目的探讨64层螺旋CT评判腹部 段贲门癌与食管癌淋巴结转移的临床价 值。方法 选取2010年4月至2013年5月期 间我院收治的66例腹段食管癌与贲门癌患 者的临床资料，CT资料及术后病理结果进 行回顾性分析，并在术后进行为期三年 的随访。结果 64层螺旋CT共检出SD(直 径)≥10mm胸腹腔淋巴结202枚，病理检 查证实SD≥10mm胸腹腔淋巴结160枚，准 确率为79.21%；而对SD<10mm的淋巴结， 64层螺旋CT检查准确率为16.78%，卡方 检验结果表明CT对SD≥10mm和SD<10mm淋 巴结的检出准确率差异显著(X2 =102.34， p<0.01)。食管癌胸腔淋巴结转移率显著 高于贲门癌(X2 =7.78，P<0.01)；贲门癌 的腹腔淋巴结转移率较食管癌高，差异有 统计学意义(X2 =4.15，P<0.05)；淋巴结 转移数目在1-4之间的患者在随访第3年时 的生存率为45.6%，而淋巴结转移数目大 于4的患者在随访第三年时已全部死亡。 结论 64层螺旋CT能够在术前较为准确的 评判患者的淋巴结转移情况，为临床治疗 方案的制定提供参考。同时能够帮助医生 判断患者的预后情况，可以在临床上推广 应用。

Objective To explore the clinical value of 64-slices spiral CTin detecting abdominal lymph node metastasis of esophageal carcinoma and abdominal cardiac carcinoma. Methods Preoperative CT images, clinical data and pathological result of abdominal esophageal carcinomas and cardiac cancers patients（66 cases） in our hospital from April 2010 to May 2011 were reviewed and analysed retrospectively, and three years of Postoperative follow-up was implemented. Results 202 abdominal cavity lymph nodes (SD≥10mm) were detected by 64-slice spiral CT, and the accuracy rate is 79.21% where as the accuracy rate is 16.78% for the abdominal cavity lymph nodes(SD<10mm). The result of chi-square shows the difference between them is significant（X2 =102.34, p<0.01. Thoracic esophageal cancer lymph node metastasis rate was significantly higher than that of abdominal cardiac carcinoma(X2 =7.78, P<0.01), abdominal lymph node metastasis rate of cardiac carcinoma was significantly higher than esophageal cancer (X2 =4.15, P<0.05). Survival rate at the first 3 years of follow-up was 45.6% for the patient whose metastasis lymph node number was between 1 and 4. And Survival rate at the first 3 years of follow-up was 0% for the patient whose the number of lymph node metastases is more than 4. Conclusion 64-slice spiral CT can accurately judge lymph node metastasis in patients, and provide a reference for the development of clinical programs. At the same time, it also can helps to determine the prognosis and could be applicated in clinical.