[Comparison of mini-probe endoscopic ultrasonography with computed tomography in preoperative staging of esophageal cancer].

OBJECTIVE: To compare mini-probe endoscopic ultrasonography (MCUS) with computed tomography (CT) in preoperative T and N staging of esophageal cancer, and to find out the MCUS parameters to judge lymph node metastasis for esophageal cancer. METHODS: Thirty-five patients received both MCUS and CT preoperatively, on both of which the T and N stages were determined. The accuracy, sensitivity, specificity, positive predicting value and negative predicting value were compared with the postoperative pathological results. RESULTS: The accuracy of MCUS was 85.7% in T staging and 85.7% and 80.0% in N staging by the two different methods, which were 45.7% and 74.3%, respectively, by CT. CONCLUSION: MCUS is better than CT in preoperative staging for esophageal cancer. The ratio of short to long axis (S/L) combined with short axis is a useful way to determine lymph node metastasis.

[Characteristics and risk factors of lymph node metastases in esophageal carcinoma].

OBJECTIVE: To investigate the status of lymph node metastases (LNM) of esophageal carcinoma and to identify the risk factors. METHODS: Clinical data of 308 patients who underwent esophagectomy with three-field lymphadenectomy during January 2006 and December 2010 were reviewed. Characteristics of LNM were studied. RESULTS: The average number of dissected lymph nodes was 35.6 ± 14.5 in 308 patients. There were 197 patients(64%) had LNM. Logistic regression analysis showed that lymphatic vessel invasion(P=0.019) and deep tumor invasion(P<0.001) were risk factors of LNM. The highest LNM site was paratracheal node(25.0%). The incidence of cervical LNM was 14.1% in the middle thoracic carcinoma, higher than that of upper thoracic (7.3%) and lower thoracic (8.3%). Rate of LNM was lower in upper thoracic carcinomas than that in middle or lower ones(P=0.001). No significant difference of LNM was found among upper, middle and lower thoracic carcinoma for cervical or thoracic nodes. Lymphatic vessel invasion(P<0.001) and metastases in paratracheal lymph nodes (P=0.014) were risk factors for cervical LNM. CONCLUSIONS: LNM of esophageal carcinoma can be found in both directions vertically and skipped metastasis. Paratracheal lymph nodes involvement is an indicator for cervical lymphadenectomy in thoracic esophageal carcinoma.