Department of Radiology, Tokyo Medical and Dental University, 5-45 Yushima 1-chome, Bunkyo-ku, Tokyo, Japan.
Acta Oncol. 2012 May;51(5):645-52. doi: 10.3109/0284186X.2011.652260. Epub 2012 Jan 10.
The prevalence of esophageal cancer accompanied by hypopharyngeal cancer (HPC) is high and increasing rapidly in Asia. The purpose of this prospective study was to evaluate the prevalence of esophageal cancer during the pretreatment of HPC patients who were routinely examined using esophagogastroduodenoscopy (EGD) and 18F-fluorodeoxyglucose/computed tomography (FDG-PET/CT) and to discuss the utility of these examinations.
Between September 2005 and September 2010, 33 patients with newly diagnosed HPC (all with squamous cell carcinoma) underwent EGD (after a conventional endoscopy, iodine staining was performed) and FDG-PET/CT examinations. We evaluated the prevalence of esophageal cancer among HPC patients according to the EGD findings and determined the sensitivity of FDG-PET/CT for the detection of esophageal primary tumors for each clinical T classification.
In 17 of the 33 patients (51.5%), 29 biopsy-proven esophageal squamous cell carcinomas were diagnosed using EGD. In eight of the 17 (47.1%) patients, two or more esophageal cancer lesions were diagnosed. Twenty-four of the 29 (82.8%) lesions were superficial esophageal cancers, and the remaining five (17.2%) lesions were advanced esophageal cancers. In six of the 29 (20.7%) esophageal cancer lesions that were detected using FDG-PET/CT, only one of the 29 (3.4%) lesions was evaluated as being equivocal; the remaining 22 (75.9%) lesions were not detected. The distribution of the clinical T classifications detected using FDG-PET/CT was as follows: T1a, 0/21 (0%); T1b, 1/3 (33%); and T3, 5/5 (100%).
The prevalence of esophageal cancer during the pretreatment of HPC patients was 51.5%; this prevalence was higher than that in previous reports. We believe that the increasing proportion of superficial lesions (82.8%) detected using iodine staining and EGD may have led to the relatively high prevalence. FDG-PET/CT detected only 20.7% of the esophageal cancers, although FDG-PET/CT is capable of detecting unexpected primary malignant tumors other than esophageal cancer.
亚洲地区食管癌合并下咽癌（HPC）的发病率正在迅速上升。本前瞻性研究旨在评估在行常规上消化道内镜检查（EGD）和 18F-氟代脱氧葡萄糖/计算机断层扫描（FDG-PET/CT）的 HPC 患者中，在进行 HPC 治疗前发现食管癌的比例，并探讨这些检查的作用。
2005 年 9 月至 2010 年 9 月，33 例新诊断的 HPC 患者（均为鳞状细胞癌）接受了 EGD（常规内镜检查后，进行碘染色）和 FDG-PET/CT 检查。我们根据 EGD 结果评估了 HPC 患者中食管癌的发生率，并确定了 FDG-PET/CT 对各临床 T 分期食管原发肿瘤的检出率。
在 33 例患者中，17 例（51.5%）经 EGD 发现 29 例活检证实的食管鳞状细胞癌。在这 17 例患者中，8 例（47.1%）诊断为 2 个或更多的食管癌灶。29 个病灶中，24 个（82.8%）为表浅食管癌，其余 5 个（17.2%）为进展期食管癌。在 FDG-PET/CT 检出的 29 个食管癌灶中，6 个（20.7%）仅 1 个（3.4%）为可疑，22 个（75.9%）未检出。FDG-PET/CT 检出的临床 T 分期分布如下：T1a，0/21（0%）；T1b，1/3（33%）；T3，5/5（100%）。
HPC 患者治疗前食管癌的检出率为 51.5%，高于以往报道。我们认为，碘染色和 EGD 检出的表浅病变比例增加（82.8%）可能是导致这一高检出率的原因。尽管 FDG-PET/CT 能够检测到食管外的意外原发性恶性肿瘤，但仅检出了 20.7%的食管癌灶。
