微探头超声内镜和CT扫描在胸段食管癌术前分期中的应用  

Comparison of mini-probe endoscopic ultrasonography with computed tomography in preoperative staging of esophageal cancer

作　　者：胡鸿[1] 相加庆[1] 张亚伟[1] 陈洁[2] 顾雅佳[3] 缪珑昇[1] 马龙飞[1] 

机构地区：[1]复旦大学附属肿瘤医院胸外科复旦大学上海医学院肿瘤学系,上海200032 [2]复旦大学附属肿瘤医院内镜科 [3]复旦大学附属肿瘤医院放射诊断科

出　　处：《中华肿瘤杂志》2006年第2期123-126,共4页Chinese Journal of Oncology

摘　　要：目的对比微探头超声内镜(MCUS)及CT在胸段食管癌术前进行T、N分期中的应用价值,探讨MCUS判断淋巴结转移的标准。方法对35例初治胸段食管癌患者分别进行MCUS扫描和CT扫描,并同时分别进行T、N分期;以术后病理为金标准,比较在对淋巴结转移的判断中,本研究试行的3种标准的准确率(即真实性)、灵敏度、特异度、阳性及阴性预测值等参数,判断其临床应用价值,并且,就MCUS扫描对淋巴结转移的判断标准进行探讨。结果本组35例中,MCUS的T分期准确率(85.7%)高于CT(45.7%),差异有统计学意义(P=0.000);MCUS的N分期中,两种标准的准确率(分别为85.7%及80.0%)均略高于CT(74.3%),但差异无统计学意义(P>0.05)。应用淋巴结短径及短长轴比例(S/L)结合的方法,研究结果显示,检测的灵敏度有所提高。结论MCUS在胸段食管癌术前分期中有重要作用,其T分期准确率明显高于传统CT扫描。以淋巴结短径与S/L结合进行分析,有望提高判断淋巴结转移的准确性。Objective To compare mini-probe endoscopic ultrasonography （MCUS） with computed tomography （CT） in preoperative T and N staging of esophageal cancer, and to find out the MCUS parameters to judge lymph node metastasis for esophageal cancer. Methods Thirty-five patients received both MCUS and CT preoperatively, on both of which the T and N stages were determined. The accuracy, sensitivity, specificity, positive predicting value and negative predicting value were compared with the postoperative pathological results. Results The accuracy of MCUS was 85.7% in T staging and 85.7% and 80.0% in N staging by the two different methods, which were 45.7% and 74.3% , respectively, by CT. Conclusion MCUS is better than CT in preoperative staging for esophageal cancer. The ratio of short to long axis （S/L） combined with short axis is a useful way to determine lymph node metastasis.

关 键 词：微探头超声内镜 食管癌 淋巴结转移 

分 类 号：R735.1[医药卫生—肿瘤] R814.42[医药卫生—临床医学]