CAJ | 학술논문

目的：比较超声内镜（EUS）与CT检查在食管癌术前临床分期中的准确率。方法对临床诊断为食管癌的68例患者按照随机数字表的方法随机分为EUS检查组和CT检查组，每组各34例，于术前行EUS或CT检查，并按照TNM（2003）分期标准作出诊断，与术后病理分期结果比较。结果以食管癌术后病理分期作为标准，术前EUS检查T、N分期的诊断准确率分别为Tis期0（0／2），T1期75．0％（3／4），T2期75．0％（6／8），T3期86．7％（13／15），T4期80．0％（4／5），T期总准确率为76．5％（26／34）；N0期71．4％（5／7），N1期75．0％（9／12），N2期0（0／11），N3期0（0／4），N期总准确率为41．2％（14／34）。术前CT检查T、N分期的诊断准确率分别为Tis期0（0／1），T1期33．3％（2／6），T2期28．6％（2／7），T3期78．6％（11／14），T4期83．3％（5／6），T期总准确率为58．8％（20／34），与EUS检查组T期总准确率相比差异有统计学意义（P＜0．05）；N0期77．8％（7／9），N1期76．9％（10／13），N2期66．7％（4／6），N3期50．0％（3／6），N期总准确率为70．6％（24／34），与EUS检查组N期总准确率相比差异有统计学意义（P＜0．05）。结论 EUS检查对食管癌的临床T期诊断准确率较高，而CT检查对食管癌的N期诊断准确率较高，术前采用EUS联合CT检查可能对指导术前制订治疗方案、评估预后有重要意义。
목적：비교초성내경（EUS）여CT검사재식관암술전림상분기중적준학솔。방법대림상진단위식관암적68례환자안조수궤수자표적방법수궤분위EUS검사조화CT검사조，매조각34례，우술전행EUS혹CT검사，병안조TNM（2003）분기표준작출진단，여술후병리분기결과비교。결과이식관암술후병리분기작위표준，술전EUS검사T、N분기적진단준학솔분별위Tis기0（0／2），T1기75．0％（3／4），T2기75．0％（6／8），T3기86．7％（13／15），T4기80．0％（4／5），T기총준학솔위76．5％（26／34）；N0기71．4％（5／7），N1기75．0％（9／12），N2기0（0／11），N3기0（0／4），N기총준학솔위41．2％（14／34）。술전CT검사T、N분기적진단준학솔분별위Tis기0（0／1），T1기33．3％（2／6），T2기28．6％（2／7），T3기78．6％（11／14），T4기83．3％（5／6），T기총준학솔위58．8％（20／34），여EUS검사조T기총준학솔상비차이유통계학의의（P＜0．05）；N0기77．8％（7／9），N1기76．9％（10／13），N2기66．7％（4／6），N3기50．0％（3／6），N기총준학솔위70．6％（24／34），여EUS검사조N기총준학솔상비차이유통계학의의（P＜0．05）。결론 EUS검사대식관암적림상T기진단준학솔교고，이CT검사대식관암적N기진단준학솔교고，술전채용EUS연합CT검사가능대지도술전제정치료방안、평고예후유중요의의。
Objective To evaluate the guidance value of endoscopic ultrasonography (EUS) and CT scan in preoperative clinical staging for diagnosis and treatment of esophageal cancer .Methods 68 patients with esophageal cancer were randomly divided into EUS group and CT group using a random numbers table(34 cases in each group) .Patients in EUS group were examined by EUS , patients in CT group were examined by CT scan ,and staged according to the TNM (2003) staging system ,and were compared with surgical pathologic findings .Results The accuracy rates of T staging by EUS were 0(0/2) for Tis ,75 .0% (3/4) for T1 ,75 .0% (6/8) for T2 ,86 .7% (13/15) for T3 ,80 .0% (4/5) for T4 ,and the totle accuracy rate was 76 .5% (26/34) for T ;those of N staging were 71 .4% (5/7) for N0 ,75 .0% (9/12) for N1 ,0(0/11) for N2 ,0(0/4) for N3 ,and the totle accuracy rate was 41 .2% (14/34) for N .The accuracy rate of T staging by CT scan were 0(0/1) for Tis ,33 .3% (2/6) for T1 ,28 .6% (2/7) for T2 ,78 .6% (11/14) for T3 ,83 .3% (5/6) for T4 and the totle accuracy rate was 58 .8% (20/34) for T ,the difference was statistically significant com-pared with the EUS group(P<0 .05);those of N staging were 77 .8% (7/9) for N0 ,76 .9% (10/13) for N1 ,66 .7% (4/6) for N2 , 50 .0% (3/6) for N3 and the totle accuracy rate was 70 .6% (24/34) for N ,the difference was statistically significant compared with the EUS group (P<0 .05) .Conclusion The accuracy rate of EUS are higher for diagnosis in esophageal cancer and preoperative T staging .The accuracy rate of CT scan are higher for the preoperative N staging .EUS combined with CT scan has great significance for choosing ideal therapy plan for esophageal cancer ,and for estimating prognosis of esophageal cancer .