喉癌的CT分期(附91例CT一病理对照分析)

目的探讨CT对喉癌术前分期的准确性.材料与方法91例经手术切除的喉癌,用CT观察肿瘤的侵犯范围、有无喉软骨受侵及颈部淋巴结转移;按双盲法根据CT征象进行分期并与手术病理结果对照分析.结果CT术前肿瘤(T)分期的准确性为84%,诊断颈部淋巴结转移及喉软骨受侵的敏感性、特异性、准确性分别是80%、94%、91%和70%、96%、93%,判断肿瘤侵犯周围结构的准确性在87%～100%之间.结论CT能很好地显示肿瘤的侵犯范围及有无颈部淋巴结转移,对喉癌的术前分期有较高的准确性,失误的主要原因包括不能显示轻微的甲状软骨破坏、不易诊断正常大小的颈部淋巴结转移.

CT Staging of Laryngeal Carcinoma(CT-pathologic Correlative Study of 91 Cases)

purpose: To evaluate the CT diagnostic accuracy in preoperative staging of the laryngeal carcinoma. Materials and methods: 91 patients with laryngeal carcinoma were confirmed by surgery. On CT scan, the tumor extension, laryngeal cartilage destruction and metastatic lymph nodes were investigated. The tumor staging with CT-pathologic correlative study were performed by using double-blind methods. Results: The accuracy of the preoperative staging (T) was 84%, the sensitivity, specificity and accuracy for characterizing metastatic lymph nodes and laryngeal cartilage destruction were 80%, 94 %, 91% and 70%, 96%, 93 % respectively, and the accuracy for detecting surrounding structure invasions of tumors were ranged from 87 % to 100 %. Conclusion: CT can reliably exhibit the extension of the tumors and detect metastatic lymph nodes, and is useful in praperative staging of laryngeal carcinoma, but it has some limitations for showing slightly destruction of laryngeal cartilage and metastatic lymph nodes with normal size.