[Show abstract][Hide abstract] ABSTRACT: To evaluate the value of miniprobe sonography (MPS), spiral CT and MR imaging (MRI) in the tumor and regional lymph node staging of esophageal cancer.
Eight-six patients (56 men and 30 women; age range of 39-73 years, mean 62 years) with esophageal carcinoma were staged preoperatively with imaging modalities. Of them, 81 (94 %) had squamous cell carcinoma, 4(5 %) adenocarcinoma, and 1(1 %) adenoacanthoma. Eleven patients (12 %) had malignancy of the upper one third, 41 (48 %) of the mid-esophagus and 34 (40 %) of the distal one third. Forty-one were examined by spiral CT in whom 13 were co-examined by MPS, and forty-five by MRI in whom 18 were also co-examined by MPS. These imaging results were compared with the findings of the histopathologic examination for resected specimens.
In staging the depth of tumor growth, MPS was significantly more accurate (84 %) than spiral CT and MRI (68 % and 60 %, respectively, P<0.05). The specificity and sensitivity were 82 % and 85 % for MPS; 60 % and 69 % for spiral CT; and 40 % and 63 % for MRI, respectively. In staging regional lymph nodes, spiral CT was more accurate (78 %) than MPS and MRI (71 % and 64 %, respectively), but the difference was not statistically significant. The specificity and sensitivity were 79 % and 77 % for spiral CT; 75 % and 68 % for MPS; and 68 % and 62 % for MRI, respectively.
MPS is superior to spiral CT or MRI for T staging, especially in early esophageal cancer. However, the three modalities have the similar accuracy in N staging. Spiral CT or MRI is helpful for the detection of far-distance metastasis in esophageal cancer.
World Journal of Gastroenterology 02/2003; 9(2):219-24. · 2.43 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: AIM: To evaluate the relationship of H pylori infection, H pylori -related gastritis, serum gastrin and motilin levels and esophageal lesions in gastroesophageal reflux disease (GERD). METHODS: All 53 GERD patients were divided into non- erosive reflux disease (NERD group, 32 cases) and reflux esophagitis (RE group, 21 cases ) by endoscopy. The de- grees of gastritis in antrum and body as well as esophagitis were evaluated by pathological examinations. Fasting serum gastrin and motilin concentrations were determined by radioimmunoassay. H pylori was examined by serum H pylori- antibody, Warthin-Starry stain, urease-dependent test (rapid urease test or 14C-breath test). H pylori infection was affirmed when at least two of three tests were positive. 20 normal persons were as controls. In NERD group, 18 were H pylori positive and 14 were negative. In RE group 12 were H pylori positive and 9 were negative. According to the classification of esophagitis, 11 were Class , 7 Class and 3 Class . There were 30 H pylori (+) and 23 H pylori (-) in 53 GERD patients.
[Show abstract][Hide abstract] ABSTRACT: AIM: To explore the use of capsule endoscopy to detect colon disorders following the completion of small intestine disease diagnosis on the basis of implementation of energy consumption control for the endoscope, body position adjustment and food serving. METHODS: Seventy-six patients who received capsule endoscopy examination to exclude ileus were divided into two study groups: Group 1 (n = 39) and Group 2 (n = 37). Patients in Group 1 were examined by ordinary procedures. In contrast, patients in Group 2 were examined by modified procedures. The endoscope was manipulated to reduce the frequency of photo- graphing and the brightness of endoscopic im- age before the capsule reached the duodenum. Within two hours after the capsule traveled inside the duodenum, the position of the mov- ing capsule was observed continuously while the patient's body position was adjusted. The patients were laid flat with buttocks slightly elevated when the capsule moved into the co- lon. Meanwhile, the patients were served with food. When the capsule reached the hepatic flexure, the patients were laid on their left side. When the capsule reached the splenic flexure, the patients were laid in flat position. After the capsule battery was exhausted, the recorder was retrieved. The position of the capsule inside the patient's body was examined by X-ray. RESULTS: Endoscopic capsules worked for 4 ± 0.9 h in the colon in Group 1. The capsules reached the recta in only four cases, and re- mained in the ileocecus in the other 35 cases, of which two cases of ileocecal polypi were de- tected. In contrast, endoscopic capsules worked for 5 ± 0.7 h in the colon in Group 2. The move- ment inside the colon was active after the pa- tients took food. The capsules reached beyond the colon ascendens in 19 (51.4%) cases. Seven (18.9%) cases of colon diseases were detected in Group 2. Statistical differences were noted in the detection rate of colon diseases and the working duration of endoscopic capsules be- tween the two groups (both P < 0.05). More- over, a significant difference was observed in the effective rate of colon detection between the two groups (P < 0.01). CONCLUSION: Implementation of battery en- ergy control, patient position adjustment, and food serving during capsule endoscopy can effectively prolong the working duration of en- doscopic capsules in the colon and increase the detection rate of colon diseases.