基于食管癌病理标本长度推算的实际长度与CT长度的比较研究

目的 探讨CT扫描在确定食管癌病变长度方面与实际长度上的差异及其符合程度.方法 采用病理大切片技术对52例食管癌行肿瘤组织标本固定后收缩比研究,得出换算实际长度的收缩比.137例患者术前行螺旋CT扫描并在CT图像上行食管癌靶区勾画和长度测量,术后测量食管癌标本固定后长度,根据收缩比回推实际长度,比较两者差异和符合率.结果 食管癌平均收缩为术中长度的90%±10%.食管癌实际长度为(4.1±1.8)cm,CT长度为(5.8±2.4)am,两者差异有统计学意义(t=9.68,P=0.000).CT长度与实际长度相符者56例,仅占40.9%(56/137).结论 食管癌CT长度与实际长度相比存在一定差距,确定合理的食管癌病变长度要参考食管钡餐造影、食管镜等检查结果来综合判断.

Compare the tumor length in CT images with the real length calculated from surgical specimen in esophageal carcinoma

Objective To evaluate the variance and the concordance between the tumor length measured by CT scans and that measured by surgical specimens in esophageal carcinoma. Methods Fiftytwo surgical specimens of the esophageal carcinoma were made into pathological giant section.The shrinkage ratio of tumor was calculated by comparing the length of the specimen fixed by formalin for 24 h and that measured during the operation.One hundred and thirty-seven patients with esophageal carcinoma underwent spiral CT scan before the surgery,and the length of the gross tumor volume was obtained.After the tumor length of the fixed specimen had been measured,the real tumor length in situ was calculated using the shrinkage ratio.Then the variance and the concordance between the tumor length in CT scans and that in situ were compared.Results The mean shrinkage ratio was 90%±10%.The mean tumor length in CT scans was longer than that in situ(5.8 am±2.4 cm vs 4.1 cm±1.8 cm,P=9.68,P=0.000).The concordance of the length measured by the two methods was 40.9%(56/137). Conclusions A certain variance existed between the tumor length in CT images and that computed from surgical specimen in esophageal carcinoma.The results of esophagography and endoscopy should also be referred to delineate the gross tumor volume of esophageal carcinoma.