The value of esophageal activity examination under X-ray fluoroscopy and chest CT in assessing the resectability of upper thoracic esophageal cancer_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

CAO Jianwei ¹ , GENG Mingfei ¹ , ZHOU Fuyou ¹ , ZHU Dongshan ¹ ,  LI Hui ²

1. Department of Thoracic Surgery, Anyang Tumor Hospital, Anyang, 455000, Henan, P.R.China;
2. Department of Thoracic Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100020, P.R.China;

Corresponding author：

LI Hui, Email: huilee@vip.sina.com

Keywords：

Esophageal cancer; activity degree; diagnostic value; resection rate

DOI：

10.7507/1007-4848.202006069

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Objective To investigate the value of esophageal activity examination under X-ray fluoroscopy and chest CT in evaluating the resectability of upper thoracic esophageal cancer.Methods A total of 221 upper thoracic esophageal carcinoma patients underwent radical operation between 2009 and 2015 in our hospital were enrolled, including 141 males and 80 females with a median age of 59 (47-79) years. Preoperative routine esophageal activity examination under X-ray fluoroscopy and chest enhanced CT were performed to determine whether the tumor had external invasion. The results of the two methods were compared with that observed during the operation.Results The number of patients with esophageal activity score 1-6 was 70, 85, 32, 29, 2 and 3, respectively. The area under the receiver operating characteristic (ROC) curve (AUC) of esophageal activity examination was 0.897 (95%CI 0.85-0.93, P<0.001), and the cut off value was >3. According to the ROC curve activity score, 4-6 points were considered as invasion, and 1-3 points were non-invasion. The sensitivity, specificity, accuracy and misdiagnosis rate of esophageal activity examination was 75.0%, 89.3%, 88.2%, 10.7%, respectively, and those of CT scan were 75.0%, 66.8%, 67.4%, 33.2%, respectively. Compared with CT scan, the specificity of esophageal activity examination was higher and the misdiagnosis rate was lower. Compared with the detection during the operation, 86.7% of patients with actual invasion of trachea and 85.7% of patients with actual invasion of other parts were in accordance with the esophageal activity examination results.Conclusion Esophageal activity examination under X-ray fluoroscopy can accurately predict the resectability of upper thoracic esophageal cancer, which is a useful supplement to chest CT examination, especially in the aspect of judging the relationship between lesions and the trachea.

Citation： CAO Jianwei, GENG Mingfei, ZHOU Fuyou, ZHU Dongshan, LI Hui. The value of esophageal activity examination under X-ray fluoroscopy and chest CT in assessing the resectability of upper thoracic esophageal cancer. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2021, 28(9): 1044-1048. doi: 10.7507/1007-4848.202006069 Copy

1.	张光岩. X线钡餐造影与CT对食管癌诊断价值分析. 现代诊断与治疗, 2018, 29(15): 2420-2422.
2.	李东峰, 徐慧萍. 多层螺旋CT在食管癌手术切除的评估及预后评估. 中国CT和MRI杂志, 2018, 16(1): 102-104, 110.
3.	Moss AA. Esophageal carcinoma: Pretherapy staging by computed tomography. Am J Roentgenol, 1981, 136(6): 1051-1056.
4.	朱宗明, 冯银波, 陶广宇, 等. 基于CT图像纹理分析方法对胸段食管癌术前T分期的研究价值. 临床放射学杂志, 2019, 38(1): 72-76.
5.	贾明选, 刘书文, 郭亮, 等. 64排螺旋CT在评估胸段食管癌手术切除治疗的可行性分析. 中国CT和MRI杂志, 2015, 13(12): 19-21.
6.	高松, 王善政, 郑勇, 等. X线影像中食管癌移动度与术后病理及切除率的关系. 肿瘤防治杂志, 2004, 11(9): 971-972.
7.	黄河, 陈立兵, 毛岸荣, 等. 食管肿瘤移动度的测定及其临床意义. 中国肿瘤临床, 2005, 32(23): 1356-1357.
8.	严海霞. X 线钡餐造影对食道癌的诊断价值. 医学信息, 2015, 28(36): 80.
9.	韩文周, 刘彦中, 胡艳霞. 动态观察胸段食管肿瘤移动度对筛选手术患者的临床价值. 中国民康医学, 2011, 23(1): 43-44.
10.	卢丽华. X 线气钡双对比造影及螺旋CT在食管癌中的价值. 影像研究与医学应用, 2019, 3(20): 77-78.
11.	史芸芳. 64 排CT对食管癌外侵的评判及手术评估. 中国CT和MRI杂志, 2013, 11(5): 42-43, 52.
12.	胡知文. X 线钡餐造影、螺旋CT扫描单独及联合检查在食管癌术前分期评估中的应用价值分析. 现代消化及介入诊疗, 2020, 25(1): 120-123.
13.	向晓燕. X-线钡餐及CT影像诊断食管癌的价值比较. 现代医学与健康研究电子杂志, 2019, 3(14): 140-141.

1. 张光岩. X线钡餐造影与CT对食管癌诊断价值分析. 现代诊断与治疗, 2018, 29(15): 2420-2422.
2. 李东峰, 徐慧萍. 多层螺旋CT在食管癌手术切除的评估及预后评估. 中国CT和MRI杂志, 2018, 16(1): 102-104, 110.
3. Moss AA. Esophageal carcinoma: Pretherapy staging by computed tomography. Am J Roentgenol, 1981, 136(6): 1051-1056.
4. 朱宗明, 冯银波, 陶广宇, 等. 基于CT图像纹理分析方法对胸段食管癌术前T分期的研究价值. 临床放射学杂志, 2019, 38(1): 72-76.
5. 贾明选, 刘书文, 郭亮, 等. 64排螺旋CT在评估胸段食管癌手术切除治疗的可行性分析. 中国CT和MRI杂志, 2015, 13(12): 19-21.
6. 高松, 王善政, 郑勇, 等. X线影像中食管癌移动度与术后病理及切除率的关系. 肿瘤防治杂志, 2004, 11(9): 971-972.
7. 黄河, 陈立兵, 毛岸荣, 等. 食管肿瘤移动度的测定及其临床意义. 中国肿瘤临床, 2005, 32(23): 1356-1357.
8. 严海霞. X 线钡餐造影对食道癌的诊断价值. 医学信息, 2015, 28(36): 80.
9. 韩文周, 刘彦中, 胡艳霞. 动态观察胸段食管肿瘤移动度对筛选手术患者的临床价值. 中国民康医学, 2011, 23(1): 43-44.
10. 卢丽华. X 线气钡双对比造影及螺旋CT在食管癌中的价值. 影像研究与医学应用, 2019, 3(20): 77-78.
11. 史芸芳. 64 排CT对食管癌外侵的评判及手术评估. 中国CT和MRI杂志, 2013, 11(5): 42-43, 52.
12. 胡知文. X 线钡餐造影、螺旋CT扫描单独及联合检查在食管癌术前分期评估中的应用价值分析. 现代消化及介入诊疗, 2020, 25(1): 120-123.
13. 向晓燕. X-线钡餐及CT影像诊断食管癌的价值比较. 现代医学与健康研究电子杂志, 2019, 3(14): 140-141.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

The value of esophageal activity examination under X-ray fluoroscopy and chest CT in assessing the resectability of upper thoracic esophageal cancer

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