Endoscopic ultrasonography in cancer staging for gastrointestinal malignancies

Abstract

Endoscopic ultrasonography has gained a pivotal role in cancer staging for gastrointestinal malignancies because of its ability to image both the layers of the intestinal wall and peri-intestinal lymph nodes and organs. Endoscopic ultrasonography should be used after computerized tomography, positron emission tomography scanning or magnetic resonance imaging scan has shown no distant metastatic disease. The TNM classification is used for gastrointestinal system cancer staging with endoscopic ultrasonography. Endoscopic ultrasonography staging accuracy is applicable to all luminal gastrointestinal tract cancers, with an approximate T-stage accuracy of 85% and N-stage accuracy of 75%. Accurate cancer staging is needed because it provides prognostic information and guides treatment. Additionally, endoscopic ultrasonography fine-needle aspiration can be used to biopsy any malignantappearing lymph nodes, and it slightly increases the N-stage accuracy.

Keywords

• Endoscopic ultrasonography, cancer staging, gastrointestinal system cancer

Gastrointestinal sistem kanserlerinin evrelemesinde endoskopik ultrasonografi

Öz

Endoskopik ultrosonografi, barsak duvarının tüm katmanlarının ve barsak çevresi lenf nodlarını gösterebilmesi nedeniyle gastrointestinal sistem kanserlerinin evrelemesinde kilit rol oynar. Endoskopik ultrosonografi ile kanser evrelemesi; bilgisayarlı tomografi, pozitron emisyon tomografi ve bilgisayarlı tomografi veya manyetik rezonans görüntüleme de uzak metastaz saptanmayan olgularda endikedir. Endoskopik ultrosonografi ile gastrointestinal sistem kanserlerinin evrelemesinde tümör nod metastaz sınıflaması kullanılır. Yaklaşık olarak bütün gastrointestinal sistem kanserlerinde T evrelemesinde endoskopik ultrosonografinin tanısal doğruluk oranı %85, N evrelemesinde ise doğruluk oranı %75'dir. Kanserlerin doğru evrelenmesi önemlidir çünkü; prognoz hakkında bilgi sağlar ve tedaviye yön verebilmektedir. Ek olarak endoskopik ultrosonografi yardımıyla malign görünümdeki lenf nodlarından iğne aspirasyonu yapılır ve bu sayede N evrelemesinin tanısal doğruluğu artar.

Anahtar Kelimeler

• Endoskopik ultrasonografi, kanser evrelemesi, gastrointestinal sistem kanserleri

Kaynakça

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