胃引流区淋巴结短径值与胃癌转移相关性探讨

目的:探讨胃引流区淋巴结短径值大小与胃癌转移的相关性。方法:回顾性分析经手术病理证实并行切除及淋巴结清扫术的38例胃癌的MSCT资料,测量胃周淋巴结短径径值,并与术后病理进行对照研究。结果:38例中,经MSCT于23组胃引流区检出淋巴结共217个,其中阳性淋巴结105个(阳性率48.4%),阴性淋巴结112个;阳性组淋巴结的短径均数为(9.7±6.2)mm,阴性组淋巴结短径均数为(6.0±2.1)mm,两均数间差异有统计学意义(P<0.01)。阳性淋巴结按短径径值大小分为4组,短径1～5mm组阳性率为20.8%(5/24),6～9mm组阳性率为42.5%(54/127),10～15mm组阳性率为61.2%(30/49),15mm以上组阳性率为94.1%(16/17),后3组间差异有统计学意义(P<0.05)。以短径值>5mm为评估阈值,敏感性为95.2%(100/105),特异性为16.1%(18/112);以短径值>10mm为评估阈值,敏感性为43.8%(46/105),特异性为81.2%(91/112)。结论:随着胃引流区淋巴结短径的增大,发生淋巴结转移的可能性增加,但以某一径值作为评估转移阈值,无法同时保证诊断敏感性与特异性,故MSCT评估胃癌淋巴转移不能单纯依靠径值。

Correlation between the short diameters of gastric draining lymph nodes measured by MSCT and gastric cancer metastasis

Objective： To investigate the correlation between the short diameters of gastric draining lymph nodes and gastric cancer metastasis. Methods： 38 cases of gastric cancer were retrospectively analyzed, which were confirmed by operation, lymph nodes resection and pathology. Measured the short diameter of lymph nodes around stomach and compared with patholo- gy after operation. Results： There were 217 lymph nodes in 23 groups of gastric draining examined by MSCT among 38 cases. There were 105 positive lymph nodes with positive rate of 48.40/00. 112 negative lymph nodes. The mean short diameter was （9.7 ± 6.2）mm in positive lymph nodes and （6.0± 2.1 ）mm in negative lymph nodes, and the difference was statistically significant （ P 〈0.01）. Positive lymph nodes were divided into 4 groups according the short diameter. Positive rate was 20.8% （5/ 24）, 42.5%（54/127）, 61.2%（30/49）, 94.1% （16/17） in groups of short diameter 1-5 mm, 6-9 mm, 10-15 mm and more than 15 mm, retrospectively, with significant difference among the latter 3 groups. When evaluate threshold was drawn up according the short diameter more than 5mm, the sensitivity was 95.2% （100/105）, specificity was 16.1% （18/112）. While, when evaluate threshold was drawn up according the short diameter more than 10 mm, the sensitivity became 43.8% （46/ 105）, specificity became 81.3% （91/112）. Conclusion： With the increase of gastric draining lymph node short diameter, the possibility of gastric cancer metastasis increases. It can＇t ensure diagnose sensitivity and specificity at the same time. So we can＇t evaluate gastric cancer lymph metastasis only according the diameter of lymph node by MSCT.