Background and Study Aims: The presence or absence of lymph-node metas
tasis is the single most important factor in determining the strategy
for treating superficial carcinoma of the esophagus, In this study, ul
trasound (US) and endoscopic ultrasonography (EUS) were used in the di
agnosis of lymph-node metastases, and the accuracy and limitations of
these methods were assessed. Patients and Methods: Prospectively, 37 p
atients with superficial esophageal cancer were studied by US and EUS
before surgery, and the results were compared with the histological fi
ndings. Twelve of the patients had histologically confirmed lymph-node
metastases. Ultrasonographic images of the lymph nodes were classifie
d into three types, based on their boundaries and internal echoes. Res
ults: The sensitivity, specificity, and accuracy of predicting mediast
inal lymph-node metastasis by EUS diagnosis were 80.0%, 87.5%, and 86.
5%, respectively. The sensitivity specificity, and accuracy of US in t
he assessment of cervical and abdominal lymph-node metastasis were 71.
4%, 86.7%, and 83.3%, respectively. In cases in which there was a soli
tary metastatic lymph node, the detection rate was higher than in case
s with two or more positive nodes, R-lost metastatic lymph nodes corre
ctly diagnosed by US and EUS were larger than 6 mm and had tumor invol
ving more than one-third of their cross-sectional area. Conclusions: I
n patients with superficial esophageal carcinomas, US is accurate in s
taging cervical and abdominal lymph nodes. EUS is accurate in staging
mediastinal lymph nodes.