Hölscher A H, Dittler H J, Siewert J R
Department of Surgery, Technische Universität München, Germany.
World J Surg. 1994 May-Jun;18(3):312-20. doi: 10.1007/BF00316809.
Endoscopic ultrasonography (EUS) and computed tomography (CT) should be used as complementary methods for TNM staging of esophageal cancer. EUS is the most accurate modality for staging primary tumor and mediastinal lymph node metastases. CT should be used to detect infiltration of other mediastinal organs and distant metastases. For esophageal cancer staging magnetic resonance imaging (MRI) is not superior to CT. For detection of cervical lymph node metastases percutaneous ultrasonography is appropriate. In patients with advanced distal carcinoma of the esophagus, hepatic and peritoneal metastases and intraabdominal lymph node infiltration should be ruled out by laparoscopy prior to surgery. The results of preoperative staging are relevant if the management of esophageal cancer comprises not only surgery but also endoscopic mucosectomy, primary palliative procedures, and especially neoadjuvant radiochemotherapy. Within therapeutic trials the precise staging prior to treatment is essential for analysis of the results. The value of routine postoperative staging during a follow-up program is yet unproved for esophageal cancer.
内镜超声检查（EUS）和计算机断层扫描（CT）应用于食管癌TNM分期的补充方法。EUS是对原发性肿瘤和纵隔淋巴结转移进行分期的最准确方式。CT应用于检测其他纵隔器官的浸润和远处转移。对于食管癌分期，磁共振成像（MRI）并不优于CT。对于检测颈部淋巴结转移，经皮超声检查是合适的。对于晚期食管远端癌患者，术前应通过腹腔镜检查排除肝转移、腹膜转移和腹内淋巴结浸润。如果食管癌的治疗不仅包括手术，还包括内镜黏膜切除术、原发性姑息治疗，尤其是新辅助放化疗，那么术前分期的结果是相关的。在治疗试验中，治疗前的精确分期对于结果分析至关重要。食管癌随访计划中常规术后分期的价值尚未得到证实。
