Metrika članka

  • citati u SCindeksu: [2]
  • citati u CrossRef-u:0
  • citati u Google Scholaru:[=>]
  • posete u poslednjih 30 dana:7
  • preuzimanja u poslednjih 30 dana:4
članak: 1 od 1  
Medicinski pregled
2008, vol. 61, br. 11-12, str. 557-561
jezik rada: srpski
vrsta rada: izvorni naučni članak
doi:10.2298/MPNS0812557R


Uloga endorektalnog ultrazvuka u određivanju stadijuma karcinoma rektuma
Univerzitet u Novom Sadu, Medicinski fakultet, Institut za onkologiju

e-adresa: radovanovic.zoran@onko.onk.ns.ac.yu

Sažetak

Preoperativno određivanje stadijuma karcinoma rektuma je od presudnog značaja za planiranje terapije, individualno za svakog pacijenta. Ova studija je imala za cilj da utvrdi tačnost endorektalnog ultrazvuka u preoperativnom određivanju stadijuma karcinoma rektuma. Pedeset bolesnika sa dijagnostikovanim karcinomom rektuma (31 muškarac, 19 žena) pregledani su endorektalnim ultrazvukom sa sondom od 7,5 MHz. Preoperativnu hemioiradijaciju primilo je 38 pacijenata te je kod njih pregled rađen pre i nakon sprovedene zračne terapije. Rezultati pregleda su upoređivani sa histološkim nalazima operativnog preparata. Patohistološki je postavljena dijagnoza 4 T0, 3 T1, 12 T2, 30 T3 i jedan T4 tumor. Metastaze u limfnim čvorovima su identifikovane kod 17 pacijenata. Ukupna tačnost endorektalnog ultrazvuka u određivanju T stadijuma bila je 66% a u određivanju N stadijuma 70%. U proceni da li postoji proboj zida rektuma ili ne (T1-2 vs. T3-4 / Dukes A vs. Dukes B) endorektalni ultrazvuk je pokazao senzitivnost, specifičnost i tačnost od 74%, 68% i 72%. Endorektalni ultrazvuk je pouzdana dijagnostička procedura u određivanju stadijuma karcinoma rektuma. To je brz, bezbedan, tačan i jeftin pregled, pacijenti ga dobro podnose, te treba da bude dijagnostička metoda izbora u određivanju stadijuma karcinoma rektuma, iako treba uzeti u obzir izvesne teškoće u dijagnostici kod pacijenata koji su primili radioterapiju.

Ključne reči

Karcinomi rektuma; Ultrazvuk; Određivanje stadijuma carcinoma

Reference

Akasu, T., Sugihara, K., Moriya, Y., Fujita, S. (1997) Limitations and pitfalls of transrectal ultrasonography for staging of rectal cancer. Dis Colon Rectum, 40(10 Suppl): S10-5
Akbari, R.P., Wong, W.D. (2003) Endorectal ultrasound and the preoperative staging of rectal cancer. Scand J Surg, 92(1): 25-33
Beynon, J., Mortensen, N.J., Foy, D.M., Channer, J.L., Virjee, J., Goddard, P. (1986) Pre-operative assessment of local invasion in rectal cancer: Digital examination, endoluminal sonography or computed tomography?. Br J Surg, 73(12): 1015-7
Burtin, P., Rabot, A.F., Heresbach, D., Carpentier, S., Rousselet, M.C., le Berre, N., Boyer, J. (1997) Interobserver agreement in the staging of rectal cancer using endoscopic ultrasonography. Endoscopy, 29(7): 620-5
Fuchsjäger, M.H., Maier, A.G., Schima, W., Zebedin, E., Herbst, F., Mittlböck, M., i dr. (2003) Comparison of transrectal sonography and double-contrast Mr imaging when staging rectal cancer. Am J Roentgenol / AJR, 181, str. 421-7
Garcia-Aguilar, J., Pollack, J., Lee, S., de Hernandez, A.E., Mellgren, A., Wong, W., Finne, C.O., Rothenberger, D.A., Madoff, R.D. (2002) Accuracy of endorectal ultrasonography in preoperative staging of rectal tumors. Dis Colon Rectum, 45(1): 10-5
Goldman, S., Arvidsson, H., Norming, U., Lagerstedt, U., Magnusson, I., Frisell, J. (1991) Transrectal ultrasound and computed tomography in preoperative staging of lower rectal adenocarcinoma. Gastrointest Radiol, 16(3): 259-63
Herzog, U., von Flüe, M., Tondelli, P., Schuppisser, J.P. (1993) How accurate is endorectal ultrasound in the preoperative staging of rectal cancer?. Dis Colon Rectum, 36(2): 127-34
Hildebrandt, U., Feifel, G. (1985) Preoperative staging of rectal cancer by intrarectal ultrasound. Dis Colon Rectum, 28(1): 42-6
Kim, N.K., Kim, M.J., Yun, S.H., Sohn, S.K., Min, J.S. (1999) Comparative study of transrectal ultrasonography, pelvic computerized tomography, and magnetic resonance imaging in preoperative staging of rectal cancer. Dis Colon Rectum, 42(6): 770-5
Knaebel, H., Koch, M., Feise, T., Benner, A., Kienle, P. (2005) Diagnostics of rectal cancer: Endorectal ultrasound. Recent Results Cancer Res, 165: 46-57
Kruskal, J.B., Kane, R.A., Sentovich, S.M., Longmaid, H.E. (1997) Pitfalls and sources of error in staging rectal cancer with endorectal us. Radiographics, 17(3): 609-26
Kwok, H., Bissett, I.P., Hill, G.L. (2000) Preoperative staging of rectal cancer. Int J Colorectal Dis, 15(1): 9-20
Marusch, F., Koch, A., Schmidt, U., Zippel, R., Kuhn, R., Wolff, S., Pross, M., Wierth, A., Gastinger, I., Lippert, H. (2002) Routine use of transrectal ultrasound in rectal carcinoma: results of a prospective multicenter study. Endoscopy, 34(5): 385-90
Medich, D., McGinty, J., Parda, D., Karlovits, S., Davis, C., Caushaj, P., Lembersky, B. (2001) Preoperative chemoradiotherapy and radical surgery for locally advanced distal rectal adenocarcinoma: Pathologic findings and clinical implications. Dis Colon Rectum, 44(8): 1123-8
Minsky, B.D. (2004) Combined modality therapy of resectable rectal cancer: Current approaches. Tech Coloproctol, 8(2): 67-76
Napoleon, B., Pujol, B., Berger, F., Valette, P.J., Gerard, J.P., Souquet, J.C. (1991) Accuracy of endosonography in the staging of rectal cancer treated by radiotherapy. Br J Surg, 78(7): 785-8
Nesbakken, A., Løvig, T., Lunde, O.C., Nygaard, K. (2003) Staging of rectal carcinoma with transrectal ultrasonography. Scand J Surg, 92(2): 125-9
Orrom, W.J., Wong, W.D., Rothenberger, D.A., Jensen, L.L., Goldberg, S.M. (1990) Endorectal ultrasound in the preoperative staging of rectal tumors. A learning experience. Dis Colon Rectum, 33(8): 654-9
Rau, B., Hünerbein, M., Barth, C., Wust, P., Haensch, W., Riess, H., Felix, R., Schlag, P.M. (1999) Accuracy of endorectal ultrasound after preoperative radiochemotherapy in locally advanced rectal cancer. Surg Endosc, 13(10): 980-4
Roubein, L.D., Lynch, P., Glober, G., Sinicrope, F.A. (1996) Interobserver variability in endoscopic ultrasonography: a prospective evaluation. Gastrointest Endosc, 44(5): 573-7
Starck, M., Bohe, M., Fork, F.T., Lindstrom, C., Sjoberg, S. (1995) Endoluminal ultrasound and low-field magnetic resonance imaging are superior to clinical examination in the preoperative staging of rectal cancer. Eur J Surg, 161(11): 841-5