食管癌肿瘤体积与病理T分期对照研究

目的 探讨食管癌肿瘤体积（GTV）与病理T分期的关系，为食管癌临床T分期提供参考指标。方法 2005年1月~2005年12月手术治疗的食管癌患者208例，术前均行胸部CT扫描，应用三维治疗计划系统勾画食管癌GTV-T靶区，并计算GTV-T体积，测量食管病变的最大直径及病变长度，同时记录术中实测食管病变长度，分析CT扫描显示的食管癌GTV-T体积及各径线与术后病理T分期间的关系。结果 CT图像上勾画的GTV长度与术中实测食管病变长度间未见统计学差异（t=-1.786,P=0.076）。T1期GTV T体积与T2、T3、T4期的GTV T体积之间差异有统计学意义（P<0.05）。T2期与T3期的GTV-T体积相比差异也有统计学意义（P<0.05），但T2期与T4期的GTV-T体积相比未见统计学差异，T3期与T4期的GTV T体积之间亦未见统计学差异。CT显示食管病变的长度及病变在最大层面上的直径T1、T2期与T3、T4期对比差异均有统计学意义（P<0.05），而T3与T4期间差异无统计学意义。结论 随着食管癌T分期的增加，肿瘤体积逐渐增大，CT扫描显示的GTV体积有可能成为指导食管癌临床T分期的参考指标。

Comparison of Pathological T-staging with Gross Tumor Volume (GTV) of Esophageal Cancer by CT Scanning

Objective To explore relationship between the pathological T-staging and the gross tumor volume (GTV) of esophageal cancer by CT scanning and provide the reference for clinical T-stageing of esophageal carcinoma.Methods Two hundred and eight patients with esophageal cancer have received operation from January 2005 to December. They all were checked by CT scanning on chest before operation. GTV-T target was delineated by applying 3D radiotherapy system. The largest diameter and the lesion of esophageal affection were measured for each case, and GTV-T volume was calculated. Recorded and measured the lesion length of esophageal cancer in operation. Analyze the relation ship of the GTV-T volume, the maximum diameter, the length of lesion and the pathological T-staging.Results There was no significant difference between the length of GTV and the lesion length measured by in operation of esophageal cancer （t=-1.786,P=0.076）.The GTV-T volume of T1 stage was significantly different compared with T2, T3, T4 stage (P<0.05), as same between T2 and T3 stage in GTV (P<0.05). But the GTV was not different between T2 and T4 stage, T3 and T4 stage. About the lesion length and the maximum diameter, T1 stage was significantly different with T3, T4 stage (P<0.05). There was no difference between T1 and T2 stage. Furthermore, T2 stage was dramatically different with T3 and T4 stage in the maximum diameter and length of esophageal lesion (P<0.05), but no difference between T3 and T4 stage. Conclusion The later pathological T-stage is, the larger tumor volume is. The GTV-T volume of esophageal cancer might be used as guidance of esophageal cancer clinical T stage.