Consigliere D, Chua C L, Hui F, Yu C S, Low C H
Department of Surgery, Tan Tock Seng Hospital, Singapore.
J R Coll Surg Edinb. 1992 Apr;37(2):113-7.
Between January 1988 and June 1991, 75 patients with carcinoma of the oesophagus or gastro-oesophageal junction were evaluated by computed tomography (CT). Fifty of these patients underwent operation, allowing 48 cases to have a detailed surgical and pathological verification of CT features. For thoracic oesophageal tumours the accuracy of CT was 59% for fat plane status, 86% for aortic contact, 81% for tracheobronchial tree compression and 66% for direct local invasion. CT was 69% accurate for identifying lymph nodes, of which only 38% contained metastatic deposits. For gastro-oesophageal junction tumours, CT was 74% accurate for fat plane status and 90% accurate for direct local invasion. Accuracy for detecting lymph node involvement was 63%, metastatic tumour being present in 91% of these nodes. By pathological staging, only 15% of all resections could be considered potentially curative. The value of CT was found to be in predicting a palliative or curative resection, and in warning the surgeon about possible infiltration of specific mediastinal or abdominal structures that would be encountered during operative dissection.
1988年1月至1991年6月期间，对75例食管癌或胃食管交界癌患者进行了计算机断层扫描（CT）评估。其中50例患者接受了手术，48例患者的CT特征得到了详细的手术和病理验证。对于胸段食管肿瘤，CT对脂肪平面状态的准确率为59%，对主动脉接触情况的准确率为86%，对气管支气管树受压情况的准确率为81%，对局部直接侵犯情况的准确率为66%。CT识别淋巴结的准确率为69%，其中只有38%的淋巴结有转移灶。对于胃食管交界部肿瘤，CT对脂肪平面状态的准确率为74%，对局部直接侵犯情况的准确率为90%。检测淋巴结受累的准确率为63%，这些淋巴结中91%存在转移瘤。通过病理分期，所有切除病例中只有15%可被认为有可能治愈。发现CT的价值在于预测姑息性或根治性切除，并提醒外科医生注意手术解剖过程中可能遇到的特定纵隔或腹部结构的浸润情况。
