Diagnostic value of endoscopic ultrasonography and CT in T, N stage of preoperative esophageal cancer

Abstract

To evaluate the preoperative endoscopic ultrasonography (EUS) and CT in the diagnosis of TN stage of esophageal cancer. Fifty-one hospitalized patients with esophageal cancer in our center from July 2002 to January 2004 were enrolled in this study. According to UICC (1997) TNM clinical stage, the TN stage results of esophageal cancer by EUS and CT examination of above 51 cases were compared with the postoperative pathological TN stage. (1)The accuracy rates of T and N stage by EUS were 82.4%(42/51) and 88.0%(45/51) respectively. The accuracy rates of T and N stage by CT were 52.9%(27/51) and 51.0%(26/51) respectively. The accuracy rates of T and N stage by combination of EUS and CT were 86.3%(44/51) and 90.0%(46/51). (2)The consistent condition among EUS, CT or combination of EUS and CT with pathology: The Kappa of EUS to T and N stage were 0.700(P<0.001) and 0.763(P<0.001). The Kappa of CT to T and N stage were 0.275(P=0.002) and 0.006(P=0.964). The Kappa of EUS+CT to T and N stage were 0.769(P<0.001) and 0.801(P<0.001). (3)Significant differences were found between EUS and CT:PT=0.001(chi(2)=10.079) and PN<0.001(chi(2)=16.730). No significant difference was found between EUS+CT and EUS. EUS can be used as important and main preoperative examination because of presenting high accuracy rate in the diagnosis of T and N stage of esophageal cancer. EUS+CT does not improve accuracy rate significantly in TN stage diagnosis of esophageal cancer.