Biomedical subjects
Publications and source records attributed to M Georg.
Endosonography has become a widely accepted diagnostic procedure in the staging of gastrointestinal tumors over the past 10 years. The question of whether endosonography is equally as effective in the diagnosis of regional lymph node metastases has not been conclusively answered. This article presents a brief review of in vitro studies of lymph node analysis in the upper and lower gastrointestinal tract.
A total of 90 regional lymph nodes (43 benign/47 metastatic) from 16 surgical resection specimens of patients with esophageal and gastric carcinoma were examined in vitro by endosonography. The validity of endosonographic criteria of lymph node dignity (size, echogenicity, internal echo pattern and margin structure) was assessed using computer-supported B-mode analysis and compared to histopathological results. Of 26 lymph nodes with a diameter of more than 10 mm, 19 were metastatic (72%). The subjective assessment of the internal echo pattern (homogeneity) and the node margins by an experienced observer allowed the diagnosis of metastatic lymph nodes, but there was a high proportion of false positives (52%). Lymph node echogenicity, assessed either subjectively or by computer analysis, did not permit the differentiation between benign and metastatic lymph nodes.
From April 1989 to June 1991 63 patients with esophageal cancer were investigated by endosonography with the object of ascertaining the depth of intrathoracic tumor infiltration and lymphnode involvement. The sensitivity in diagnosing tumor infiltration amount to 0.74; the sensitivity for involvement of regional lymphnode was 0.84, specificity 0.44. In an in-vitro analysis endosonographic criteria for the assessment of regional lymphnodes are proved. Echogenic structure seems not to be a valuable criterium.