摘要
目的探讨CT检出淋巴结数目、大小与淋巴结转移的关系。方法对65例根治性手术切除的贲门癌螺旋CT检出淋巴结情况进行回顾性分析。利用PACS工作站进行图像阅读,将CT检出淋巴结数目及大小情况按照有无转移进行统计学比较,利用ROC曲线,分析应用CT检出淋巴结数目及大小指标诊断贲门癌淋巴结转移的敏感性和特异性。结果(1)转移组CT检出淋巴结数目平均为(14.20±7.72)枚,明显多于非转移组(6.86±3.37)枚。(2)No.1、3、7组淋巴结转移组与非转移组CT检出数目差异具有统计学意义。(3)ROC曲线分析,检出淋巴结总数8枚作为判断转移的最佳截割点,敏感性82.4%,特异性71.4%;No.1、3、7组共检出5枚淋巴结作为判断转移的最佳截割点,敏感性82.4%,特异性71.4%;CT检出最大淋巴结直径为12mm作为判断转移的最佳截割点,敏感性80.4%,特异性78.6%。(4)联合检出8枚淋巴结和最大淋巴结直径为12mm标准进行串联试验,敏感性72.5%,特异性92.9%。结论(1)淋巴结的总检出数与淋巴结转移有一定的相关性;(2)No.1、3、7组为贲门癌转移好发组,当三组检出总数>5枚时提示转移可能;(3)结合CT检出淋巴结数目、大小等相关影像学指标进行综合分析,有助于提高贲门癌淋巴结转移CT诊断的特异性。
Objective To discuss the relationship between metastases and size or number of lymph nodes （LNs） detected by CT through comparing with pathological results. Methods Helical CT was performed in 65 patients. Various groups were classified according to histopathologic results on N staging. Sensitivity and specificity were evaluated by means of receiver operator characteristic curve （ ROC ） to determine the diagnostic values of size and number. Results （ 1 ） The numbers of LNs detected by CT in each patients with and without LNs metastases were 14.20±7.72 and 6. 86±3.37 ,respectively, with a significant difference. （ 2 ） Differences of LNs＇ number among No. 1,3,7 stations between metastasis group and nonmetastasis one were significant. （3） The sensitivity and specificity were 82.4% and 71.4% ,82.4% and 71.4% ,80. 4% and 78. 6% respectively,according to ROC analysis,when criterions of 8 LNs detected in each patients, 5 total nodes detected in No. 1 ,3,7 stations in each patients,12mm of the largest LN detected in each patients was used to determine metastasis. （4）The sensitivity and specificity were 72. 5% and 92. 9% respectively,by combining the number and size indicators. Conclusion （ 1 ） There is a tightly correlation between number of LNs detected by CT and metastasis. （ 2 ） LNs metastases is strongly indicated when most nodes are presented in No. 1,3,7 stations. When 5 total nodes criteflon was used, the sensitivity and specificity were 82.4% and 71.4% respectively. （ 3 ） Combining the number and size indicators can increase specificity of diagnosing metastases.
出处
《中国实用外科杂志》
CSCD
北大核心
2007年第1期67-71,共5页
Chinese Journal of Practical Surgery
基金
北京市首都医学发展科研基金资助(编号:2003-3039)
关键词
责门癌
食管-胃结合部癌
淋巴结转移
N分期
计算机体层成像
Cardiac neoplasm
Esophagogastric junction carcinoma
Lymph node metastases
N stages
Computed tomography, CT
