摘要
目的:食管癌术前临床分期对选择合理治疗方案至关重要,微探头超声内镜(mini-probe endoscopic ultrasonography,MCUS)对食管癌T、N分期诊断准确率高,目前已成为国外食管癌治疗前的常规诊断和分期方法,本研究比较多层螺旋CT(multi-slice computer tomography,MSCT)与MCUS对食管癌患者术前评估的价值以及对手术方案预测的意义。方法:前瞻性纳入明确诊断为食管癌158例患者。随机分为MSCT组(A组)和MCUS组(B组)各79例,术前均行X线钡餐、消化道内镜活检外,再分别接受MSCT检查和MCUS检查,据此进行术前分期和手术方案的预测,并与术后病理分期和实际手术方案比较。结果:实际纳入152例,A组(75例)和B组(77例)间基线特征差异无统计学显著性(P>0.05)。术前T分期准确度A组60.00%,B组84.41%,两组间差异有显著性统计学意义(P=0.001)。术前N分期准确度A组77.33%,B组83.12%,两组比较差异无统计学意义(P=0.370)。对手术方案预测的准确度A组73.33%,B组89.61%,两组间有统计学差异(P=0.010)。结论:MCUS对食管癌术前分期、手术方案的预测准确度高于MSCT,从而为临床选择合理治疗方案具有一定的指导意义,建议有条件的医院对食管癌患者进行常规MCUS检查。
Objective： Preoperative clinical staging is the key for selecting the ideal therapy for esophageal cancer. Mini-probe endoscopic ultrasonography （MCUS）, an accurate diagnostic technique for T and N staging of esophageal cancer, is used commonly in other countries but seldom in China. This study aimed to investigate the role of Multi-slice Computer Tomography （MSCT） with MCUS in the preoperative assessment of patients with esophageal cancer in order to determine their value in surgical decision making. Methods： A total of 158 patients with esophageal cancer were prospectively enrolled into the study. Participants were randomly assigned into group A （n=79） or group B （n=79） and then received a preoperative X-Ray barium meal and gastroscope. They also had MSCT examination or MCUS according to their group. The outcome of preoperative staging and predictive surgery programs with postoperative pathologic staging and final surgery programs were compared between group A and group B. Result： There were 152 patients available for analysis. There was no statistical difference in the baseline characteristics between group A （n=75） and group B （n=77）. The accuracy of preoperative T staging, N staging and surgical procedure prediction in group A were 60.00%, 77.33% and 73.33%. The corresponding rates in group B were 84.41%, 83.12% and 89.61%. In T staging and surgical procedure prediction, significant statistical differences were observed between the two groups with P=-0.001 and P=0.010, respectively. However the analy- sis showed no significant differences in N staging between the two groups （P=-0.370）. The relationship between multiple clinicopathologic factors and surgical procedures was analyzed. Conclusion： Group B has higher accuracy in preoperative staging for esophageal cancer and provides better evidence to make surgery decisions than group A. We suggest that mini-probe endoscopic ultrasonography become a routine medical examination in more hospitals.
出处
《中国肿瘤临床》
CAS
CSCD
北大核心
2010年第22期1300-1303,共4页
Chinese Journal of Clinical Oncology
关键词
食管癌
超声内镜
X线计算机体层成像
肿瘤分期
Esophageal neoplasm
Endoscopic ultrasonography
Tomography
Neoplasm staging
作者简介
通讯作者：高坤祥5100gkxl99@163．com
