ENDOSCOPIC ULTRASOUND ELASTOGRAPHY IN ASSESSMENT OF LYMPH NODES IN PATIENTS WITH HEPATOCELLULAR CARCINOMA PREPARED FOR LIVING DONOR LIVER TRANSPLANTATION

Abdelaziz Mahmoud, Mohga Reda, Amany Ibrahim, Manar SALAH-ELDIN
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Abstract

Lymph nodes are the most frequent site of extrahepatic metastases for hepatocellular carci- - cal ones from those best suited for non-surgical management. Diagnosis cannot be completely confirmed by imaging and operative exploration. Endoscopic ultrasound elastography (EUS-EG) has a marked role in assessment of lymph nodes in HCC patients and optimizing their management accordingly. This study assessed diagnostic accuracy of EUS-EG in suspected lymph nodes in HCC potential candidates for living donor liver transplantation (LDLT) and identifued its role in diagnosis and staging of hepatocellular carcinoma. The study was conducted at the Tropical Medicine department, Ain Shams University, Ain Shams Center of Organ Transplantation (ASCOT) and Endoscopy Unit, Theodor Bilharz Research Institute between July 2018 & May2023. The patients 24 with HCC and abdominal lymphadenopathy were prepared for LDLT. Liver function tests, Positron emission tomography (PET) scan, EUS-EG, EUS-guided fine needle aspiration (EUS-FNA). The results showed the prevalence of metastatic lymph nodes by EUS-FNA was 41.7%. EUS-EG and PET scan had same sensitivity of 80.0% in detecting metastatic lymph nodes. But, EUS-EG had a higher specificity 85.7% compared to 57.1% specificity of PET scan.
内窥镜超声弹性成像技术在评估准备接受活体肝移植的肝细胞癌患者淋巴结方面的应用
淋巴结是肝细胞钙化最常见的肝外转移部位,也是最适合非手术治疗的部位。影像学检查和手术探查无法完全确诊。内镜超声弹性成像(EUS-EG)在评估肝癌患者淋巴结并相应优化治疗方面具有显著作用。这项研究评估了 EUS-EG 对可能接受活体肝移植(LDLT)的 HCC 候选者中疑似淋巴结的诊断准确性,并确定了它在肝细胞癌诊断和分期中的作用。该研究于2018年7月至2023年5月期间在艾因夏姆斯大学热带医学系、艾因夏姆斯器官移植中心(ASCOT)和Theodor Bilharz研究所内窥镜室进行。24 名患有 HCC 和腹腔淋巴结病的患者为 LDLT 做好了准备。肝功能检查、正电子发射断层扫描(PET)、EUS-EG、EUS引导下细针穿刺(EUS-FNA)。结果显示,通过 EUS-FNA 检查发现转移淋巴结的比例为 41.7%。EUS-EG 和 PET 扫描检测转移淋巴结的敏感性相同,均为 80.0%。但 EUS-EG 的特异性为 85.7%,而 PET 扫描的特异性为 57.1%。
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