SUPERFICIAL ESOPHAGEAL-CARCINOMA - CONTRI BUTION OF ENDOSCOPY AND ENDOSCOPIC ULTRASONOGRAPHY

Superficial esophageal carcinoma (SEC) is characterized by infiltratio n of the mucosa and/or submucosa, with or without involvement of the l ymph nodes, Lymph node involvement is uncommon (<5%) in SEC confined t o the mucosa I?ut occurs in up to 30-45 % of SECs involving tile submu cosa. It follows that the prognosis of submucosal forms is more severe and that therapeutic decisions should be made accordingly, The diagno sis of SEC rests on endoscopic examination of the esophagus with colle ction of biopsies under visual guidance. Use of specific stains in hig h-risk patients Increases the diagnostic efficacy of this procedure, S EC should be suspected whenever the relief or color of the esophageal mucosa is abnormal, Endoscopy does not accurately predict the depth of parietal involvement or the involvement of lymph nodes, which are bes t determined by endoscopic ultrasonography. However, the 7.5 and 12 MH z probes routinely used for endoscopic ultrasonography fail to discrim inate accurately between forms with and without submucosal involvement . Recently developed 20-MHz probes capable of visualizing the muscular is propria are expected to prove more effective in this regard and the refore to be of greater assistance in making therapeutic decisions.