Ruf G, Hauenstein K H, Rudolf M, Schöffel U, Lausen M, Wimmer B
Langenbecks Arch Chir. 1986;368(1):3-11. doi: 10.1007/BF01261297.
The correlation of the preoperative staging by CT with the postoperative staging was prospectively investigated in 112 patients with carcinoma of the rectum. The influence of CT on the choice of surgical treatment was also proven. The evaluation of the infiltration of perirectal tissue and especially of other organs is possible with CT. According to TNM classification the pre- and postoperative staging showed identical results by conventional diagnostic methods in T1 in 7/16, in T2 in 22/38, in T3 in 37/49 and in T4 in 5/9 patients. With the additional CT identical results were found in T1 in 7/14, in T2 in 25/31, in T3 in 49/53 and in T4 in 13/14 cases. Thus, the preoperative staging turned out to be correct with CT in 94/112 cases (83.9%). By conventional diagnostic methods identical results were found in 71/112 patients (63.4%). The infiltration of other organs was suspected preoperatively in 24 cases with CT and was found intraoperatively in 30/112 (accuracy 94.6%, sensitivity 88%, specificity 96%). Metastases of lymph nodes were suspected in the tomograms in 32/49 patients (65.3%). By the differentiated interpretation of the tumor growth with special regard to the "Grenzlamellen" of the rectum the CT gives important information for planning therapy.
对112例直肠癌患者进行前瞻性研究,探讨术前CT分期与术后分期的相关性。还证实了CT对手术治疗选择的影响。CT能够评估直肠周围组织尤其是其他器官的浸润情况。根据TNM分类,常规诊断方法显示,16例T1期患者中有7例、38例T2期患者中有22例、49例T3期患者中有37例、9例T4期患者中有5例术前和术后分期结果相同。加上CT检查后,14例T1期患者中有7例、31例T2期患者中有25例、53例T3期患者中有49例、14例T4期患者中有13例术前和术后分期结果相同。因此,术前CT分期在112例患者中有94例(83.9%)是正确的。常规诊断方法在112例患者中有71例(63.4%)结果相同。CT术前怀疑24例患者有其他器官浸润,术中发现112例中有30例(准确率94.6%,敏感性88%,特异性96%)。49例患者中有32例(65.3%)在断层扫描中怀疑有淋巴结转移。通过对肿瘤生长的差异化解读,特别是关注直肠的“边界层”,CT为治疗方案的制定提供了重要信息。