The value of esophageal activity examination under X-ray fluoroscopy and chest CT in assessing the resectability of upper thoracic esophageal cancer
- VernacularTitle:X 线透视下食管癌活动度检查和胸部 CT 在评估胸上段食管癌可切除率中的价值
- Author:
Jianwei CAO
1
;
Mingfei GENG
1
;
Fuyou ZHOU
1
;
Dongshan ZHU
1
;
Hui LI
2
Author Information
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
- Publication Type:Journal Article
- Keywords:
Esophageal cancer;
activity degree;
diagnostic value;
resection rate
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2021;28(09):1044-1048
- CountryChina
- Language:Chinese
-
Abstract:
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.
