To assess the accuracy and limitations of endoscopic ultrasonography (EUS) in the preoperative staging of esophageal and gastric carcinoma, we performed a prospective controlled study over a five year period. Data from 63 patients with esophageal cancer and 147 patients with gastric cancer who underwent surgery were available for comparison of the endosonographic TNM classification to the histophathological findings of the resected specimens. The overall accuracy of EUS in the assessment of tumor infiltration depth was 85.7% and 78% in esophageal and gastric cancer, respectively. The sensitivity of EUS in the detection of regional lymph node metastases was 90% in esophageal and 87% in gastric carcinoma. The most frequent causes of misdiagnoses by endosonography were microscopic tumor invasion and peritumorous inflammatory changes. The inability to traverse a tumor stenosis restricted the endosonographic evaluation in 31.6 and 14% of the cases with esophageal and gastric cancer, respectively.
Cases of adenoid cystic carcinomas of the salivary (n = 90) and lacrimal glands (n = 6) from the years 1965-1980 were evaluated retrospectively with regard to clinical, epidemiologic and histomorphologic parameters, and in 52 cases, nuclear DNA content was assessed using a single cell scanning cytophotometry procedure in order to determine prognostic factors. Clinical courses were poor with a high incidence of recurrences, hematogenous metastases and deaths from tumor. Histology was related to prognosis, glandular tumors showing a better prognosis than solid ones. Tumor size greater than 4 cm was correlated with an unfavorable clinical course in all cases. Cytophotometry yielded various types of histograms (7 diploid, 10 proliferative, 14 triploid, 19 atypical, 2 tetraploid). Significant correlations were found as to the time of survival, tumors with diploid histograms showing the longest intervals and those with atypical ones the shortest. Although the prognosis of adenoid cystic carcinoma remains poor, cytophotometry can offer additional prognostic information in the individual case.
The Salivary Gland Registry provided 21 cases of epithelial‐myoepithelial duct carcinoma of salivary glands from 1965–1980 which were evaluated retrospectively for clinical follow‐up and cytophotometric data; 81% were localized in the major, 19% in the minor salivary glands. The male: female ratio was 1:1.1, 10 patients (47, 6%) being men and 11 (52,4%) women. The youngest patient was 27, the oldest 91 y old. The mean age was 59.3 y (overall), 57.9 y (women) and 61.0 (men). The clinical course was characterized by lymph node metastases present at initial diagnosis and local recurrences in 23.5%. No patient died of the tumor. In 12 cases, cytochemical assessment of nuclear DNA by means of single cell scanning cytophotometry yielded diploid histograms. According to clinical and cytophotometrical data, epithelial‐myoepithelial duct carcinoma of salivary glands can be regarded as a proper tumor entity of low grade malignancy.
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