Lally K P, Arnstein M, Siegel S, Miller J H, Gilsanz V, Ettinger L, Atkinson J B
Arch Surg. 1986 Oct;121(10):1125-7. doi: 10.1001/archsurg.1986.01400100031005.
Potential long-term complications of radiotherapy and chemotherapy in the pediatric patient with Hodgkin's disease necessitate accurate staging. To determine the accuracy of abdominal computed tomography (CT) and gallium citrate Ga 67 scans in staging Hodgkin's disease, we reviewed the charts of all children with Hodgkin's disease seen at Childrens Hospital of Los Angeles from 1975 to 1985. Patients with pathologically proved stage IV disease (ie, bone marrow involvement) and those who only underwent staging laparotomy were excluded. A total of 40 children underwent staging by laparotomy and staging by abdominal CT and/or 67Ga scan. The CT and 67Ga scans were reviewed by radiologists in a blinded manner and compared with the results of a formal staging laparotomy. Of the 38 patients whose disease was staged with 67Ga scan, disease in ten was understaged and in four overstaged, for a 37% incorrect staging rate. Of the 14 patients whose disease was staged by CT scan, disease in three was understaged and in one overstaged, for a 29% incorrect staging rate. In view of the inaccuracy of noninvasive studies and the impact of incorrect staging on treatment, we recommend that a staging laparotomy be performed in all children with Hodgkin's disease who are not proved to have stage IV disease.
霍奇金病患儿放疗和化疗的潜在长期并发症使得准确分期成为必要。为了确定腹部计算机断层扫描（CT）和枸橼酸镓Ga 67扫描在霍奇金病分期中的准确性，我们回顾了1975年至1985年在洛杉矶儿童医院就诊的所有霍奇金病患儿的病历。病理证实为IV期疾病（即骨髓受累）的患者以及仅接受分期剖腹手术的患者被排除在外。共有40名儿童接受了剖腹分期以及腹部CT和/或67Ga扫描分期。放射科医生以盲法对CT和67Ga扫描进行了评估，并与正式分期剖腹手术的结果进行了比较。在通过67Ga扫描进行疾病分期的38例患者中，有10例疾病分期过低，4例分期过高，分期错误率为37%。在通过CT扫描进行疾病分期的14例患者中，有3例疾病分期过低，1例分期过高，分期错误率为29%。鉴于非侵入性检查的不准确性以及分期错误对治疗的影响，我们建议对所有未被证实为IV期疾病的霍奇金病患儿进行分期剖腹手术。
