Abstract
Background and Study Aims: The presence or absence of lymph-node metastasis is the single most important factor
in determining the strategy for treating superficial carcinoma of the esophagus. In
this study, ultrasound (US) and endoscopic ultrasonography (EUS) were used in the
diagnosis of lymph-node metastases, and the accuracy and limitations of these methods
were assessed.
Patients and Methods: Prospectively, 37 patients with superficial esophageal cancer were studied by US
and EUS before surgery, and the results were compared with the histological findings.
Twelve of the patients had histologically confirmed lymph-node metastases. Ultrasonographic
images of the lymph nodes were classified into three types, based on their boundaries
and internal echoes.
Results: The sensitivity, specificity, and accuracy of predicting mediastinal lymph-node metastasis
by EUS diagnosis were 80.0 %, 87.5 %, and 86.5 %, respectively. The sensitivity, specificity,
and accuracy of US in the assessment of cervical and abdominal lymph-node metastasis
were 71.4 %, 86.7 %, and 83.3 %, respectively. In cases in which there was a solitary
metastatic lymph node, the detection rate was higher than in cases with two or more
positive nodes. Most metastatic lymph nodes correctly diagnosed by US and EUS were
larger than 6 mm and had tumor involving more than one-third of their cross-sectional
area.
Conclusions: In patients with superficial esophageal carcinomas, US is accurate in staging cervical
and abdominal lymph nodes. EUS is accurate in staging mediastinal lymph nodes.
