Esophageal Cancer
Copyright ©The Author(s) 2003. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Feb 15, 2003; 9(2): 219-224
Published online Feb 15, 2003. doi: 10.3748/wjg.v9.i2.219
Preoperative TN staging of esophageal cancer: Comparison of miniprobe ultrasonography, spiral CT and MRI
Ling-Fei Wu, Bing-Zhou Wang, Jia-Lin Feng, Wei-Rong Cheng, Guo-Re Liu, Xiao-Hua Xu, Zhi-Chao Zheng
Ling-Fei Wu, Bing-Zhou Wang, Jia-Lin Feng, Wei-Rong Cheng, Xiao-Hua Xu, Zhi-Chao Zheng, Department of Gastroenterology, Department of Information, Guo-Rui Liu, Department of Medical Imaging, Department of Surgery, Department of Pathology, Second Affiliated Hospital, Shantou University Medical College, Shantou 515041, Guangdong Province China
Author contributions: All authors contributed equally to the work.
Supported by Guangdong Medical Science Fund, No. A1999429
Correspondence to: Dr. Ling-Fei Wu, Department of Gastroenterology, Second Affiliated Hospital, Shantou University MedicalCollege, Shantou 515041, Guangdong Province China. lingfeiwu@21cn.com
Telephone: +86-754-8355461 Fax: +86-754-8346543
Received: July 20, 2002
Revised: August 4, 2002
Accepted: August 29, 2002
Published online: February 15, 2003
Abstract

AIM: To evaluate the value of miniprobe sonography (MPS), spiral CT and MR imaging (MRI) in the tumor and regional lymph node staging of esophageal cancer.

METHODS: Eight-six patients (56 men and 30 women; age range of 39-73 years, mean 62 years) with esophageal carcinoma were staged preoperatively with imaging modalities. Of them, 81 (94%) had squamous cell carcinoma, 4 (5%) adenocarcinoma, and 1 (1%) adenoacanthoma. Eleven patients (12%) had malignancy of the upper one third, 41 (48%) of the mid-esophagus and 34 (40%) of the distal one third. Forty-one were examined by spiral CT in whom 13 were co-examined by MPS, and forty-five by MRI in whom 18 were also co-examined by MPS. These imaging results were compared with the findings of the histopathologic examination for resected specimens.

RESULTS: In staging the depth of tumor growth, MPS was significantly more accurate (84%) than spiral CT and MRI (68% and 60%, respectively, P < 0.05). The specificity and sensitivity were 82% and 85% for MPS; 60% and 69% for spiral CT; and 40% and 63% for MRI, respectively. In staging regional lymph nodes, spiral CT was more accurate (78%) than MPS and MRI (71% and 64%, respectively), but the difference was not statistically significant. The specificity and sensitivity were 79% and 77% for spiral CT; 75% and 68% for MPS; and 68% and 62% for MRI, respectively.

CONCLUSION: MPS is superior to spiral CT or MRI for T staging, especially in early esophageal cancer. However, the three modalities have the similar accuracy in N staging. Spiral CT or MRI is helpful for the detection of far-distance metastasis in esophageal cancer.

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