Halvorsen R A, Thompson W M
Invest Radiol. 1987 Jan;22(1):2-16. doi: 10.1097/00004424-198701000-00001.
The utility and limitations of CT staging of carcinomas of the esophagus, stomach, small bowel, and colon are reviewed. Routine preoperative staging of esophageal carcinoma is recommended because of CT's sensitivity of more than 90% in detecting mediastinal invasion and a specificity of more than 85% in collected series. We recommend the use of CT as a problem-solving technique rather than as a routine preoperative test in patients with gastroesophageal junction, and gastric and small bowel malignancies. Routine use of CT to stage colorectal carcinomas also does not seem justifiable, due to the inability of CT to determine the depth of bowel wall involvement and to detect tumor in normal size lymph nodes. CT can help differentiate tumors that invade the pelvic side walls from more limited cancers and, therefore, in certain cases can aid in therapy planning. CT is the best method for detecting local recurrence in patients with rectosigmoid carcinomas.
本文回顾了CT对食管癌、胃癌、小肠癌和结肠癌进行分期的作用及局限性。由于CT在检测纵隔侵犯方面的敏感性超过90%，在已收集的系列研究中特异性超过85%，因此建议对食管癌进行常规术前分期。对于胃食管交界部、胃和小肠恶性肿瘤患者，我们建议将CT用作解决问题的技术，而非常规术前检查。由于CT无法确定肠壁受累深度以及检测正常大小淋巴结中的肿瘤，因此常规使用CT对结直肠癌进行分期似乎也不合理。CT有助于区分侵犯盆腔侧壁的肿瘤与范围较局限的癌症，因此在某些情况下可辅助治疗方案的制定。CT是检测直肠乙状结肠癌患者局部复发的最佳方法。
