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您的检索式：作者名="Stuart Paterson"
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| 1 | Endoscopic ultrasound-guided elastography in the nodal staging of oesophageal cancer显示文摘AIM:To assess quantitative endoscopic ultrasound (EUS)guided elastography in the nodal staging of oesophagogastric cancers.METHODS:This was a single tertiary centre study assessing 50 patients with established oesophago-gastric cancer undergoing EUS-guided fine needle aspiration biopsy (FNAB) of lymph nodes between July 2007 and July 2009.EUS-guided elastography of lymph nodes was performed before EUS-FNAB.Standard EUS characteristics were also described.Cytological determination of whether a lymph node was malignant or benign was used as the gold standard for this study.Comparisons of elastography and standard EUS characteristics were made between the cytologically benign and malignant nodes.The main outcome measure was the accuracy of elastography in differentiating between benign and malignant lymph nodes in oesophageal cancers.RESULTS:EUS elastography and FNAB were performed on 53 lymph nodes.Cytological malignancy was found in 23 nodes,one was indeterminate,one was found to be a gastrointestinal stromal tumor and 25 of the nodes were negative for malignancy.On 3 occasions insufficient material was obtained for analysis.The area under the curve for the receiver operating characteristic curve for elastography strain ratio was 0.87 (P<0.0001).Elastography strain ratio had a sensitivity 83%,specificity 96%,positive predictive value 95%,and negative predictive value 86% for distinguishing between malignant and benign nodes.The overall accuracy of elastography strain ratio was 90%.Elastography was more sensitive and specific in determining malignant nodal disease than standard EUS criteria.CONCLUSION:EUS elastography is a promising modality that may complement standard EUS and help guide EUS-FNAB during staging of upper gastrointestinal tract cancer. | Stuart Paterson Fraser Duthie Adrian J Stanley | 2012 | World Journal of Gastroenterology2012，18，9： | 10 |
| 2 | Mediastinal node staging by positron emission tomographycomputed tomography and selective endoscopic ultrasound with fine needle aspiration for patients with upper gastrointestinal cancer:Results from a regional centre显示文摘AIM To investigate the impact of endoscopic ultrasound-guided fine-needle aspiration(EUS-FNA) and positron emission tomography-computed tomography(PET-CT) in the nodal staging of upper gastrointestinal(GI) cancer in a tertiary referral centre.METHODS We performed a retrospective review of prospectively recorded data held on all patients with a diagnosis of upper GI cancer made between January 2009 and December 2015. Only those patients who had both a PET-CT and EUS with FNA sampling of a mediastinal node distant from the primary tumour were included. Using a positive EUS-FNA result as the gold standard for lymph node involvement, the sensitivity, specificity, positive and negative predictive values(PPV and NPV) and accuracy of PET-CT in the staging of mediastinal lymph nodes were calculated. The impact on therapeutic strategy of adding EUS-FNA to PET-CT was assessed.RESULTS One hundred and twenty one patients were included. Sixty nine patients had a diagnosis of oesophageal adenocarcinoma(Thirty one of whom were junctional), forty eight had oesophageal squamous cell carcinoma and four had gastric adenocarcinoma. The FNA results were inadequate in eleven cases and the PET-CT findings were indeterminate in two cases, therefore thirteen patients(10.7%) were excluded from further analysis. There was concordance between PET-CT and EUS-FNA findings in seventy one of the remaining one hundred and eight patients(65.7%). The sensitivity, specificity, PPV and NPV values of PET-CT were 92.5%, 50%, 52.1% and 91.9% respectively. There was discordance between PET-CT and EUS-FNA findings in thirty seven out of one hundred and eight patients(34.3%). MDT discussion led to a radical treatment pathway in twenty seven of these cases, after the final tumour stage was altered as a direct consequence of the EUS-FNA findings. Of these patients, fourteen(51.9%) experienced clinical remission of a median of nine months(range three to forty two months). CONCLUSION EUS-FNA leads to altered staging of upper GI cancer, resulting in more patients receiving radical treatment that would have been the case using PET-CT staging alone. | Chris Harrington Lyn Smith Jennifer Bisland Elisabet López González Neil Jamieson Stuart Paterson Adrian John Stanley | 2018 | World Journal of Gastrointestinal Endoscopy2018，10，1： | 4 |
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