DR摄影与螺旋CT诊断食管癌的价值比较

The value of DR photography and spiral CT in the diagnosis of esophageal cancer

目的 探讨比较DR摄影与螺旋CT诊断食管癌的价值。方法 将本院2016年1月至2017年6月收治的高度疑似食管癌患者86例作为研究对象,均分别采用DR摄影与螺旋CT检查,与手术病理结果对照。结果 手术病理检查确诊68例食管癌,DR确诊53例,CT确诊49例;DR摄影诊断Ⅰ期(早期)食管癌准确率显著高于CT(62.50%比29.17%,P<0.05),DR、CT诊断Ⅱ期、Ⅲ期、Ⅳ期食管癌准确率比较无统计学差异(P>0.05);DR摄影与CT诊断食管癌的灵敏度、特异度、阳性预测值及准确度比较无统计学差异(P>0.05),DR诊断的阴性预测值显著高于CT(28.57%比13.64%,P<0.05)。结论 DR摄片可作为食管癌诊断的首选检查方式,有助于提升早期食管癌检出率,降低假阴性率,CT更适合中晚期食管癌术前精确判断食管癌大小、位置、形态、部位、远端转移、淋巴结转移。

Objective To investigate the value of DR photography and spiral CT in the diagnosis of esophageal carcinoma. Methods 86 cases of highly suspected esophageal cancer patients admitted to our hospital from January 2016 to June 2017 were selected as subjects, who underwent DR photography and spiral CT examination respectively, as compared with the surgical pathology results. Results 68 cases of esophageal cancer were diagnosed by pathological examination, and 53 cases were confirmed by DR, 49 cases by CT. The accuracy of DR photography in the diagnosis of stage I esophageal cancer was significantly higher than that of CT (62.50% vs.29.17%, P<0.05), there were no statistically significant differences in the accuracy of DR and CT in the diagnosis of stage II, III, IV esophageal cancer (P>0.05). There were no statistically significant differences in the sensitivity, specificity, positive predictive value, and accuracy of DR photography and CT in the diagnosis of esophageal cancer (P>0.05);the negative predictive value of DR diagnosis was significantly higher than that of CT (28.57% vs.13.64%, P<0.05). Conclusion DR radiography can be used as the first choice for the diagnosis of esophageal carcinoma, helps to promote early detection rate for esophageal cancer and reduce false negative rate;CT is more suitable for patients with preoperative accurate judgment of size, location, shape, position, distal metastasis, and lymph node metastasis.