MSCT对食管癌患者术前临床分期诊断及复发预测的价值分析  

Analysis of the Value of MSCT for Preoperative Clinical Staging Diagnosis and Recurrence Prediction in Oesophageal Cancer Patients Before Radiotherapy

作　　者：刘庆轲 蒋烈夫 任统伟 杨贤增 LIU Qingke;JIANG Liefu;REN Tongwei(Nanyang Zhang Zhongjing Hospital,Nanyang,473000)

机构地区：[1]河南省南阳张仲景医院,473000

出　　处：《实用癌症杂志》2024年第5期800-802,808,共4页The Practical Journal of Cancer

摘　　要：目的探讨MSCT对食管癌患者术前临床分期诊断及复发预测的价值。方法回顾性选取108例食管癌患者,术前均进行MSCT检查,以手术病理检查为金标准,分析MSCT对食管癌者T、N分期的诊断价值及复发预测价值。结果MSCT检查诊断食管癌T分期:T17例、T221例、T347例、T423例,诊断准确率为90.7%,与病理检查诊断结果的一致性较好(Kappa=0.88);MSCT检查诊断食管癌N分期:N085例、N114例,诊断准确率为91.7%,与病理检查诊断结果的一致性较好(Kappa=0.82)。患者的性别、年龄、T分期及化疗和GTV-L与患者有无复发均无相关性,而在复发的患者中N1分期、GTV-D≥3.5 cm、GTV-V≥23.8 cm^(3)和GTV-V/L≥3.5 cm^(2)的患者占比较高(P均<0.05);Logistic回归分析结果显示,GTV-D、GTV-V和N分期均是食管癌患者复发的独立影响因素(P<0.05)。结论MSCT对食管癌术前分期及复发风险预测有着非常高的临床价值,且发现GTV-D、GTV-V和淋巴结转移是食管癌复发的独立危险因素,因此MSCT可作为食管癌术前评估的主要检查方式。Objective To investigate the value of MSCT for preoperative clinical staging diagnosis and recurrence prediction in patients with oesophageal cancer.Methods Retrospectively selected 108 cases of esophageal cancer patients,all of whom underwent MSCT before surgery,and analyzed the diagnostic value of MSCT on T and N staging and the predictive value of recurrence in patients with esophageal cancer,using surgical pathology examination as the gold standard.Results MSCT diagnosed esophageal cancer T-stage T1 in 7 cases,T2 in 21 cases,T3 in 47 cases,and T4 in 23 cases,and the diagnostic accuracy was 90.7%,which was in good agreement with pathological examination result(Kappa=0.88),and the difference was not statistically significant(χ^(2)=0.124,P=0.988);The diagnostic accuracy of MSCT was 91.7%,which was in good agreement with pathological examination(Kappa=0.82),and the difference was not statistically significant(χ^(2)=0.003,P=0.958);Gender,age,T-stage,chemotherapy and GTV-L were not correlated with recurrence,while among patients with recurrence,N1 stage,GTV-D≥3.5 cm,GTV-V≥23.8 cm^(3) and GTV-V/L≥3.5 cm were higher among patients with recurrence(all P<0.05);Logistic regression analysis showed that GTV-D,GTV-V and N stage were all independent influencing factors for recurrence in patients with esophageal cancer(P<0.05).Conclusion MSCT has a very high clinical value for preoperative staging and recurrence risk prediction of esophageal cancer,and GTV-D,GTV-V and lymph node metastasis were found to be independent risk factors for recurrence of esophageal cancer,so MSCT can be one of the main examination modalities for preoperative evaluation of esophageal cancer.

关 键 词：多层螺旋CT 食管癌 诊断 复发 预测价值 

分 类 号：R735.1[医药卫生—肿瘤]