Evaluation of Mutidetector Computer Tomography in Diagnosing TN Staging and Typing of Adenocarcinoma of Esophagogastric Junction_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

WANG Chenglong , ZHENG Xingju , SUN Jiayu , LI Zhenglin , CHEN Xian , WU Bing

Department of Radiology， West China Hospital， Sichuan University， Chengdu 610041， Sichuan Province， China;

Corresponding author：

Keywords：

Adenocarcinoma of esophagogastric junction; Multi-detector row helical CT; Neoplasms; Staging; Typing

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Objective 　To evaluate the clinical value of multi-detector row helical CT (MDCT) in Diagnosing the TN staging and typing of adenocarcinoma of esophagogastric junction.
Methods 　From January 2008 to June 2011，149 consecutive cases with AEG confirmed surgery were examined by using MDCT scanner before surgery in West China Hospital，pathologic and operative finding diagnosis were correlated with that results of MDCT .
Results 　The accuracies of MDCT for the T1, T2, T3, and T4 staging was 97.3%，91.3%，84.5%， and 89.3%，respectively， and for the typing of Ⅰ,Ⅱ, andⅢwas 84.6%, 63.8%, and 79.2%，respectively. The accuracies of MDCT to judge the metastasis of lymph node was 88.6%（132/149）. The feature of metastasis of lymph node with circular and fusion，significantly and obviously enhanced，ring and heterogeneous enhanced, which the positive rate of pathological metastasis was higher (P=0.000).
Conclusions 　MDCT is an excellent diagnostic tool for the diagnosis of the TN staging and typing of AEG, which is useful for the selection of the surgical procedure and decision operation path.

Citation： WANG Chenglong,ZHENG Xingju,SUN Jiayu,LI Zhenglin,CHEN Xian,WU Bing,.. Evaluation of Mutidetector Computer Tomography in Diagnosing TN Staging and Typing of Adenocarcinoma of Esophagogastric Junction. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2012, 19(4): 446-451. doi: Copy

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15.	Shin SH， Jung H， Choi SH， et al. Clinical significance of splenic hilar lymph node metastasis in proximal gastric cancer [J]. Ann Surg Oncol， 2009， 16(5)：1304-1309.
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20.	Wayman J， Forman D， Griffin SM. Monitoring the changing pattern of esophago-gastric cancer：data from a UK regional cancer registry [J]. Cancer Causes Control， 2001， 12(10)：943-949.
21.	刘巍，宋丽楠，关丽云，等. 胸段食管癌及食管胃交界部癌根治术后患者生存质量影响因素的研究 [J]. 中国肿瘤临床，2009， 36(15)： 875-878．.
22.	催超，孙立波，舒振波，等. 进展期近端胃癌根治术联合脾脏切除术适应证的选择 [J]. 中国普外基础与临床杂志， 2010，17(1)：22-24．.
23.	Siewert JR， Stein HJ， Feith M. Adenocarcinoma of the esophago-gastric junction [J]. Scand J Surg， 2006， 95(4)：260-269.
24.	von Rahden BH， Stein HJ， Siewert JR. Surgical management of esophagogastric junction tumors [J]. World J Gastroenterol，2006， 12(41)：6608-6613.
25.	姜波健，吴巨钢，俞继卫，等. 胃癌淋巴管生成、淋巴管浸润及淋巴结微转移的临床意义 [J]. 中国普外基础与临床杂志，2008， 15(12)：903-909．.

1. Hasegawa S， Yoshikawa T. Adenocarcinoma of the esophagogastric junction：incidence, characteristics, and treatment strategies [J]. Gastric Cancer， 2010， 13(2)：63-73.
2. 张祥宏，王其彰. 对食管胃交界腺癌的认识与争议 [J]. 中华肿瘤杂志， 2008， 12(30)：947-949．.
3. Tsiouris A， Hammoud Z， Velanovich V. Barrett’s esophagus after resection of the gastroesophageal junction： effects of concomitant fundoplication [J]. World J Surg， 2011， 35(8)：1867-1872.
4. 黄娟，陈卫霞，王小鹏，等. 多排螺旋CT 对胃癌T 分期的诊断价值 [J]. 四川大学学报( 医学版)， 2009， 40(6)：1105-1109.
5. Rice TW， Blackstone EH， Rusch VW. A cancer staging primer：esophagus and esophagogastric junction [J]. J Thorac Cardiovasc Surg， 2010， 139(3)：527-529.
6. Siewert JR， Stein HJ. Classification of adenocarcinoma of the esophagogastric junction [J]. Br J Surg， 1998， 85(11)：1457-1459.
7. Meier I， Susanne M， Papadopoulos T， et al. Adenocarcinoma of the esophagogastric junction：the pattern of metastatic lymph node dissemination as a rationale for elective lymphatic target volume definition [J]. Int J Radiat Oncol Biol Phys， 2008， 70(5)：1408-1417.
8. Lyratzopoulos G， Barbiere JM， Gajperia C， et al. Trends and variation in the management of oesophagogastric cancer patients：a population-based survey [J]. BMC Health Serv Res， 2009， 9：231.
9. Lehrbach DM， Cecconello I， Ribeiro Jr U， et al. Adenocarcinoma of the esophagogastric junction：relationship between clinicopathological data and p53， cyclin D1 and Bcl-2 immunoexpressions [J]. Arq Gastroenterol， 2009， 46(4)：315-320.
10. Westerterp M， Koppert LB， Buskens CJ， et al. Outcome of surgical treatment for early adenocarcinoma of the esophagus or gastro-esophageal junction [J]. Virchows Arch， 2005， 446(5)：497-504.
11. 郭华，杨志浩，高剑波，等. 进展期胃癌淋巴结转移的螺旋CT 征象与病理学检查相对照 [J]. 中国医学影像技术， 2009，25(7)： 1211-1214．.
12. Deans C， Yeo MS， Soe MY， et al. Cancer of the gastric cardia is rising in incidence in an Asian population and is associated with adverse outcome [J]. World J Surg， 2011， 35(3)：617-624.
13. Epari K, Cade R. Oesophagectomy for tumours and dysplasia of the oesophagus and gastro-oesophageal junction [J]. ANZ J Surg， 2009， 79(4)：251-257.
14. Crumley AB， Stuart RC， Mckernan M， et al. Comparison of pre-treatment clinical prognostic factors in patients with gastrooesophageal cancer and proposal of a new staging system [J]. J Gastrointest Surg， 2010， 14(5)：781-787.
15. Shin SH， Jung H， Choi SH， et al. Clinical significance of splenic hilar lymph node metastasis in proximal gastric cancer [J]. Ann Surg Oncol， 2009， 16(5)：1304-1309.
16. Weitz J， Jaques DP， Brennan M， et al. Association of splenectomy with postoperative complications in patients with proximal gastric and gastroesophageal junction cancer [J]. Ann Surg Oncol，2004， 11(7)：682-689.
17. 彭俊生. 食管胃交界部腺癌术中脾门和脾动脉干淋巴结清扫与胰腺体尾脾脏能否保留 [J]. 中华胃肠外科杂志， 2010，13(9)： 642-643．.
18. Gertler R， Stein HJ， Loos M， et al. How to classify adenocarcinomas of the esophagogastric junction：as esophageal or gastric cancer [J]. Am J Surg pathol， 2011， 35(10)：1512-1522.
19. Ott K， Bader FG， Lordick F， et al. Surgical factors influence the outcome after Ivor-Lewis esophagectomy with intrathoracic anastomosis for adenocarcinoma of the esophagogastric junction：a consecutive series of 240 patients at an experienced center [J].Ann Surg Oncol， 2009， 16(4)：1017-1025.
20. Wayman J， Forman D， Griffin SM. Monitoring the changing pattern of esophago-gastric cancer：data from a UK regional cancer registry [J]. Cancer Causes Control， 2001， 12(10)：943-949.
21. 刘巍，宋丽楠，关丽云，等. 胸段食管癌及食管胃交界部癌根治术后患者生存质量影响因素的研究 [J]. 中国肿瘤临床，2009， 36(15)： 875-878．.
22. 催超，孙立波，舒振波，等. 进展期近端胃癌根治术联合脾脏切除术适应证的选择 [J]. 中国普外基础与临床杂志， 2010，17(1)：22-24．.
23. Siewert JR， Stein HJ， Feith M. Adenocarcinoma of the esophago-gastric junction [J]. Scand J Surg， 2006， 95(4)：260-269.
24. von Rahden BH， Stein HJ， Siewert JR. Surgical management of esophagogastric junction tumors [J]. World J Gastroenterol，2006， 12(41)：6608-6613.
25. 姜波健，吴巨钢，俞继卫，等. 胃癌淋巴管生成、淋巴管浸润及淋巴结微转移的临床意义 [J]. 中国普外基础与临床杂志，2008， 15(12)：903-909．.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Evaluation of Mutidetector Computer Tomography in Diagnosing TN Staging and Typing of Adenocarcinoma of Esophagogastric Junction

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