掌握食管癌影像学:放射科医生需要了解的内容。
Mastering esophageal cancer imaging: what radiologists need to know.
作者信息
D'Alessandro Carlo, Pittacolo Matteo, De Grandis Andrea, Garzotto Pietro, Galuppini Francesca, Moletta Lucia, Pierobon Elisa Sefora, Capovilla Giovanni, Zanchettin Gianpietro, Salvador Renato, Valmasoni Michele, Quaia Emilio, Crimì Filippo
机构信息
Institute of Radiology, Department of Medicine (DIMED), University of Padova, Padova, Italy.
Department of Surgical, Oncological, and Gastroenterological Sciences, University of Padova School of Medicine, Padova, Italy, Padova, Italy.
出版信息
Abdom Radiol (NY). 2025 Jun 7. doi: 10.1007/s00261-025-04988-8.
Esophageal cancer, particularly squamous cell carcinoma (SCC) and adenocarcinoma (EAC), is a major contributor to cancer-related mortality. The different histopathologic subtypes have different pathological origins, epidemiology and prognosis. TNM staging system allows to stratify the prognosis and determine the most appropriate treatment. Surgery remains the gold standard for treating early-stage esophageal cancer, including various procedures that can adapt to the singular cases helping to reduce morbidity. However, esophagectomy remains burdened by considerable postoperative complications, such as anastomotic leakage, pleural effusion, pneumonia, acute respiratory distress syndrome, stricture formation, chylothorax, delayed gastric emptying, hiatal herniation, and reflux esophagitis. Accurate radiologic evaluation plays a crucial role in detecting, characterizing, and staging esophageal cancer, directly influencing treatment strategies. Radiological imaging is pivotal in determining patient's prognosis, both for the management of post-operative complications and for long-term follow-up. A thorough understanding of the imaging characteristics and underlying pathology is essential for improving diagnostic accuracy and guiding therapeutic decision-making.
食管癌,尤其是鳞状细胞癌(SCC)和腺癌(EAC),是癌症相关死亡的主要原因。不同的组织病理学亚型具有不同的病理起源、流行病学特征和预后。TNM分期系统有助于对预后进行分层并确定最合适的治疗方法。手术仍然是治疗早期食管癌的金标准,包括各种可适应个别病例的手术程序,有助于降低发病率。然而,食管切除术仍然受到相当多术后并发症的困扰,如吻合口漏、胸腔积液、肺炎、急性呼吸窘迫综合征、狭窄形成、乳糜胸、胃排空延迟、食管裂孔疝和反流性食管炎。准确的放射学评估在食管癌的检测、特征描述和分期中起着关键作用,直接影响治疗策略。放射影像学对于确定患者的预后至关重要,无论是对于术后并发症的管理还是长期随访。深入了解成像特征和潜在病理对于提高诊断准确性和指导治疗决策至关重要。