Thompson W M, Halvorsen R A, Foster W L, Williford M E, Postlethwait R W, Korobkin M
AJR Am J Roentgenol. 1983 Nov;141(5):951-8. doi: 10.2214/ajr.141.5.951.
A reevaluation of computed tomography (CT) for staging carcinoma of the esophagus and gastroesophageal junction was performed in 76 patients. For comparison 26 patients without carcinoma of the esophagus with a normal mediastinum at surgery were included in the evaluation. Four radiologists evaluated the CT scans without knowledge of the diagnosis. After determining if there was an adequate amount of fat, they were asked to evaluate each case for the presence or absence of local invasion and distant metastases. The radiologists correctly identified all 26 normal patients. Eighteen of the 76 carcinoma patients had a paucity of fat, but only six were thought to have truly indeterminate scans. CT correctly identified 40 of the 44 esophageal carcinoma patients with mediastinal invasion and 11 of the 15 patients without invasion (accuracy 88%). CT correctly identified 15 of 19 patients with distant abdominal metastases and 28 of 30 patients without metastases (accuracy 88%). CT was only 50% accurate in predicting the presence or absence of invasion in the 12 patients with gastroesophageal junction tumors and only 58% accurate in predicting distant metastases. CT correctly staged 46 (94%) of 49 patients with esophageal carcinoma but only five (42%) of 12 patients with gastroesophageal junction tumors. These results confirm that CT should be used as a major staging method in all patients with esophageal carcinoma.
对76例食管癌和食管胃交界癌患者进行了计算机断层扫描（CT）分期的重新评估。为作比较，将26例手术时纵隔正常且无食管癌的患者纳入评估。四位放射科医生在不知诊断结果的情况下对CT扫描进行评估。在确定是否有足够的脂肪后，要求他们评估每个病例是否存在局部侵犯和远处转移。放射科医生正确识别了所有26例正常患者。76例癌症患者中有18例脂肪量少，但只有6例被认为扫描结果真正难以确定。CT正确识别了44例有纵隔侵犯的食管癌患者中的40例以及15例无侵犯患者中的11例（准确率88%）。CT正确识别了19例有远处腹部转移的患者中的15例以及30例无转移患者中的28例（准确率88%）。在预测12例食管胃交界肿瘤患者是否存在侵犯方面，CT的准确率仅为50%，在预测远处转移方面准确率仅为58%。CT正确地对49例食管癌患者中的46例（94%）进行了分期，但对12例食管胃交界肿瘤患者中仅5例（42%）进行了正确分期。这些结果证实，CT应作为所有食管癌患者的主要分期方法。
