Lanfermann H, Krestin G P, Müller J M, Huber P
Institut für Radiologische Diagnostik, Universität zu Köln.
Rontgenblatter. 1990 Jun;43(6):241-4.
64 patients were operated on for carcinoma of the oesophagus during a five-year period (1/83 to 1/88) at the Department of Surgery of the University of Cologne; 95.3% of these suffered from squamous cell carcinoma. A preoperative CT of the thorax was performed in 38 patients, 13 of whom underwent abdominothoracic surgery and 25 blunt oesophagus dissections. The CT and plain diagnostic results were compared retrospectively and postoperatively with the intraoperative or histological findings. Three of seven oesophageal carcinomas of up to 2 cm size were not identified by CT. Infiltration of adjacent mediastinal structures by T3 carcinomas was detected in 16 of 22 cases with 3 false positive findings. In blunt oesophagus dissection the preoperatively diagnosed lymph node status agreed with the histological findings in more than 80% of the cases; a limitation, however, was the fact that only those lymph nodes could be assessed that clung to the resectate. In contrast, agreement was seen in only 7 of 13 cases (with 6 false negative findings) after abdominothoracic resection of oesophageal carcinomas. On the whole, there was agreement between preoperative and histological staging according to the TNM classification (UICC = in 50% of the cases, whereas in almost 40% (n = 15) the size or extension of the tumour growth had been underestimated preoperatively. Hence, the value of CT for the preoperative staging of oesophageal carcinoma is restricted.
在科隆大学外科，64例患者在五年期间（1983年1月至1988年1月）接受了食管癌手术；其中95.3%患有鳞状细胞癌。38例患者术前行胸部CT检查，其中13例接受了胸腹联合手术，25例进行了钝性食管剥离术。将CT和普通诊断结果与术中或组织学结果进行回顾性比较。7例直径达2cm的食管癌中，3例未被CT发现。22例T3期癌中，16例检测到邻近纵隔结构受侵，有3例假阳性结果。在钝性食管剥离术中，术前诊断的淋巴结状态与组织学结果在80%以上的病例中相符；然而，一个局限性是只能评估那些附着于切除标本的淋巴结。相比之下，食管癌胸腹联合切除术后，13例中只有7例相符（有6例假阴性结果）。总体而言，根据TNM分类，术前与组织学分期存在一致性（UICC = 50%的病例），而术前几乎40%（n = 15）的肿瘤大小或扩展被低估。因此，CT对食管癌术前分期的价值有限。
