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Endoscopy 2013; 45(08): 667-670
DOI: 10.1055/s-0033-1344024
Case report/series
© Georg Thieme Verlag KG Stuttgart · New York

Endoscopic ultrasound combined with submucosal saline injection for differentiation of T1a and T1b esophageal squamous cell carcinoma: a novel technique

J.-J. Li
1   Department of Endoscopy, State Key Laboratory of Oncology in South China, Sun Yat-sen University, Guangzhou, China
,
H.-B. Shan
1   Department of Endoscopy, State Key Laboratory of Oncology in South China, Sun Yat-sen University, Guangzhou, China
,
M.-F. Gu
2   Department of Radiation Oncology, State Key Laboratory of Oncology in South China, Sun Yat-sen University, Guangzhou, China
,
L. He
3   Massachusetts General Hospital Cancer Center and Harvard Medical School, Boston, Massachusetts, USA
,
L.-J. He
1   Department of Endoscopy, State Key Laboratory of Oncology in South China, Sun Yat-sen University, Guangzhou, China
,
L.-M. Chen
1   Department of Endoscopy, State Key Laboratory of Oncology in South China, Sun Yat-sen University, Guangzhou, China
,
G.-Y. Luo
1   Department of Endoscopy, State Key Laboratory of Oncology in South China, Sun Yat-sen University, Guangzhou, China
,
G.-L. Xu
1   Department of Endoscopy, State Key Laboratory of Oncology in South China, Sun Yat-sen University, Guangzhou, China
› Author Affiliations
Further Information

Publication History

submitted 27 November 2012

accepted after revision 01 March 2013

Publication Date:
27 June 2013 (online)

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Endoscopic ultrasound (EUS) is the optimum method for investigation of early esophageal squamous cell carcinoma (ESCC). However, it is difficult to substage early ESCC as T1a or T1b. The aim of this study was to improve the staging accuracy of early ESCC by using EUS combined with submucosal saline injection (SSI). The study enrolled 15 patients with suspected early ESCC who were examined by EUS and subsequently by SSI combined with EUS. The patients then underwent endoscopic or surgical resection within 10 days. The accuracy of EUS staging (alone or following SSI) was evaluated and compared with the pathological results postoperatively. No severe complications of the SSI arose. EUS plus SSI easily distinguished the mucosa from the lesion and the submucosa because of the low-echoic saline-filled cushion in the submucosa. The accuracy of SSI combined with EUS for staging T1a or T1b was 86.7 %, which was better than that using EUS alone (60.0 %).

 

  • References

  • 1 Sobin LH, Gospodarowicz MK, Wittekind C eds. TNM Classification of Malignant Tumours. 7th. edn. Oxford: Wiley-Blackwell; 2010
    Search in Google Scholar
  • 2 NCCN. Clinical Practice Guidelines in Oncology: Esophageal and Esophagogastric Junction Cancers. Version 2.2011. National Comprehensive Cancer Network; 2011
    PubMedSearch in Google Scholar
  • 3 Rampado S, Bocus P, Battaglia G et al. Endoscopic ultrasound: accuracy in staging superficial carcinomas of the esophagus. Ann Thorac Surg 2008; 85: 251-256
    CrossrefPubMedSearch in Google Scholar
  • 4 Lin SH, Chang JY. Esophageal cancer: diagnosis and management. Chin J Cancer 2010; 29: 843-854
    CrossrefPubMedSearch in Google Scholar
  • 5 Low DE. Update on staging and surgical treatment options for esophageal cancer. J Gastrointest Surg 2011; 15: 719-729
    CrossrefPubMedSearch in Google Scholar
  • 6 The Paris endoscopic classification of superficial neoplastic lesions: esophagus, stomach, and colon. Participants in the Paris workshop. November 30 to December 1, 2002. Gastrointest Endosc 2003; 58: 3-43
    CrossrefPubMedSearch in Google Scholar
  • 7 Pfau PR, Perlman SB, Stanko P et al. The role and clinical value of EUS in a multimodality esophageal carcinoma staging program with CT and positron emission tomography. Gastrointest Endosc 2007; 65: 377-384
    CrossrefPubMedSearch in Google Scholar
  • 8 van Zoonen M, van Oijen MG, van Leeuwen MS et al. Low impact of staging EUS for determining surgical resectability in esophageal cancer. Surg Endosc 2012; 26: 2828-2834
    CrossrefPubMedSearch in Google Scholar
  • 9 May A, Günter E, Roth F et al. Accuracy of staging in early oesophageal cancer using high resolution endoscopy and high resolution endosonography: a comparative, prospective, and blinded trial. Gut 2004; 53: 634-640
    CrossrefPubMedSearch in Google Scholar