Division of Cancer & Genetics, School of Medicine, Cardiff University, UK.
Oxford OesophagoGastric Centre, Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, UK; Department of Oncology, Old Road Campus Research Building, Roosevelt Drive, University of Oxford, UK.
Best Pract Res Clin Gastroenterol. 2018 Oct-Dec;36-37:17-25. doi: 10.1016/j.bpg.2018.11.009. Epub 2018 Nov 22.
The survival of oesophageal cancer is poor as most patients present with advanced disease. Radiological staging of oesophageal cancer is complex but is fundamental to clinical management. Accurate staging investigations are vitally important to guide treatment decisions and optimise patient outcomes. A combination of baseline computed tomography (CT), endoscopic ultrasound (EUS) and positron emission tomography (PET) are currently used for initial treatment decisions. The potential value of these imaging modalities to re-stage disease, monitor response and alter treatment is currently being investigated. This review presents an essential update on the accuracy of oesophageal cancer staging investigations, their use in re-staging after neo-adjuvant therapy and introduces evolving imaging techniques, including novel biomarkers that have clinical potential in oesophageal cancer.
食管癌的生存率较差,因为大多数患者就诊时已处于晚期疾病。食管癌的影像学分期较为复杂,但对临床管理至关重要。准确的分期检查对于指导治疗决策和优化患者预后至关重要。目前,基线计算机断层扫描(CT)、内镜超声(EUS)和正电子发射断层扫描(PET)的组合用于初始治疗决策。目前正在研究这些成像方式在重新分期疾病、监测反应和改变治疗方面的潜在价值。本文对食管癌分期检查的准确性及其在新辅助治疗后重新分期中的应用进行了重要更新,并介绍了新兴的成像技术,包括在食管癌中有临床应用潜力的新型生物标志物。