摘要
目的分析卵巢癌腹膜后淋巴结转移的危险因素,并观察其MRI、CT影像特点。方法将资阳市第一人民医院自2014年1月至2018年5月收治的有明确手术病理诊断结果,且术前CT、MRI影像资料完整无缺失的89例原发性卵巢癌患者纳入研究范围,先行单因素分析,再筛选单因素分析有差异选项进一步Logistic回归分析卵巢癌腹膜后淋巴结转移的危险因素,同时观察MRI、CT影像特点。结果双侧卵巢癌患者腹膜后淋巴结转移率显著高于单侧(左侧或右侧),上皮性卵巢癌患者转移率显著高于非上皮性卵巢癌,低分化上皮性卵巢癌患者转移率显著高于高分化、中分化患者,临床分期Ⅳ期转移率>Ⅲ期>Ⅱ期>Ⅰ期,首次细胞减灭术后残留病灶直径>2cm患者转移率显著大于残余病灶直径≤2cm、0cm患者,术前有腹腔化疗的卵巢癌患者转移率显著高于无腹腔化疗患者,1期手术患者转移率显著高于2期,差异均有统计学意义(P<0.05);Logistic回归分析,临床分期、首次细胞减灭术后残留病灶直径是卵巢癌腹膜后淋巴结转移的危险因素(P<0.05);CT诊断卵巢癌腹膜后淋巴结转移的灵敏度为88.63%、特异度为97.26%、准确率为94.01%,阳性预测值95.12%、阴性预测值93.42%、kappa值0.870;MRI则为98.86%、99.326%、99.15%、98.86%、99.32%、0.981。结论临床分期、首次细胞减灭术后残留病灶直径是卵巢癌腹膜后淋巴结转移的危险因素,应引起临床重视,且CT、MRI均对腹膜后淋巴结转移均有一定显示,或可为卵巢癌患者治疗方案的制定提供影像学资料。
Objective To analyze the risk factors of retroperitoneal lymph node metastasis of ovarian cancer,to observe its images characteristics of MRI and CT.Methods 89 primary ovarian cancer patients with clear surgical pathological diagnosis results and preoperative complete CT and MRI images data in the hospital from January 2014 to May 2018 were enrolled in the study.Univariate analysis was performed firstly,Logistic regression analysis was used to analyze the different options screened by univariate analysis which were the risk factors of retroperitoneal lymph node metastasis in ovarian cancer,the image features of MRI and CT were observed.Results The rate of retroperitoneal lymph node metastasis was significantly higher in patients with bilateral ovarian cancer than that with unilateral ovarian cancer (left or right side).The metastatic rate of patients with epithelial ovarian cancer was significantly higher than that of patients with non-epithelial ovarian cancer.The metastatic rate of patients with poorly differentiated epithelial ovarian cancer was significant higher than that of patients with high and medium differentiation.Arranging the metastasis rate from high to low,the order was stage Ⅳ,Ⅲ stage,Ⅱ stage and Ⅰ stage,the metastasis rate in patients with the residual lesions diameter greater than 2cm after first cytoreductive surgery was significantly greater than that in patients with residual lesions diameter less than or equaling to 2cm and 0cm.The metastasis rate in ovarian cancer patients with intraperitoneal chemotherapy was significantly higher than that in patients without intraperitoneal chemotherapy.The metastasis rate of patients with stage 1 surgery was significantly higher than that in patients with stage 2 (P<0.05).Logistic regression analysis showed that clinical stage,the diameter of residual lesions after cytoreductive surgery were the risk factors for retroperitoneal lymph node metastasis of ovarian cancer (P<0.05).The sensitivity,specificity,accuracy,positive predictive value,negative predictive value and the kappa value for the diagnosis of retroperitoneal lymph node metastasis of ovarian cancer with CT were 88.63%,97.26%,94.01%,95.12%,93.42% and 0.870,respectively,the above 6 indexes with MRI were 98.86%,99.326%,99.15%,98.86%,99.32%,and 0.981,respectively.Conclusion The clinical stage,the diameter of residual lesions after first cytoreductive surgery are the risk factors for retroperitoneal lymph node metastasis of ovarian cancer,which should be paid attention to clinically.Both CT and MRI have certain indications for retroperitoneal lymph node metastasis,which may provide imaging data for the development of therapeutic regimens of ovarian cancer patients.
作者
付信飞
马青松
黎俊
FU Xin-fei;Ma Qing-song;LI Jun(Department of Medical Imaging,First People's Hospital,Ziyang 641300,Sichuan Province,China)
出处
《中国CT和MRI杂志》
2020年第9期134-138,共5页
Chinese Journal of CT and MRI
