[内镜超声检查与CT对术前食管癌T、N分期的诊断价值]

[Diagnostic value of endoscopic ultrasonography and CT in T, N stage of preoperative esophageal cancer].

作者信息

Hu Yi, Fu Jian-Hua, Rong Tie-Hua, Yang Hong, Huang Wei-Zhao, Wang Geng, Zheng Bin, Zhu Zhi-Hua

机构信息

Department of Thoracic Surgery, Cancer Center, National Key Laboratory of Oncology in South China, Sun Yat-sen University, Guangzhou 510060, China.

出版信息

Zhonghua Wei Chang Wai Ke Za Zhi. 2008 Mar;11(2):150-3.

PMID:18344083

Abstract

OBJECTIVE

To evaluate the preoperative endoscopic ultrasonography (EUS) and CT in the diagnosis of TN stage of esophageal cancer.

METHODS

Fifty-one hospitalized patients with esophageal cancer in our center from July 2002 to January 2004 were enrolled in this study. According to UICC (1997) TNM clinical stage, the TN stage results of esophageal cancer by EUS and CT examination of above 51 cases were compared with the postoperative pathological TN stage.

RESULTS

(1)The accuracy rates of T and N stage by EUS were 82.4%(42/51) and 88.0%(45/51) respectively. The accuracy rates of T and N stage by CT were 52.9%(27/51) and 51.0%(26/51) respectively. The accuracy rates of T and N stage by combination of EUS and CT were 86.3%(44/51) and 90.0%(46/51). (2)The consistent condition among EUS, CT or combination of EUS and CT with pathology: The Kappa of EUS to T and N stage were 0.700(P<0.001) and 0.763(P<0.001). The Kappa of CT to T and N stage were 0.275(P=0.002) and 0.006(P=0.964). The Kappa of EUS+CT to T and N stage were 0.769(P<0.001) and 0.801(P<0.001). (3)Significant differences were found between EUS and CT:PT=0.001(chi(2)=10.079) and PN<0.001(chi(2)=16.730). No significant difference was found between EUS+CT and EUS.

CONCLUSIONS

EUS can be used as important and main preoperative examination because of presenting high accuracy rate in the diagnosis of T and N stage of esophageal cancer. EUS+CT does not improve accuracy rate significantly in TN stage diagnosis of esophageal cancer.

摘要

目的

评估术前内镜超声检查（EUS）和CT在食管癌TN分期诊断中的价值。

方法

选取2002年7月至2004年1月在本中心住院的51例食管癌患者。根据UICC（1997）TNM临床分期标准，将上述51例患者的EUS和CT检查的食管癌TN分期结果与术后病理TN分期进行比较。

结果

（1）EUS对T分期和N分期的准确率分别为82.4%（42/51）和88.0%（45/51）。CT对T分期和N分期的准确率分别为52.9%（27/51）和51.0%（26/51）。EUS与CT联合检查对T分期和N分期的准确率分别为86.3%（44/51）和90.0%（46/51）。（2）EUS、CT或EUS与CT联合检查与病理结果的一致性：EUS对T分期和N分期的Kappa值分别为0.700（P<0.001）和0.763（P<0.001）。CT对T分期和N分期的Kappa值分别为0.275（P=0.002）和0.006（P=0.964）。EUS+CT对T分期和N分期的Kappa值分别为0.769（P<0.001）和0.801（P<0.001）。（3）EUS与CT之间存在显著差异：PT=0.001（χ²=10.079），PN<0.001（χ²=16.730）。EUS+CT与EUS之间无显著差异。