The Value Of PET/CT And MSCT In Preoperative Staging Of Esophageal Carcinoma

Objective: To investigate the value of PET/CT and MSCT in the diagnosis and staging of esophageal cancer preoperative T, N and M, analyzing the advantages and disadvantages of the two methods, and provide a theoretical basis for the preoperative staging and choice of treatment for esophageal carcinoma.Methods: A retrospective analysis of 85 cases were selected of esophageal carcinoma treated in our hospital from March 2009 to March 2015,whose medical records were statistically analyzed. 85 cases of esophageal cancer patients with esophageal cancer, and the data were statistically analyzed.All patients underwent MSCT and PET/CT examinations before operation,and the results were analyzed and discussed by 3 doctors. Comprehensively analyzed the T,N and M staging of esophageal carcinoma.Within 10 days after getting examination results,all patients were treated by surgical operation,then the corresponding regional lymph nodes were cleared and sent to pathological examination.T,N and M staging of postoperative pathological examination were used as the gold standard to compare the specificity, sensitivity and accuracy of and PET/CT and MSCT in the preoperative staging of esophageal carcinoma,then analyzed the advantages and disadvantages of the two methods.The results:?1?The pathological results showed that the clinical staging of 85 patients were: 19 cases of I, 23 cases of II, 30 cases of III, 13 cases of IV, among which 15 cases were T₁,19 cases of T₂, 31 cases of T₃, 20 cases of T₄, 32 cases of N₀, 53 cases of N₁ stage. A total of 38 cases had lymph node metastasis, lymph node metastasis rate was 44.71%. There were a total of 490 lymph nodes in the operation, with an average of 12.89 per patient?6-32 nodes?,among which the cases who happened lymph node metastasis was 54,so the rate of metastasis was 11.02%.The lymph node metastasis rates in thoracic, middle and lower segments rate were 13.16%, 55.26% and 31.58% respectively.?2? The T₁,T₂,T₃,T₄ stageings accuracy rates of PET/CT were respectively 26.67%, 15.79%, 51.61%, 95.00% compared with the results of surgical pathology,and N₀,N₁ stageings accuracy rates were respectively 87.50%,94.34%,so accuracy rate of T staging was 49.41%, N staging 91.76%.The T₁,T₂,T₃,T₄ stageings accuracy rates of MSCT were respectively 33.33%,31.58%,61.29%,85.00% compared with the results of surgical pathology,and N₀,N₁ stageings accuracy rates were respectively 81.13%,58.49%,so accuracy rate of T staging was 55.29%, N staging 54.12%.?3? Compared with the results of PET/CT and MSCT, there was no statistically significant difference in T staging?P>0.05?, and there was significant difference in T staging?P=0.000?.?4? The sensitivities, positive predictive values and negative predictive values between PET/CT and MSCT in T staging had statistical significances?P < 0.05?,which in N staging were significantly different?P < 0.01? besides sensitivities.The T staging results of PET/CT examination were in poor agreement with the pathological results,and the N staging results were highly consistent with the pathological results.The T staging results of MSCT examination were in poor agreement with the pathological results, and the N staging results were in moderate agreement with the pathological results.?5? The accuracy rates, sensitivities, specificities, positive predictive values, positive predictive values and negative predictive values of PET/CT and MSCT were not statistically significant?P > 0.05?, and the M staging results of PET/CT examination were highly consistent with the pathological results, MSCT examination in moderate agreement with the pathological results.Conclusion: PET/CT compared with MSCT examination in the diagnosis of esophageal carcinoma preoperative staging is more advantageous, especially in the sensitivities of T staging, positive predictive values and negative predictive values, sensitivities of N staging, and PET/CT in the N and M staging has a high credibility, to provide reliable basis for physicians to select clinical treatment.