CT检查食管癌不同区域淋巴结转移规律分析

目的探讨CT检查食管癌不同区域淋巴结转移规律。方法回顾性分析118例行根治性切除术的食管癌病例,术前行下颈区、纵隔、上腹部CT扫描,观察测量不同区域淋巴结的大小及个数,判断转移情况,术后与病理诊断对照分析。结果全组淋巴结总转移率为38.1%,纵隔和上腹部的淋巴结转移率较高,分别为36.7%和41.6%。术前CT检查食管癌不同区域淋巴结转移的灵敏度、特异度、阳性预测值、阴性预测值分别为下颈区75.0%、84.5%、27.2%、96.9%,纵隔63.0%、90.1%、65.3%、92.1%,上腹部70.0%、97.2%、70.0%、97.2%。结论术前CT检查下颈区、纵隔、上腹部能比较准确地反映食管癌淋巴结转移的分布规律,对下颈区淋巴结转移的灵敏度较高。

CT examination of lymph node metastasis in esophageal cancer in different regions

Objective To investigate the CT examination of lymph node metastasis in esophageal cancer in different regions.Methods A total of 118 patients undergoing radical resection of esophageal cancer were retrospectively analyzed.These patients received preoperative CT scan on ower neck area,mediastinum,and the upper abdomen.The size and number of lymph nodes in different regions were observed and measured to determine the condition of metastasis.All the results were compared with the postoperative histopathology.Results The whole group’s lymphatic metastasis rate was 38.1%.However,the rate was higher in mediastinal and upper abdominal region,and was 36.7% and 41.6%,respectively.The sensitivity,specificity,positive predictive value,and negative predictive value of the lymph node metastasis of esophageal cancer in different regions with preoperative CT were： lower neck area,75.0%,84.5%,27.2%,96.9%;mediastinum 63.0%,90.1%,65.3%,92.1%;upper abdomen 70.0%,97.2%,70.0%,97.2%,respectively.Conclusion Preoperative CT examination of the lower neck area,mediastinum,and upper abdomen can more accurately reflect the distribution of lymph node metastasis in esophageal carcinoma,especially in the lower neck area.