Levine M S, Chu P, Furth E E, Rubesin S E, Laufer I, Herlinger H
Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia 19104, USA.
AJR Am J Roentgenol. 1997 Jun;168(6):1423-6. doi: 10.2214/ajr.168.6.9168701.
The purpose of this study was to determine the sensitivity of barium studies in revealing carcinoma of the esophagus and esophagogastric junction.
We retrospectively reviewed 50 cases of squamous cell carcinoma of the esophagus (n = 25) and adenocarcinoma of the esophagus (n = 14) or esophagogastric junction (n = 11) in which double-contrast (n = 46) or single-contrast (n = 4) barium studies had been done. The original radiology reports were reviewed to determine whether the lesions had been seen on barium studies and whether cancer had been diagnosed. Records were also reviewed to determine the number of patients who underwent esophageal endoscopy because of findings suggestive of cancer on barium studies at some point from January 1992 through December 1992. Pathology records were then reviewed to determine the number of true- and false-positive barium studies during this same period.
Lesions were shown on barium studies in 49 (98%) of 50 patients, and carcinoma of the esophagus or esophagogastric junction was diagnosed or suspected in 48 patients (96%). In a separate part of the study, we found that endoscopy had been recommended to rule out malignant tumor in only 26 (1%) of 2484 patients who underwent barium studies at some point from January 1992 through December 1992. Endoscopy revealed cancer in 11 of those 26 patients; the remaining 15 were assumed to have false-positive radiologic examinations. Barium studies therefore had a positive predictive value of 42%.
The double-contrast barium study is a sensitive technique for the diagnosis of carcinoma of the esophagus and esophagogastric junction. This high sensitivity can be achieved while recommending endoscopy in only about 1% of all patients who undergo barium studies.
本研究旨在确定钡餐检查对揭示食管癌及食管胃交界部癌的敏感性。
我们回顾性分析了50例食管癌患者，其中食管鳞状细胞癌25例，食管腺癌14例，食管胃交界部腺癌11例，这些患者均接受了双重对比（46例）或单对比（4例）钡餐检查。查阅原始放射学报告，以确定钡餐检查时是否发现病变以及是否诊断为癌症。还查阅记录以确定在1992年1月至1992年12月期间因钡餐检查发现提示癌症的结果而接受食管内镜检查的患者数量。然后查阅病理记录以确定同一时期钡餐检查的真阳性和假阳性数量。
50例患者中有49例（98%）在钡餐检查中显示有病变，48例患者（96%）被诊断或怀疑患有食管癌或食管胃交界部癌。在该研究的另一部分中，我们发现，在1992年1月至1992年12月期间接受钡餐检查的2484例患者中，仅26例（1%）因排除恶性肿瘤而被建议进行内镜检查。这26例患者中有11例经内镜检查发现患有癌症；其余15例被认为放射学检查为假阳性。因此，钡餐检查的阳性预测值为42%。
双重对比钡餐检查是诊断食管癌及食管胃交界部癌的一种敏感技术。在仅约1%接受钡餐检查的患者中建议进行内镜检查的情况下，即可实现这种高敏感性。
