Evaluation of Tumor Invasion to the Bronchial Wall and Nodal Metastasis by Endobronchial Ultrasonography

DOI 3 References
  • Sekine Yasuo
    Department of Thoracic Surgery, Graduate School of Medicine,Chiba University
  • Baba Masayuki
    Department of Thoracic Surgery, Graduate School of Medicine,Chiba University
  • Chiyo Masako
    Department of Thoracic Surgery, Graduate School of Medicine,Chiba University
  • Hoshino Hidehisa
    Department of Thoracic Surgery, Graduate School of Medicine,Chiba University
  • Yasufuku Kazuhiro
    Department of Thoracic Surgery, Graduate School of Medicine,Chiba University
  • Yoshida Shigetoshi
    Department of Thoracic Surgery, Graduate School of Medicine,Chiba University
  • Suzuki Makoto
    Department of Thoracic Surgery, Graduate School of Medicine,Chiba University
  • Shibuya Kiyoshi
    Department of Thoracic Surgery, Graduate School of Medicine,Chiba University
  • Iizasa Toshihiko
    Department of Thoracic Surgery, Graduate School of Medicine,Chiba University
  • Saitoh Yukio
    Department of Thoracic Surgery, Graduate School of Medicine,Chiba University
  • Fujisawa Takehiko
    Department of Thoracic Surgery, Graduate School of Medicine,Chiba University

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  • 経気管支超音波診断(EBUS)による腫瘍の気管支壁深達度とリンパ節転移の評価

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The precise investigation of tumor extent is very important for the decision of treatment strategy. In particular, extrabronchial invasion and peribronchial nodal metastasis influence the determination of clinical staging and operation method. The purpose of this study was to investigate the usefulness of endobronchial ultrasonography (EBUS) for evaluating the depth of bronchial wall invasion and nodal swelling by comparing its results to those of chest computed tomography and pathology. A total of 32 patients in whom tumors were detected out by bronchoscopy (30 primary lung cancers and 2 metastatic lung tumors) were entered into this study. The EBUS findings were obtained using thin ultrasonic probes (20 MHz, radial scanner) UM3R, EUM-3 and MH240 (Olympus, Japan). Lymph node metastasis was determined when the shape was round and the diameter exceeded 10 mm. Bronchoscopic findings of the tumors were 17 nodular, 8 polypoid, 6 thickened types and 1 case of submucosal invasion. Based on the relationship between tumor and bronchial cartilage, EBUS images revealed 13 intra-bronchial and 19 extra-bronchial invasions, which results were consistent with microscopic findings. The EBUS images could visualize hilar and intra-pulmonary lymph nodes (#10, 11,12, 13) well. In particular, intra-pulmonary lymph nodes were imaged by EBUS better than those by chest CT. In conclusion, EBUS is expected to be a useful modality for the evaluation of bronchial tumor invasion and nodal metastasis.

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