多层螺旋CT对腹段食管癌与贲门癌淋巴结转移特征的评价

Evaluation of Lymph Node Metastasis Features of Abdominal Esophageal Carcinomas and Cardiac Cancer by Multi-Detector Spiral CT

目的探讨腹段食管癌及贲门癌淋巴结转移特征的异同点。方法收集36例腹段食管癌及28例贲门癌患者术前CT资料,观察记录淋巴结大小、优势分布情况,并进行统计学分析,了解有无差异。结果以淋巴结短径≥10 mm为转移标准,腹段食管癌CT淋巴结检出率为73.5%(144/196),贲门癌CT淋巴结检出率为83.7%(170/203)。腹段食管癌胸腔淋巴结转移率:7区11.1%(4/36)、8区27.8%(10/36)、9区8.3%(3/36),腹腔转移以No.7组36.1%(13/36)、No.1组19.4%(7/36)及No.2组11.1%(4/36)为主。贲门癌淋巴结转移以第1站的No.1组17.9%(5/28)、No.2组28.6%(8/28)、No.3组39.3%(11/28)、No.4组25.0%(7/28)及第2站的No.7组35.7%(10/28)为主。结论 CT以短径≥10 mm为淋巴结转移判断标准具有可行性,但存在一定假阳性率。腹段食管癌胸腔淋巴结转移以7、8、9区为主,腹腔转移以No.7组及No.1、No.2组为主。贲门癌淋巴结转移以第1站的No.1～No.4组及第2站的No.7组为主。

Objective To explore the differences and similarities of the featurs of lymph node metatasis of abdominal esophageal carcinoma and cardiac cancer.Methods Preoperative CT images of abdominal esophageal carcinomas and cardiac cancers were reviewed and analysed on lymph node size and preponderant distribution.Results Short diameter ≥10 mm of lymph node at CT was adopted as metastasis criterion.The detection rates of abdominal esophageal carcinomas and cardiac cancers were 73.5%（144/196） and 83.7%（170/203）,respectively.Thoracic lymph node metastasis rate of abdominal esophageal carcinomas was 11.1%（4/36） in 7 area,27.8%（10/36） in 8 area,8.3%（3/36） in 9 area,while celiac lymph node metastasis rate was 36.1%（13/36） in No.7 group,19.4%（7/36） in No.1 group,and 11.1%（4/36） in No.2 group primarily.Lymph node metastasis rate of cardiac cancers was 17.9%（5/28） in No.1 group,28.6%（8/28） in No.2 group,39.3%（11/28） in No.3 group,and 25.0%（7/28） in No.4 group for the first stop lymph nodes,and 35.7%（10/28） in No.7 group for the second stop primarily.Conclusion As metastasis criterion,short diameter ≥10 mm of lymph node at CT is feasible,but there exist certain false-positive rate.Thoracic lymph node metastasis of abdominal esophageal carcinomas is mainly in the 7,8,and 9 area,while celiac metastasis is mainly in No.7,No.1,and No.2 groups.Lymph node metastasis of cardiac cancers is in No.1,No.2,No.3,No.4,and No.7 group primarily.