The Study Of Esophageal Cancer Staging Using Chest CT And EUS Before Operation

Objective: T_here was not systematically study in esophageal cancer staging before operation up to now. T_he aim of this study was to assess the diagnosis value of esophageal cancer T_N staging using chest computed tomography (CT₎ and endoscope ultrasonography (EUS) before operation.Methods : 100 patients in the retrospective study were suffered from esophageal carcinomas that were proved with surgical resection and histological examination from Aug. 2007 to Dec. 2009. Of these patients, 70 were male, 30 female, aged from 39 to 78 (mean 52.23±7.28). All patients were not received preoperative chemo- and radiotherapy therapy. Preoperative T_N staging of esophageal cancer were evaluated by chest CT scanning and EUS detection. Location lymph-nodes were dissected and examination. T_he relation between esophageal cancer and near organs including trachea, aorta, azygos vein and thoracic duct were recorded in operation. Post-operation staging of esophageal cancer were evaluated according to tissue specimen and pathological features. Post-operation pathological staging was considered as gold staging standard. By comparison of Pre-operation staging and post-operation staging, accuracy rate of esophageal cancer T_N staging using chest CT scanning and EUS detection were confirmed.Results: (1) T_he sensitivity and accuracy rates in T₁ and T₂ stage were significantly lower than that of T₃ and T₄ stage by chest CT to discriminate the stage of esophageal cancer(P≤0.05); While specificity were not significantly different between any two stages( P>0.05). Sensitivity and specificity had not significantly different between N0 and N1 stage(P>0.05). Accuracy rate in N1 stage was significantly higher than that in N0 stage(P≤0.05).(2) T_he sensitivity, specificity and accuracy rates among different T stage were not significantly different by EUS to diagnose esophageal cancer(P>0.05). T_here was significantly different in accuracy rate between N0 and N1 by EUS to diagnose esophageal cance(rP≤0.05), while sensitivity and specificity were not significantly different between any two stages(P>0.05).(3) T_here were not significantly different in the sensitivity, specificity and accuracy rates among T₁, T₂, T₃ and T₄ stage by united chest CT and EUS (CT_-EUS) (P>0.05). Similarly, there was not significantly different in N0 and N1stage (P>0.05).(4) T_he sensitivity,specificity and accuracy rate in different T stages by chest CT_, EUS and CT_-EUS were that EUS was significantly better than chest CT in T₁ andT₂ stage (P≤0.05)and chest CT was significantly better than EUS in T₃ and T₄ stage (P≤0.05). T_he comparison in different N0 stage were that the specificity of CT was significantly better than that of EUS (P≤0.05)while the specificity and accuracy rate between CT and EUS were not significantly different. In N1stage, the sensitivity of EUS was better than that of CT (P≤0.05), while specificity and accuracy rate between CT and EUS were not significantly different(P>0.05). T_he sensitivity,specificity and accuracy rate of CT-EUS were significantly better than that of any single examination in both T and N stage(P≤0.05).Conclusion: It is helpful that any single examination of chest CTscanning or EUS detection may accurately stage esophageal cancer before operation. CT_-EUS may obviously improve accuracy rate of esophageal cancer in T and N stage before operation.