CT扫描食管造影和内窥镜测量食管癌病变长度的价值

The Value of CT Scan, Esophagogram and Endoscopy in Defining the Length of Esophageal Carcinoma

目的:探讨CT扫描、食管造影和内窥镜测量食管癌病变长度的价值。方法:应用CT扫描、食管造影和内窥镜等方法测量74例食管癌病变长度,以食管癌病理标本收缩比回推至人体内实际长度为标准,比较各检查方法测量食管癌病变长度的符合程度。结果:食管癌病变长度从小到大依次为镜检长度、实体肿瘤长度、食管造影长度和CT扫描长度,其中镜检长度和造影长度与实体肿瘤长度较为接近。CT扫描、食管造影和内窥镜测量食管癌病变长度的符合率分别为41.9%(31/74)、55.4%(41/74)和73.0%(54/74),CT扫描符合率最低(P=0.001)。CT扫描重度不符合率为65.1%(28/43),食管造影为42.4%(14/33),内窥镜为30.0%(6/20),CT扫描所占比例最高(P=0.019)。结论:镜检长度关和键造词影长食度管与癌实体计肿算瘤机长体度层较摄为影接术近,食CT管测钡量餐食造管影癌病内变窥长镜度与长实度体肿瘤长度差异较大。

Objective： To evaluate the value of CT scan, esophagogram and endoscopy in approximating the length of esophageal carcinoma tumors. Methods： Seventy-four patients with esophageal carcinoma underwent spiral CT scan, esophagogram and endoscopy before surgery and the length of the tumor was measured. Using the actual tumor length obtained by correcting postoperative pathological specimen length with a shrinkage ratio, the tumor length as measured by CT, esophagogram and endoscopy were compared. Results： In general the values predicted by endoscopy and esophagogram were closest to the actual tumor length in situ. The increasing order was tumor length measured by endoscopy, tumor length in situ obtained by calculation, tumor length measured by esophagogram and tumor length measured by CT scan. The accuracy of tumor length predictions from CT scan, esophagogram and endoscopy compared to the actual tumor length was 41.9% （31/ 74）, 55.4% （41174） and 73.0% （54/74）, respectively. CT scan, esophagogram and endoscopy examinations accounted for 65.1% （28/43）, 42.4% （14/33） and 30.0% （6/20）, respectively, of the discrepancies of more than 2 cm from the real tumor length in situ. Conclusion： Tumor length measurements by endoscopy and esophagogram are more accurate for predicting actual tumor length than those from CT scans.