食管癌病变长度不同检测方法的比较

Analysis of different methods to measure lesion of esophageal carcinoma

目的对胸段食管癌病变长度的不同检测方法进行分析比较，探讨CT测量食管癌病变长度的准确性，为食管癌放疗靶区的精确勾画提供理论依据。方法将598例胸段食管鳞状细胞癌患者经CT扫描、X线钡餐造影测量的病变长度与术中手术标本进行回顾性对比研究，对其间存在的差异进行分析。结果CT扫描、X线钡餐造影、手术标本的食管病变平均长度分别为（6．70±2．52）cm、（5．13±1．91）cm和（5．23±1．93）cm。CT扫描的病变长度与手术标本比较差异有统计学意义（P=0．000）；X线钡餐造影病变长度较手术标本偏短，但二者差异无统计学意义（P=0．106）；病变长度从大到小顺序依次为CT扫描、手术标本、X线钡餐造影。结论CT扫描的食管癌病变长度较手术标本实际肿瘤长度偏长，而X线钡餐造影稍偏短。在应用CT勾画食管癌放疗靶区判定病变长度时，应综合参考X线钡餐造影等其他检查。

Objective To compare accuracy of methods to measure lesion of thoracic segment esophageal carcinoma, and to provide the theory evidence for the precise sketch of irradiation targets. Methods A total of 598 patients with thoracic segment esophageal squamous cell carcinoma were enrolled in this retrospective study. Their lesion lengths were measured and compared respectively in intraoperative specimen, X-ray barium meal and CT. Results Measured mean lengths of lesion were respectively （6.70±2.52） cm, （5.13±1.91）cm and （5.23±1.93）cm in CT, X-ray barium meal and intraoperative specimen. There were significant differences in lesion lengths between intraoperative specimen and CT （P =0.000）. There were no significant differences in lesion lengths between intraoperative specimen and X-ray barium meal（P =0.106）. Lesion lengths were from top to bottom CT, intraoperative specimen and X-ray barium meal. There were no significant differences in lesion lengths between different pathological type, different T staging intraoperative specimen and X-ray barium meal （P 〉0.05）, but there were significant differences in lesion lengths between different pathological types （except intracavitary type）, different T stagings intraoperative specimen and CT（P 〈 0.05）. Conclusion Lesion length measured with CT is longer than that measured with intraoperative specimen, but it is shorter with X-ray barium meal than that with intraoperative specimen. It is suggested that X-ray barium meal and other examinations should be referred generally in using CT to depict esophageal carcinoma radiotherapy area.