CAJ | 학술논문

目的：评价多层螺旋 CT(multi-slice computed tomography,MSCT)对胸段食管鳞癌各区域淋巴结转移的诊断效能并探讨其淋巴结转移的分布特征。方法回顾性分析190例行根治性切除术的胸段食管鳞癌患者的 CT 资料,观察 MSCT 所示颈部,上、中、下纵隔区及腹部淋巴结的大小及数目,判断其转移情况,并与术后病理进行对照。结果全组淋巴结转移率为44.7%,淋巴结转移度为10.7%。胸上、中、下段食管鳞癌淋巴结转移率分别为55.6%(15/27)、67.6%(73/108)和78.2%(43/55)。胸上、中、下段食管癌淋巴结转移率最高者分别为105组(14.8%)、108组(23.1%)、110组(36.4%)。术前 MSCT 诊断中纵隔淋巴结转移的敏感性、特异性、阳性预测值、阴性预测值、Youden 指数分别为69.4%、85.8%、35.6%、96.1%、0.552。结论胸段食管鳞癌最常见的转移部位为肿瘤相应部位食管旁淋巴结,术前 MSCT 增强扫描能准确地反映食管癌淋巴结转移的分布规律并能提高诊断率。
목적：평개다층라선 CT(multi-slice computed tomography,MSCT)대흉단식관린암각구역림파결전이적진단효능병탐토기림파결전이적분포특정。방법회고성분석190례행근치성절제술적흉단식관린암환자적 CT 자료,관찰 MSCT 소시경부,상、중、하종격구급복부림파결적대소급수목,판단기전이정황,병여술후병리진행대조。결과전조림파결전이솔위44.7%,림파결전이도위10.7%。흉상、중、하단식관린암림파결전이솔분별위55.6%(15/27)、67.6%(73/108)화78.2%(43/55)。흉상、중、하단식관암림파결전이솔최고자분별위105조(14.8%)、108조(23.1%)、110조(36.4%)。술전 MSCT 진단중종격림파결전이적민감성、특이성、양성예측치、음성예측치、Youden 지수분별위69.4%、85.8%、35.6%、96.1%、0.552。결론흉단식관린암최상견적전이부위위종류상응부위식관방림파결,술전 MSCT 증강소묘능준학지반영식관암림파결전이적분포규률병능제고진단솔。
Objective To evaluate the diagnostic performance of multi-slice computed tomography for lymph node metastasis in patients with thoracic esophageal carcinoma and to explore the distribution characteristics of lymph node metastases in patient with thoracic esophageal carcinoma.Methods Contrast-enhanced MSCT images of 1 90 consecutive patients with thoracic esophageal car-cinoma were retrospectively reviewed.All patients underwent radical resection.The lymph nodes’size and number in every regions were evaluated ,after postoperative pathology and CT results were reviewed and compared.Results The overall rate of lymph node metastasis was 44.7%,the degree of lymph node metastasis was 10.7%.The rates of lymph nodes metastasis for upper,middle, and lower thoracic esophageal carcinoma were 55.6%(1 5/27),67.6%(73/108)and 78.2%(43/55)respectively,the most commonly metastasized region was NO.105(14.8%),NO.108(23.1%)and NO.1 10 (36.4%).For middle mediastinal region the sensitivity, specificity,positive predictive values ,negative predictive values,and Youden’s index of preoperative MSCT scan were 69.4%,85.8%,35.6%, 96.1% and 0.552.Conclusion The most common region of lymph node metastasis for thoracic esophageal carcinoma is the region around the esophageal.Preoperative contrast-enhanced MSCT scan can accurately reveal the distribution of lymph node metastasis of thoracic esophageal carcinoma and improve diagnostic accuracy.