食管钡餐造影联合CT检查在食管癌术前分期以及预后评估中的价值分析

The Value of Esophageal Barium Meal Angiography Combined with CT Examination in Preoperative Staging and Prognosis Evaluation of Esophageal Cancer

目的探究食管钡餐造影联合CT检查在食管癌术前分期及预后评估中的价值。方法回顾性分析2018年3月~2019年9月本院收治的105例食管癌患者的资料,根据术前影像学检查方式分为钡餐造影组(20例)、CT组(23例)和钡餐造影联合CT组(联合组,60例),分析不同组别术前T、N分期与病检结果的差异性,并依据钡餐造影联合CT检查评价标准将放疗后3个月的患者疗效分为完全缓解(CR)、部分缓解(PR)以及无缓解(NR),绘制Kapan-Meier曲线进行生存分析,并分析影响食管癌患者3年生存率的因素。结果钡餐造影组诊断术前分期的灵敏度、特异度、准确率及Kappa值分别为62.50%、66.67%、65.00%、0.286,CT组为60.00%、69.23%、65.22%、0.292,钡餐造影联合CT组为80.00%、90.48%、87.10%、0.705,钡餐造影联合CT组检查与病理金标准诊断术前分期的效能更佳(P<0.05)。42例患者依据放疗后3个月后的疗效情况,发现CR者22例、PR者35例以及NR者5例。CR患者1年、3年的生存率分别为81.82%、50.00%,PR患者则为54.29%、22.86%,NR患者为20.00%、0.00%,CR患者1年、3年的生存率均较PR、NR患者更高(P<0.05);CR患者的生存时间为(26.32±2.37)个月,PR患者为(16.66±2.05)个月,NR患者为(10.80±2.52)个月,CR患者生存时间较PR及NR患者更高(χ^(2)=10.111,P=0.006<0.05)。术前Ⅱ~Ⅳ期、放疗3个月NR、治疗后淋巴及体积>1.0cm2均为食管癌患者预后的影响因素(P<0.05)。结论食管钡餐造影联合CT检查在食管癌术前分期以及放疗后疗效、预后的评判中均有较好的临床应用价值。

Objective To investigate the value of barium meal imaging of the esophagus combined with CT examination in the preoperative staging and prognostic assessment of esophageal cancer.Methods retrospectively analysed the data of 105 esophageal cancer patients admitted to our hospital from March 2018 to September 2019,and divided into barium meal contrast group(20 cases),CT group(23 cases)and barium meal contrast combined CT group(combined group,60 cases)according to the preoperative imaging modality,analysed the differences in preoperative T and N staging and pathological findings of the different groups,and classified patients into complete remission(C.R.)and prognosis(P.P.A.)according to the barium meal contrast combined CT examination Based on the evaluation criteria,the efficacy of patients 3 months after radiotherapy was classified into complete remission(CR),partial remission(PR)and no remission(NR),and Kapan-Meier curves were plotted for survival analysis,and the factors affecting the 3-year survival rate of oesophageal cancer patients were analysed.Results The sensitivity,specificity,accuracy and Kappa value for diagnosing preoperative staging were 62.50%,66.67%,65.00%and 0.286 in the barium meal contrast group,60.00%,69.23%,65.22%and 0.292 in the CT group,80.00%,90.48%,87.10%and 0.705 in the barium meal contrast combined with CT group.In the barium meal imaging combined with CT group,the efficacy of preoperative staging diagnosis with the pathological gold standard was better(P﹤0.05).42 patients were found to have 22 cases of CR,35 cases of PR,and 5 cases of NR based on the efficacy after 3 months of radiotherapy,and the survival rates of 1 year and 3 years for patients with CR were 81.82%and 50.00%,respectively,while those for patients with PR were 54.29%and 22.86%,and those for patients with NR were 20.00%,and those for patients with NR were 20.00%,and those for patients with NR were 20.00%and 20.00%,respectively.and 20.00%and 0.00%for NR patients,the survival rates at 1 and 3 years were higher in CR patients than in PR and NR patients(P﹤0.05);the survival time was(26.32±2.37)months for CR patients,(16.66±2.05)months for PR patients,and(10.80±2.52)months for NR patients,and the survival time of CR patients was higher than that of PR and NR patients were higher(χ^(2)=10.111,P=0.006﹤0.05).Preoperative stage II-IV,radiotherapy 3 months NR,post-treatment lymph and volume﹥1.0cm2 were all influential factors in the prognosis of oesophageal cancer patients(P﹤0.05).Conclusion Barium meal imaging of esophagus combined with CT examination has good clinical application value in preoperative staging of esophageal cancer as well as in judging the efficacy and prognosis after radiotherapy.