| 多层螺旋CT和超声内镜对食管癌术前评估及手术方案选择的随机对照研究 |
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| 引用本文： | 江吕泉,高坤祥,郑建,陈建,吴昊.多层螺旋CT和超声内镜对食管癌术前评估及手术方案选择的随机对照研究[J].中国肿瘤临床,2010,37(22):1300-1303. |
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| 作者姓名： | 江吕泉 高坤祥 郑建 陈建 吴昊 |
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| 作者单位： | 作者单位:武警江苏总队医院胸外科(江苏省扬州市225003);①第四军医大学唐都医院胸外科 |
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| 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MCU检查。
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| 关 键 词： | 食管癌 超声内镜 X 线计算机体层成像 肿瘤分期 |
| 收稿时间： | 2010-01-11 |
A Randomized Controlled Trial of Preoperative Assessment of Esophageal Carcinoma with Multi-slice Computer Tomography and Mini-probe Endoscopic Ultrasonography in the Selection of Surgical Programs |
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| JIANG Lvquan,GAO Kunxiang,ZHENG Jian,CHEN Jian,WU Hao.A Randomized Controlled Trial of Preoperative Assessment of Esophageal Carcinoma with Multi-slice Computer Tomography and Mini-probe Endoscopic Ultrasonography in the Selection of Surgical Programs[J].Chinese Journal of Clinical Oncology,2010,37(22):1300-1303. |
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| Authors: | JIANG Lvquan GAO Kunxiang ZHENG Jian CHEN Jian WU Hao |
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| Affiliation: | 1Department of Thoracic Surgery, Jiangsu Provincial Corps Hospital of Chinese People's Armed Police Forces,Yangzhou 225003, China |
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| Abstract: | 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 can-cer, is used commonly in other countries but seldom in China. This study aimed to investigate the role of Multi-slice Comput-er Tomography (MSCT) with MCUS in the preoperative assessment of patients with esophageal cancer in order to deter-mine their value in surgical decision making. Methods:A total of 158 patients with esophageal cancer were prospectively en-rolled into the study. Participants were randomly assigned into group A ( n=79) or group B ( n=79) and then received a preop-erative 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 were152 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 preop -erative T staging, N staging and surgical procedure prediction in group A were 60.00% ,77.33% and 73.33% . The corre-sponding 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. |
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