摘要
目的探讨淋巴结直径大小与转移的关系。方法分析经手术病理证实的45例胃癌全阴组与全阳组淋巴结的螺旋CT资料,并与病理进行对照研究。结果螺旋CT检出病理诊断为全阳组和全阴组的各组淋巴结共267个,其中阳性淋巴结有123个,阴性淋巴结有144个。直径1～5mm和5～10mm淋巴结转移率分别为17.4%和40%;10～15mm和15mm及以上淋巴结转移率分别为62.3%和100%。阳性淋巴结直径均数为10.9±7.1mm,阴性淋巴结直径均数7.1±2.3mm,两均数间的差异有统计学意义,如以淋巴结直径10mm为域值,则阳性淋巴结的敏感性为39.8%(49/123),阳性预测值为71%(49/69),阴性预测值为62.6%(124/198),特异性为86.1%(124/144)。结论单纯依据淋巴结直径(≥10mm)判断有无转移,无法同时保证诊断的敏感性和特异性。因此,不能只注重直径较大的淋巴结,更应重视小淋巴结转移的问题,这对于提高诊断的敏感性和特异性有重要意义。
Objective To study correlations between lymph nodes size and metastases of gastric cancer. Methods The SCT findings of lymph nodes in all metastasis-positive groups and all metastasis-negative groups in 45 patients with gastric cancer confu-med by surgical pathology were retrospectively analyzed, and compared with pathologic appearance. Results 267 lymph nodes in all pathology-proved metastasis-positive groups or metastasis-negative groups were detected by SCT, including 123 lymph nodes metastasis-positive and 144 lymph nodes metastasis-negative.-The metastatic rate of lymph nodes size from 1-5mm, 5-10mm, 10-15mm and I〉 15mm were 17.4%, 40%, 62.3% and 100% respectively. The mean diameter was 10.9±7.1mm in positive lymph nodes and 7.1±2.3mm in negative lymph nodes, and the difference was statistically significant（t=6.09, P〈0.01）. If the diameter of lymph nodes ≥ 10ram was used as the criterion to detect the positive lymph nodes, the sensitivity, positive predictive value, the negative predictive value and the specificity were 39.8%, 71%,62.6% and 86.1% respectively. Conclusion If only the diameter ≥ 10mm was used as a criterion to detect the lymphadenopathy, the accuracy and specificity were unsatisfied. We accordingly pay attention to the metastasis in small lymph nodes instead of only to the large lymph nodes, which were of great significance to improve the accuracy and specificity in diagnosis.
出处
《影像诊断与介入放射学》
2007年第6期267-270,共4页
Diagnostic Imaging & Interventional Radiology
关键词
胃癌
淋巴结转移
淋巴结直径
螺旋CT
Gastric cancer, Lymphadenopathy, Lymph nodes diameter, Spiral computed tomography
