X线影像中食管癌移动度与术后病理及切除率的关系

Relationship between esophageal neoplasms roentgenraphic mobility, post-operational pathology and resection rate

为了通过手术前X线检查 ,找到一个更为可靠的判断食管癌切除率的新方法。术前 3d患者分别于立位及卧位时吞钡食管检查并摄片 ,测量立位及卧位片上肿瘤上缘至主动脉弓上缘的距离 ,并对照手术结果及术后病理做出分析。结果同一患者的X线片中 ,肿瘤上缘至主动脉弓上缘的距离在立位与卧位摄片时有一定差值 ,我们把这个差值称为食管癌移动度 ,在肿瘤部分肌层浸润组x- =1 7cm、全层浸润或外浸尚可切除组x- =0 86cm、外侵其他器官不能切除组x- =0 15cm ,食管癌移动度不同 ,其差别有统计学意义。初步研究结果显示食管癌移动度 >1 2 9cm ,提示肿瘤与周围组织粘连轻 ,切除病灶把握性较大 ;食管癌移动度 <0 86cm ,手术切除有一定困难 ;食管癌移动度 <0 3cm ,应先行放射治疗。

The objective is to find a more reliable method used for evaluate esophageal neoplasms resectional rate by roentgenography preoperation. Three days before operation, esophagography by barium meal was performed. Distance between upper border of tumor and aortic arch was measured at erect position and clinostatic position. This distance,operational results and post-operational pathology were analyzed. Distance between upper border of esophageal tumor and aortic arch in erect and clinostatic film was different. This difference was called mobility of esophageal cancer. The mobility of esophageal cancer in muscle lamina invasion group was x-=1.7 cm,in all lamina invasion or adjunctive invasion but could be resected group x-=0.86 cm,in unresectable group with adjunctive invasion x-=0.15 cm.The mobility between them had a statistic difference.In conclusion,if the mobility of esophageal neoplasms is more than 1.29 cm, it means the resection rate is high. If the mobility is less than 0.86 cm, tumor resection is difficult. Radiotherapy may be suitable firstly for patients with the mobility less than 0.3 cm.