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目的 比较胸部螺旋CT增强扫描及微探头超声内镜 (MPS)检查在评价进展期食管癌的价值。方法 3 2例进展期食管癌术前行CT扫描和MPS检查并与术后病理学比较。结果 CT扫描能发现 82 .9%的食管癌病灶 ,但不能准确诊断癌肿浸润深度。诊断纵隔结构受侵准确率 75 % ,发现区域淋巴结转移敏感性 91.7% ,特异性 80 .5 % ,对纵隔内远处淋巴结转移诊断准确率 80 %。MPS检查能检出所有病例的进展期食管癌病灶 ,癌肿浸润深度诊断准确率 81.5 % ,诊断纵隔结构受侵准确率 5 0 % ,诊断区域淋巴结转移敏感性 88.9% ,特异性 77.8% ,而对纵隔内远处转移的淋巴结均未能探及。结论 CT扫描在评价纵隔内结构受侵及远处淋巴结转移的意义较大 ,而MPS检查在判断癌肿管腔浸润深度的准确率较高。
Objective To compare the value of enhanced thoracic spiral CT and micro-probe endoscopic ultrasonography (MPS) in the evaluation of advanced esophageal cancer. Methods Thirty-two patients with advanced esophageal cancer underwent preoperative CT scan and MPS examination and compared with postoperative pathology. Results CT scan found 82.9% of esophageal cancer lesions, but can not accurately diagnose the depth of invasion of cancer. The diagnostic accuracy of mediastinal invasion was 75%. The sensitivity and specificity of regional lymph node metastasis were 91.7% and 80.5% respectively, and the diagnostic accuracy rate of remote lymph node metastasis in mediastinum was 80%. MPS examination can detect all cases of advanced esophageal cancer lesions, depth of invasion of cancer diagnosis accuracy rate of 81.5%, diagnosis of mediastinal structure invasion accuracy rate of 50%, diagnosis of regional lymph node metastasis sensitivity 88.9%, specificity 77.8%, while Mediastinal lymph nodes distant metastasis were not explored. Conclusion CT scan is more meaningful in assessing the invasion of mediastinum and distant lymph node metastasis, while the accuracy of MPS examination in determining the depth of invasion of the tumor lumen is high.