微探头超声内镜和CT扫描在胸段食管癌术前分期中的应用

目的对比微探头超声内镜（MCUS）及CT在胸段食管癌术前进行T、N分期中的应用价值,探讨MCUS判断淋巴结转移的标准。方法对35例初治胸段食管癌患者分别进行MCUS扫描和CT扫描,并同时分别进行T、N分期;以术后病理为金标准,比较在对淋巴结转移的判断中,本研究试行的3种标准的准确率（即真实性）、灵敏度、特异度、阳性及阴性预测值等参数,判断其临床应用价值,并且,就MCUS扫描对淋巴结转移的判断标准进行探讨。结果本组35例中,MCUS的T分期准确率（85．7％）高于CT（45．7％）,差异有统计学意义（P=0．000）;MCUS的N分期中,两种标准的准确率（分别为85．7％及80．0％）均略高于CT（74．3％）,但差异无统计学意义（P〉0,05）。应用淋巴结短径及短长轴比例（S／L）结合的方法,研究结果显示,检测的灵敏度有所提高。结论MCUS在胸段食管癌术前分期中有重要作用,其T分期准确率明显高于传统CT扫描。以淋巴结短径与S／L结合进行分析,有望提高判断淋巴结转移的准确性。

Comparison of mini-probe endoscopic ultrasonography with computed tomography in preoperative staging of esophageal cancer

Objective To compare mini-probe endoscopic ultrasonography (MCUS) with computed tomography (CT) in preoperative T and N staging of esophageal cancer, and to find out the MCUS parameters to judge lymph node metastasis for esophageal cancer. Methods Thirty-five patients received both MCUS and CT preoperatively, on both of which the T and N stages were determined. The accuracy, sensitivity, specificity, positive predicting value and negative predicting value were compared with the postoperative pathological results. Results The accuracy of MCUS was 85.7% in T staging and 85.7% and 80.0% in N staging by the two different methods, which were 45.7% and 74.3%, respectively, by CT. Conclusion MCUS is better than CT in preoperative staging for esophageal cancer. The ratio of short to long axis (S/L) combined with short axis is a useful way to determine lymph node metastasis.