Inculet R I, Keller S M, Dwyer A, Roth J A
Ann Thorac Surg. 1985 Dec;40(6):561-5. doi: 10.1016/s0003-4975(10)60349-9.
A prospective study was undertaken to define the usefulness of conventional full-lung linear tomography, radionuclide liver plus spleen and bone scans, and thoracic and abdominal computed tomography for the preoperative staging of carcinoma of the esophagus. Thirty-three patients with carcinoma of the esophagus were studied. The computed tomographic (CT) scan of the thorax and upper abdomen was the single most accurate noninvasive study. With computed tomography, the relationship of the tumor to the tracheobronchial tree was the feature most useful in predicting local resectability. In all patients with the finding of tracheobronchial compression by the tumor, the tumor could not be resected completely. The predictive value of this CT finding in patients with locally unresectable tumor was high (0.83), indicating its usefulness in assessing unresectability. The CT finding of visible separation between tumor mass and tracheobronchial tree was present in 10 of 14 patients with locally resectable tumor (predictive value, 0.63). However, tumor abutting the tracheobronchial tree without compression was a poor predictor of unresectability (predictive value, 0.36). The radionuclide bone scan was the only other noninvasive study to demonstrate a metastasis not evident by CT scan. The combination of chest and abdominal CT scan, bone scan, and bronchoscopy before operation will accurately stage the majority of patients with esophageal cancer but no noninvasive test is of sufficient reliability to exclude patients from operative resection if otherwise indicated.
开展了一项前瞻性研究，以确定传统全肺线性断层扫描、放射性核素肝脾联合骨扫描以及胸部和腹部计算机断层扫描在食管癌术前分期中的作用。对33例食管癌患者进行了研究。胸部和上腹部计算机断层扫描（CT）是最准确的单一非侵入性检查。通过计算机断层扫描，肿瘤与气管支气管树的关系是预测局部可切除性最有用的特征。在所有发现肿瘤压迫气管支气管树的患者中，肿瘤无法完全切除。这一CT表现对局部不可切除肿瘤患者的预测价值很高（0.83），表明其在评估不可切除性方面的作用。在14例局部可切除肿瘤患者中，有10例CT表现为肿瘤块与气管支气管树之间可见分离（预测价值为0.63）。然而，肿瘤紧靠气管支气管树但无压迫是不可切除性的不良预测指标（预测价值为0.36）。放射性核素骨扫描是唯一能显示CT扫描未发现的转移灶的其他非侵入性检查。术前胸部和腹部CT扫描、骨扫描和支气管镜检查相结合，将能准确地对大多数食管癌患者进行分期，但如果有其他手术指征，没有任何非侵入性检查具有足够的可靠性来排除患者进行手术切除。
