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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中的价值。方法 :32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 84 .4 %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的敏感性90 .9% ,特异性 81.8% ,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 81.3% ,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81.8% ,特异性 72 .7% ,而对纵隔内远处转移的淋巴结均未能探及。结论 :CT扫描在评价进展期食管癌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 examinations and compared with postoperative pathology. Results: 84.4% of esophageal lesions were found by CT scan, but the depth of invasion of the tumor was not accurately diagnosed. The diagnostic accuracy of mediastinal structures was 75%. The sensitivity of regional lymph node metastasis was 90.9% and the specificity was 81.8% , The remote diagnosis of mediastinal lymph node metastasis rate of 80%. MPS examination can detect all the cases of advanced esophageal cancer lesions, depth of invasion of cancer diagnosis accuracy rate of 81.3%, diagnosis of mediastinal structure invasion accuracy rate of 50%, diagnosis of regional lymph node metastasis sensitivity 81.8%, specificity 72.7% , While distant metastasis of the mediastinum lymph nodes have failed to explore. Conclusion: CT scanning in evaluating the invasion of esophageal carcinoma mediastinal structures and distant lymph node metastasis of great significance. The accuracy of MPS examination in determining the depth of invasion of cancer lumens is high.