ĐÁNH GIÁ GIÁ TRỊ CHẨN ĐOÁN GIAI ĐOẠN T VÀ N CỦA UNG THƯ THỰC QUẢN BẰNG CẮT LỚP VI TÍNH NGỰC - BỤNG TRƯỚC PHẪU THUẬT

Abstract

Objectives: To evaluate the diagnostic performance of preoperative chest-abdominal computed tomography (CT) for T and N staging in esophageal cancer patients with and without neoadjuvant chemoradiotherapy, using postoperative histopathology as the reference standard. Methods:A retrospective, descriptive study was conducted on 108 patients who underwent esophagectomy for esophageal cancer. CT findings were compared with histopathological results across two groups with and without neoadjuvant chemoradiotherapy. Results:In the group without neoadjuvant chemoradiotherapy, an esophageal wall thickness of ≥ 10mm predicted pT3 - pT4 with a sensitivity of 72%, specificity of 90%, positive predictive value of 72%, and negative predictive value of 90%. Esophageal lumen stenosis was significantly associated with pT3 - pT4 (p < 0.05). A lymph node size ≥ 10mm showed low sensitivity (33%) and was not significantly associated with pN(+). In the group with neoadjuvant chemoradiotherapy, the sensitivity and specificity of an esophageal wall thickness of ≥ 10mm decreased to 63% and 58%, respectively. Periesophageal fat invasion was significantly associated with pT3 - pT4 (p = 0.02). A lymph node size of ≥ 10mm showed limited sensitivity (50%) and no significant association. Conclusion: Preoperative chest-abdominal CT has high diagnostic value for T staging in patients without neoadjuvant chemoradiotherapy, but remains limited for N staging and in the neoadjuvant chemoradiotherapy group.