lymphnodes Metastasis in Esophageal Cancer

Yoshinori Takahashi

Second Department of Surgery, Akita University School of Medicine

Endoscopic ultrasonography (EUS) was performed in 35 patients with esophageal cancer. We compared one by one EUS findings with clinicopathological findings in thoracic lymph nodes to determine the usefulness and limitations of EUS. The overall rate of detection was 33%. The detection rate differed depending on location and size, and detection rates of detection in the rt. thoracic paratracheal lymph nodes, rt pulmonal hilar lymph nodes and pulmonary ligament wre low regardless of size. The rates of detection rate of metastatic lymph nodes was 83%. EUS could diagnose metastatic lymph nodes over 4 mm in the non-bifurcation lymph nodes and pulmonal hilar lymph nodes group. New criteria were devised for diagnosing metastatic lymph nodes using EUS. A lymph node was determined to be metastatic if it had three or more of the following properties: 1) with notching 2) clear border 3) long axis (more than 6 mm) 4) a heterogeneous internal echo pattern. The accuracy, sensititity and specificity of the diagnosis were 92% (49/53), 82% (14/17), and 97% (35/36) respectively. EUS was uweful for diagnosis of metastatic lymph nodes over than 4 mm in the non-bifurcation lymph nodes and pulmonal hilar lymph node group.

Key words
endoscopic ultrasonography, esophageal cancer, lymph node metastasis of esophageal cancer

Reprint requests
Yoshinori Takahashi Second Department of Surgery, Akita University School of Medicine
1-1-1 Hondo, Akita, 010 JAPAN

Accepted
October 1, 1997

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