Evaluation of Lymph Node Metastasis Features of Abdominal Esophageal Carcinomas and Cardiac Cancer by Multi-Detector Spiral CT_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

QI Rui , YU Jianqun , LI Xueming , HUANG Zixing.

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

Corresponding author：

Keywords：

Abdominal esophageal carcinoma; Cardiac cancer; Lymph node metastasis; Multidetector spiral CT

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ObjectiveTo explore the differences and similarities of the featurs of lymph node metatasis of abdominal esophageal carcinoma and cardiac cancer. MethodsPreoperative CT images of abdominal esophageal carcinomas and cardiac cancers were reviewed and analysed on lymph node size and preponderant distribution. ResultsShort diameter ≥10 mm of lymph node at CT was adopted as metastasis criterion. The detection rates of abdominal esophageal carcinomas and cardiac cancers were 73.5%（144/196） and 83.7% （170/203）, respectively. Thoracic lymph node metastasis rate of abdominal esophageal carcinomas was 11.1% （4/36） in 7 area, 27.8% （10/36） in 8 area, 8.3% （3/36） in 9 area, while celiac lymph node metastasis rate was 36.1% (13/36 ） in No.7 group, 19.4% （7/36） in No.1 group, and 11.1% （4/36） in No.2 group primarily. Lymph node metastasis rate of cardiac cancers was 17.9% （5/28） in No.1 group, 28.6% （8/28） in No.2 group, 39.3% （11/28 ） in No.3 group, and 25.0% （7/28） in No.4 group for the first stop lymph nodes, and 35.7% （10/28 ） in No.7 group for the second stop primarily. ConclusionAs metastasis criterion, short diameter ≥10 mm of lymph node at CT is feasible, but there exist certain falsepositive rate. Thoracic lymph node metastasis of abdominal esophageal carcinomas is mainly in the 7, 8, and 9 area, while celiac metastasis is mainly in No.7, No.1, and No.2 groups. Lymph node metastasis of cardiac cancers is in No.1, No.2, No.3, No.4, and No.7 group primarily.

Citation： QI Rui,YU Jianqun,LI Xueming,HUANG Zixing.. Evaluation of Lymph Node Metastasis Features of Abdominal Esophageal Carcinomas and Cardiac Cancer by Multi-Detector Spiral CT. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2011, 18(5): 555-559. doi: Copy

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13.	Stein HJ， Feith M， Siewert JR. Cancer of the esophagogastric junction [J]. Surgical Oncology， 2000, 9（1）: 3541.
14.	de Manzoni G, Morgagni P, Roviello F, et al. Nodal abdominal spread in adenocarcinoma of the cardia. Result of a multicenter prospective study [J]. Gastric Cancer， 1998， 1（2）: 146151.
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16.	崔燕海，张晓鹏，唐磊，等. 贲门癌CT检出淋巴结分布的影像学特点 [J]. 中国医学影像技术， 2007， 23（4）: 553557.
17.	朱正纲，草野满夫. 胃癌根治术中清扫腹主动脉旁淋巴结的研究现状及其临床意义 [J].中国肿瘤临床， 1997, 24（5）: 380387.
18.	de Manzoni G， Pedrazzani C， Di Leo A， et al. Metastases to the paraaortic lymph nodes in adenocarcinoma of the cardia [J]. Eur J Surg， 2001, 167（6）: 413418.
19.	所剑. 胃癌的淋巴结清扫及意义 [J]. 中国普外基础与临床杂志， 2010， 17（1）: 57.

1. 陈峻青. 胃癌、食管癌、大肠癌有关淋巴结的分组及其代号 [J]. 实用外科杂志， 1987， 7（2）: 100102.
2. 李媛，杨志刚. 纵隔淋巴结病变的断层影像表现特征及其解剖、病理学基础 [J]. 实用放射学杂志， 2007， 23（2）: 252255.
3. Udagawa H, Akiyama H. Surgical treatment of esophageal cancer Tokyo experience of the threefield technique [J]. Dis Esophagus, 2001, 14(7): 110114.
4. 伊斯坎达尔，张建庆，王海峰，等. 胸段食管癌淋巴结转移率及转移方向 [J]. 肿瘤防治研究， 2007, 34（2）: 143145.
5. 刘宝善. 消化器官肿瘤 [M]. 北京: 人民卫生出版社， 2004: 317.
6. 朱艳清，饶灵宁，韩文龙，等. 胃癌患者胃周淋巴结大小与转移及N分期的关系 [J].临床军医杂志， 2008， 36（1）: 5254.
7. Fukuya T, Honda H, Hayashi T, et al. Lymphnode metastasis: efficiency of detection with helical CT on patients with gastric cancer [J]. Radiology， 1995, 197（3）: 705711.
8. Herbella FA, Del Grande JC, Colleoni R, et al. Anatomical analysis of the mediastinal lymph nodes of normal brazilian subjects according to the classification of the japanese society for diseases of the esophagus [J]. Surg Today, 2003, 33(8): 249253.
9. Lerut T, Nafteux P, Moons J, et al. Threefield lymphadenectomy for carcinoma of the esophagus and gastroesophageal junction in 174 R0 resection impacton staging diseasefree survival and outcome [J]. Ann Surg, 2004, 240(6): 962972.
10. 纪勇，陈国强，黄斌，等. 胸段食管鳞癌淋巴结转移规律及淋巴结清扫方式探讨 [J]. 山东医药， 2010， 50（38）: 1617.
11. Tachimori Y, Kato H, Watanabe H, et al. Difference between carcinoma of the lower esophagus and the cardia [J]. World J Surg， 1996， 20（4）: 507511.
12. Ichikura T, Ogawa T, Kawabata T, et al. Is adenocarcinoma of the gastric cardia distinct entity independent of subcardial carcinoma [J]. World J Surg， 2003， 27（3）: 334338.
13. Stein HJ， Feith M， Siewert JR. Cancer of the esophagogastric junction [J]. Surgical Oncology， 2000, 9（1）: 3541.
14. de Manzoni G, Morgagni P, Roviello F, et al. Nodal abdominal spread in adenocarcinoma of the cardia. Result of a multicenter prospective study [J]. Gastric Cancer， 1998， 1（2）: 146151.
15. 李鉴，张汝刚，张大为，等. 贲门腺癌淋巴结转移及分站的COX模型多因素分析（附736例报告） [J]. 中华肿瘤杂志， 1998， 20（1）: 5456.
16. 崔燕海，张晓鹏，唐磊，等. 贲门癌CT检出淋巴结分布的影像学特点 [J]. 中国医学影像技术， 2007， 23（4）: 553557.
17. 朱正纲，草野满夫. 胃癌根治术中清扫腹主动脉旁淋巴结的研究现状及其临床意义 [J].中国肿瘤临床， 1997, 24（5）: 380387.
18. de Manzoni G， Pedrazzani C， Di Leo A， et al. Metastases to the paraaortic lymph nodes in adenocarcinoma of the cardia [J]. Eur J Surg， 2001, 167（6）: 413418.
19. 所剑. 胃癌的淋巴结清扫及意义 [J]. 中国普外基础与临床杂志， 2010， 17（1）: 57.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Evaluation of Lymph Node Metastasis Features of Abdominal Esophageal Carcinomas and Cardiac Cancer by Multi-Detector Spiral CT

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