Department of Surgery, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan.
Surg Today. 2009;39(10):888-91. doi: 10.1007/s00595-009-3952-6. Epub 2009 Sep 27.
An accurate preoperative staging is important for selecting an appropriate therapy for esophageal cancer. In particular, diagnosis of lymph node metastases influences the indication for radical surgery. [18F]Fluorodeoxyglucose positron emission tomography (FDG-PET) has been widely applied primarily as a useful tool for initial staging of esophageal cancer. However, false-negative cases sometimes make it difficult to select the appropriate treatment. We report two patients with esophageal cancer and PET-negative enlarged lymph node successfully diagnosed by laparoscopic sampling. This procedure did not only allow accurate histopathological staging, but also helped to select the optimal minimally invasive management. This technique can be recommended for patients with esophageal cancer in whom the diagnosis of enlarged lymph node cannot be confirmed by preoperative imaging.
准确的术前分期对于选择食管癌的适当治疗方法很重要。特别是，淋巴结转移的诊断影响根治性手术的适应证。[18F]氟脱氧葡萄糖正电子发射断层扫描（FDG-PET）已广泛应用于食管癌的初始分期，主要作为一种有用的工具。然而，假阴性病例有时使选择适当的治疗变得困难。我们报告了 2 例经腹腔镜取样成功诊断的食管癌和 PET 阴性肿大淋巴结的患者。该方法不仅可以进行准确的组织病理学分期，还可以帮助选择最佳的微创治疗方法。对于术前影像学检查不能确诊肿大淋巴结的食管癌患者，可推荐使用该技术。
