摘要
目的分析食管神经内分泌癌的CT影像学表现,探讨食管神经内分泌癌(NECs)和鳞状细胞癌(SCCs)的CT鉴别特征。方法收集我院经病理及免疫组化证实的22例食管神经内分泌癌,作为对照组采用1:1匹配抽样纳入22例食管鳞癌;回顾性分析两种肿瘤的临床资料和CT影像学特征。采用单变量和多变量的统计分析方法评估CT表现的各种分类和连续性变量;连续性变量的CT特征采用ROC曲线分析,最终确定转移性淋巴结大小的最佳界限值。用Kappa检验分类变量两观察者一致性;用ICC检验连续性变量两观察者一致性。结果食管神经内分泌癌与鳞癌在临床症状(吞咽困难)、瘤周食管内壁界面形态、增强模式、淋巴结转移、转移淋巴结大小、肝转移瘤增强模式等方面,差异具有统计学意义(P<0.05)。两种肿瘤的淋巴结大小的最佳界值为2.05cm。结论CT对鉴别食管神经内分泌癌与鳞癌有一定的作用,为临床治疗方式的选择及预后分析提供了一定依据。
Objective To analyze the CT findings of esophageal neuroendocrine carcinoma and to evaluate the differential CT features of esophageal neuroendocrine carcinoma(NECs)from squamous cell carcinoma(SCCs).Methods 22 patients with esophageal NECs confirmed by pathology and immunohistochemistry in our hospital were collected.As the control group,22 patients with esophageal SCCs were included by 1:1 matched sampling.The clinical data and CT imaging features of the two tumors were analyzed retrospectively.Univariate and multivariate statistical analyses were used to evaluate the classification and continuity of CT findings.Continuous variables were analyzed by receiver operating characteristic(ROC),and the optimal boundary value of metastatic lymph node size was finally determined.Kappa was used to test the consistency between the two observers of the categorical variables.The intraclass correlation coefficient(ICC)was used to test the consistency of continuity variables between two observers.Results There were statistically significant differences between esophageal SCCs and NECs in clinical symptoms(with or without dysphagia),the morphology of the air interface in the inner wall of the esophagus,enhancement mode,lymph node metastasis,the size of metastatic lymph nodes,and enhancement pattern of the hepatic metastatic tumor(P<0.05).The optimal threshold for lymph node size in both tumors was 2.05 cm.Conclusion CT plays role in the differentiation of esophageal NECs from SCCs,and provides a strong basis for the selection of clinical treatment methods and prognosis analysis.
作者
韩言秀
刘庆伟
张洁
杨林
陈心怡
黄召勤
HAN Yanxiu;LIU Qingwei;ZHANG Jie;YANG Lin;CHEN Xinyi;HUANG Zhaoqin(Department of Medical Imaging,Shandong Provincial Hospital Affiliated to Shandong First Medical University,Jinan 250021,P.R.China;Department of Radiology,Affiliated Hospital of Shandong University of Tradition Chinese Medicine,Jinan 250014,P.R.China)
出处
《医学影像学杂志》
2020年第1期73-78,86,共7页
Journal of Medical Imaging
关键词
食管
神经内分泌癌
鳞状细胞癌
体层摄影术
X线计算机
Esophagus
Neuroendocrine carcinoma
Squamous cell carcinoma
Tomography
X-ray computed
