CAJ | 학술논문

目的通过对比内镜超声及CT在食管癌、贲门癌术前进行T、N分期中的准确度,评价内镜超声的临床应用价值. 方法对28例食管癌、贲门患者术前均行内镜超声扫描和CT扫描,并分别进行T、N分期,以术后病理为金标准,比较两者分期的准确性有无差异,同时对比两者对淋巴结转移的准确率(即真实性)的差异,判断内镜超声的应用价值. 结果本组28例病例中,T分期准确率内镜超声为89.3%(25/28),高于CT的46.4%(13/28),差异有统计学意义(P=0.004,P＜0.01).N分期中,内镜超声与CT的准确率分别为82.1%(23/28)及50.0%(14/28),差异有统计学意义(P=0.035,P＜0.05).对转移淋巴结的分组统计中,内镜超声与CT的准确率分别为88.7%及72.2%,有显著性差异(χ2=7.031,P=0.008,P＜0.01).结论内镜超声在食管癌、贲门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、S/L(淋巴结短径/淋巴结长径)并结合淋巴结的超声显像特征进行分析,提高了判断淋巴结转移以及N分期的准确性.
목적 통과대비내경초성급CT재식관암、분문암술전진행T、N분기중적준학도,평개내경초성적림상응용개치. 방법 대28례식관암、분문환자술전균행내경초성소묘화CT소묘,병분별진행T、N분기,이술후병리위금표준,비교량자분기적준학성유무차이,동시대비량자대림파결전이적준학솔(즉진실성)적차이,판단내경초성적응용개치. 결과 본조28례병례중,T분기준학솔내경초성위89.3%(25/28),고우CT적46.4%(13/28),차이유통계학의의(P=0.004,P＜0.01).N분기중,내경초성여CT적준학솔분별위82.1%(23/28)급50.0%(14/28),차이유통계학의의(P=0.035,P＜0.05).대전이림파결적분조통계중,내경초성여CT적준학솔분별위88.7%급72.2%,유현저성차이(χ2=7.031,P=0.008,P＜0.01).결론 내경초성재식관암、분문암술전분기중유중요작용,기T분기준학솔명현고우전통CT소묘.이림파결단경、S/L(림파결단경/림파결장경)병결합림파결적초성현상특정진행분석,제고료판단림파결전이이급N분기적준학성.
Objective To compare T and N staging of esophageal and cardia cancer by endoscopic ultrasonography (EUS) and computed tomography (CT) before operation, and to evaluate clinical value of EUS.Methods Twenty-eight patients received examination of EUS and CT preoperatively, and the T and N staging was determined. The accuracy rates of both T, N staging were compared by the postoperative pathological results, at the same time, the accuracy rates of lymph node metastasis were compared, and the value of application of EUS was investigated. Results In the twenty-eight cases, the accuracy rates of EUS were higher than that of CT by 89.3% ( 25/28 ) to 46.4% ( 13/28 ) in T staging. And the difference had statistical significance( P = 0. 004 ,P ＜ 0.01 ). The N stagings of both were 82.1% (23/28) and 50.0% ( 14/28), and the difference had statistical significance ( P = 0. 035, P ＜ 0. 05 ). The accuracy rates of lymph node metastasis of both were 88.7% and 72.2% respectively, and the difference had statistical significance (χ2 = 7.031,P = 0.008, P ＜ 0. 01 ). Conclusions EUS has very important value in preoperative staging for esophageal cancer and cardia cancer, and the T staging of EUS is better than that of CT. The short axis and the ratio of short to long axis (S/L) combined with the lymph node ultrasonography image can improve the accuracy rates of lymph node metatsasis and N staging.