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胸中下段食管鳞癌隆突下淋巴结转移CT扫描特征与病理的一致性
引用本文:胡瑞,柳恩跃,张国庆,斯坎达尔·阿不力孜,庞作良,孙伟.胸中下段食管鳞癌隆突下淋巴结转移CT扫描特征与病理的一致性[J].肿瘤防治研究,2015,42(8):806-809.
作者姓名:胡瑞  柳恩跃  张国庆  斯坎达尔·阿不力孜  庞作良  孙伟
作者单位:830011 乌鲁木齐,新疆医科大学附属肿瘤医院胸外科(*:现单位:257000 东营,山东省东营市胜利油田中心医院胸外科)
摘    要:目的 分析胸中下段食管鳞癌隆突下淋巴结转移与CT影像学特征之间的相关性,为CT诊断提供依据。方法 选取2012—2014年间手术切除的174例胸中下段食管鳞癌患者,分析隆突下淋巴结转移与影像学CT扫描淋巴结特点的关系。结果 全组共清扫4 862枚淋巴结,平均每例清扫淋巴结(27.94±11.6)枚,转移淋巴结306枚,转移率57.47%(100/174),转移度为6.29%(306/4862)。其中,隆突下淋巴结转移率为17.24%(30/174),转移度为6.57%(44/670)。隆突下淋巴结转移与CT扫描淋巴结的短长径之比及淋巴结短径具有相关性(rs=-0.448, P<0.001; rs=0.378, P=0.002)。隆突下淋巴结转移的CT诊断与术后病理具有一致性(Kappa=0.628, P<0.001),一致率为89.66%,特异性为94.44%,敏感度为66.67%,误诊率为5.56%,漏诊率为33.33%,阳性预测值为71.43%,阴性预测值为93.15%。结论 (1)胸中下段食管鳞癌隆突下淋巴结转移与CT中淋巴结的短长径之比及淋巴结短径具有相关性;(2)术前CT扫描隆突下淋巴结转移与术后病理具有一致性。

关 键 词:胸中下段食管鳞癌  隆突下淋巴结  转移  CT  
收稿时间:2014-07-22

Consistency of Pathological and CT Scanning Characteristics of Subcarinal Lymph Node Metastasis from Middle and Lower Segment of Thoracic Esophageal Squamous Carcinoma
HU Rui,LIU Enyue,ZHANG Guoqing,Sikandaer·Abulizi,PANG Zuoliang,SUN Wei.Consistency of Pathological and CT Scanning Characteristics of Subcarinal Lymph Node Metastasis from Middle and Lower Segment of Thoracic Esophageal Squamous Carcinoma[J].Cancer Research on Prevention and Treatment,2015,42(8):806-809.
Authors:HU Rui  LIU Enyue  ZHANG Guoqing  Sikandaer·Abulizi  PANG Zuoliang  SUN Wei
Institution:Department of Thoracic Surgery, The Tumor Hospital Affiliated Xinjiang Medical University, Urumqi 830011, China (*: Present: Department of Thoracic Surgery, Shengli Oilfield Central Hospital, Dongying 257000, China)
Abstract:Objective To analyze the relationship between the subcarinal lymph node metastasis from middle and lower segment of thoracic esophageal squamous carcinoma and the CT imaging characteristics, to provide certain basis for CT diagnosis. Methods We selected 174 esophageal cancer patients who received operation from 2012 to 2014, and analyzed the relationship between the status and the characteristics of lymph nodes on CT imaging examination. Results There were 4862 lymph nodes cleaned. The average of lymph nodes was (27.94±11.6)/case. Lymph node metastasis number was 306, and transfer rate was 57.47% (100/174), and transfer degree was 6.29%(306/4862). Among them, subcarinal lymph node metastasis rate was 17.24% (30/174) and transfer degree was 6.57% (44/670). The ratio of short-length diameter was related with the shortest diameter in CT(rs=-0.448, P=0.009; rs=0.378, P=0.028). It has consistency between CT diagnosis and postoperatively pathological diagnosis of subcarinal lymph node metastasis (Kappa=0.628, P<0.001). The concordance rate was 89.66%, the specificity was 94.44%, the sensitivity was only 66.67%, the misdiagnosis rate was 5.56%, the rate of missed diagnosis was 33.33%, positive predictive value was 71.43%, and negative predictive value was 93.15%. Conclusion (1)It has relationship between subcarinal lymph node metastasis and the ratio of short-length diameter and the shortest diameter in CT. (2)It has consistency between CT diagnosis and postoperatively pathological diagnosis of subcarinal lymph node metastasis.
Keywords:Middle and lower segment of thoracic esophageal squamous carcinoma  Subcarinal lymph node  Metastasis  CT  
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