食管肿瘤移动度的测定及其临床意义

The Mobility of Esophageal Tumor and Its Clinical Significance

目的:制定食管肿瘤移动度的标准,以判断食管肿瘤的外侵程度,为临床提供手术的评估方法。方法:测量食管肿瘤在吞咽时的移动度。结果:食管肿瘤不能移动的定为0度;移动0.1～0.5cm定为Ⅰ度,0.5～1.0cm定为Ⅱ度;而移动1.0cm以上为Ⅲ度。结论:食管肿瘤移动度与肿瘤外侵程度基本成负相关。即移动度越大,外侵程度越小。移动度为0度者,无手术指征;Ⅰ度者不能手术切除或切除后易有肿瘤残留;Ⅱ度者食管肿瘤有外侵,但有手术探查指征;Ⅲ度者均可行根治性手术切除。测定食管肿瘤移动度可作为食管肿瘤可否根治性切除的重要指征之一,较其它方法更为直观、准确、经济,具有推广性。

Objective： To evaluate the mobility of esophageal tumor and its relationship with resectability of the tumor. Methods： The longitudinal movement of esophageal tumor was observed and measured by barium swallow study. Results： According to the extent of the movement, the tumor mobility was defined as follows： grade 0： tumor fixed with no visible movement; grade Ⅰ ： tumor movement of 0.1-0.5 cm; grade Ⅱ： tumor movement of 0.6～1.0 cm and grade Ⅲ： tumor movement of more than 1 cm. Conclusions： There is a negative correlation between the mobility of esophageal tumor and the in- vasion. In patients with grade-0 lesions, there is no operative indication. In grade Ⅰ, careful consideration must be given in deciding exploration and the resection of tumor may be difficult and incomplete. In grade Ⅱ, the resection may be relatively easy despite of invasion. In degree Ⅲ, a complete resection can be expected. The mobility of esophageal tumor can be applied as an easy, objective and cost-effective indication in pre-operative evaluation of such patients.