Plukker J Th M, van Westreenen H L
Department of Surgical Oncology and Abdominal Surgery, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9700 RB Groningen, The Netherlands.
Best Pract Res Clin Gastroenterol. 2006;20(5):877-91. doi: 10.1016/j.bpg.2006.05.001.
Accurate staging defines groups for stage-specific treatment, minimising inappropriate treatment. Application of dedicated staging methods - including 16-64 multidetector computed tomography (CT), endoscopic ultrasonography with fine-needle aspiration (EUS-FNA) and positron emission tomography (PET) - results in better staging of oesophageal cancer. PET as a metabolic imaging technique that is usually applied after (or recently in combination with) CT (PET/CT) improves the accuracy of non-invasive staging, especially in locally advanced oesophageal cancer patients. Whether EUS-FNA or PET/CT should be performed as a first diagnostic step is still a matter of debate. Fluoro-2-deoxyglucose (FDG) PET is also promising tool in assessing neoadjuvant treatment response. Application of these dedicated staging methods has a learning curve, suggesting a prominent role for centralisation.
准确分期可明确适合特定分期治疗的患者群体，减少不适当治疗。应用专门的分期方法——包括16至64排多层螺旋计算机断层扫描（CT）、内镜超声引导下细针穿刺活检（EUS-FNA）和正电子发射断层扫描（PET）——可更好地对食管癌进行分期。PET作为一种代谢成像技术，通常在CT（PET/CT）之后应用（或最近与CT联合应用），可提高非侵入性分期的准确性，尤其是对于局部晚期食管癌患者。EUS-FNA或PET/CT是否应作为首要诊断步骤仍存在争议。氟代脱氧葡萄糖（FDG）PET在评估新辅助治疗反应方面也是一种有前景的工具。应用这些专门的分期方法存在学习曲线，这表明集中化具有重要作用。
