ABSTRACT
Objective Compared with chest CT,endoscopic ultrasonography (EUS) can more accurately determine the upper and lower margins of esophageal cancer,and marking the upper and lower margins of the esophageal cancer with titanium clip contributes to the delineation of target area of esophageal cancer during radiotherapy.To compare the effects of esophageal X-ray,chest computed tomography (CT)scan and EUS-assisted placement of marker clip in the determination of the length of gross target volume (GTV),aiming to provide reference for the determination of GTV during esophageal cancer radiotherapy.Methods Thirty patients who were initially diagnosed with thoracic esophageal cancer by histological and cytological examinations and scheduled to receive radiotherapy were recruited in this investigation.All patients received esophageal X-ray,CT scan,and EUS-assisted placement of marker clip.The length of GTV was quantitatively measured and statistically compared among three different methods.Results The length of GTV was (6.1 ± 1.4) cm,(6.8± 1.9) cm and (6.3± 1.9) cm determined by esophageal X-ray,CT scan and EUS-assisted placement of marker clip,respectively.Compared with CT scan,the length of GTV determined by EUS-assisted placement of marker clip did not significantly differ (P=0.11).The length of GTV determined by esophageal X-ray was significantly shorter than that by CT scan (P =0.03).Among all patients,the length of GTV determined by EUS-assisted placement of marker clip was longer compared with that by chest CT scan in 22.2％ of patients.The length of GTV determined by EUS-assisted placement of marker clip was the same as that by chest CT scan in 11.1％ of patients.The length of GTV determined by EUS-assisted placement of marker clip was shorter compared with that by chest CT scan in 66.7％ of patients.Conclusions EUS-assisted placement of marker clip differs from esophageal X-ray and CT scan in determining the length of GTV,which acts as one of the effective methods in the determination of the length of GTV during esophageal cancer radiotherapy.
ABSTRACT
Gastric cancer is one of the common malignant tumors in digestive system. The incidence of gastric cancer in China is higher than that in developed countries. The prognosis of gastric cancer is closely related to the stage of cancer, and the prognosis of advanced gastric cancer is poor. Improving the detection rate of early gastric cancer is the key to improve the survival of patients with gastric cancer. Endoscopic technology developed rapidly in recent years,various forms of endoscopy have been applied in clinical practice,and the detection rate of early gastric cancer was increased. This article reviewed the advances in study on endoscopic diagnosis of early gastric cancer.
ABSTRACT
Objective To assess the feasibility of using ultra sonic endoscopy in retroperitoneal laparoscopic nephron-sparing surgery for treatment of endogenous renal tumor, and to summarize our clinical experience. Methods A female patient, aged 28 years old, was found to have a mass (diameter1.4cm×1.0cm, clinical stage T1aN0M0)in the right upper part of the kidney. Retroperitoneal laparoscopic nephron? Sparing surgery was performed. The tumor could not be accurately located during the operation due to the smooth renal surface; then ultrasonic endoscopy was used to locate the tumor; and color Doppler mode was used to observe the blood supply of the tumor and its relation with surrounding tissues. The nephron-sparing surgery was performed following the guidance of ultrasonic endoscopy positioning; the integrity of tumor resection and surgical margin were also observed. Results The involvement of the tumor an dits blood supply were clearly displayed by ultrasonic endoscopy. Nonoticeable signals of blood flow were seen around the tumor after blocking the renal artery, and the tumor was totally and thoughly removed with a negative margin of 0.5-1.0cm.There was no transfer to opening surgery. The procedure of ultrasonic endoscopy last ed for 5 min. Post operative pathological results in dicated angiomyolipoma with negative margins. Conclusion Our initial clinical practice suggests that ultrasonic endoscopy is safe and benificial for retroperitoneal laparoscopic nephron-sparing surgery in treatment of endogenous renal tumors, especially for observing the tumor location, tumor blood supply, and the integrity of resection.