现代肿瘤医学
現代腫瘤醫學
현대종류의학
JOURNAL OF MODERN ONCOLOGY
2014年
8期
1807-1810
,共4页
NSCLC%胸部 CT%淋巴结转移%淋巴结长径%病理类型
NSCLC%胸部 CT%淋巴結轉移%淋巴結長徑%病理類型
NSCLC%흉부 CT%림파결전이%림파결장경%병리류형
NSCLC%CT%lymph node metastasis%lymph node length%pathological type
目的：探讨非小细胞肺癌（NSCLC）纵隔淋巴结转移 CT 与病理的一致性，为靶区勾画提供依据。方法：选择2009年1月-2011年11月在大连医科大学附属第二医院胸外科住院并于我院行胸部 CT 检查的178例 NSCLC 病例，其中107例存在纵隔淋巴结异常。男性75例，女性32例。年龄42-80岁，中位年龄62岁。将 CT 显示的纵隔淋巴结按分区及大小记录，CT 显示异常淋巴结个数与病理阳性个数，计算淋巴结转移率，并观察真阳性、真阴性、假阳性、假阴性、敏感性、特异性、阳性预测值、阴性预测值及准确率。结果：全部病例淋巴结大小与转移的关系：长径﹤10mm 转移率17.6%，10-14mm 转移率31.7%，15-19mm 转移率58.8%，≥20mm 转移率93.9%。长径≥15mm 为阳性标准：假阳性21例，假阴性24例，CT 对纵隔淋巴结转移的敏感性57.9%，特异性58.0%，阳性预测值61.1%，阴性预测值54.7%，准确率57.9%。按分组标准判断：假阳性15例，假阴性23例，CT 对纵隔淋巴结转移的敏感性59.6%，特异性70.0%，阳性预测值69.4%，阴性预测值60.3%，准确率64.5%。结论：随着淋巴结长径的增大，淋巴结转移率逐渐升高。腺癌较鳞癌的淋巴结转移率高，且长径较小时转移率就较高。CT 异常淋巴结﹥2个较≤2个淋巴结转移率高，且长径较小时转移率就较高。
目的：探討非小細胞肺癌（NSCLC）縱隔淋巴結轉移 CT 與病理的一緻性，為靶區勾畫提供依據。方法：選擇2009年1月-2011年11月在大連醫科大學附屬第二醫院胸外科住院併于我院行胸部 CT 檢查的178例 NSCLC 病例，其中107例存在縱隔淋巴結異常。男性75例，女性32例。年齡42-80歲，中位年齡62歲。將 CT 顯示的縱隔淋巴結按分區及大小記錄，CT 顯示異常淋巴結箇數與病理暘性箇數，計算淋巴結轉移率，併觀察真暘性、真陰性、假暘性、假陰性、敏感性、特異性、暘性預測值、陰性預測值及準確率。結果：全部病例淋巴結大小與轉移的關繫：長徑﹤10mm 轉移率17.6%，10-14mm 轉移率31.7%，15-19mm 轉移率58.8%，≥20mm 轉移率93.9%。長徑≥15mm 為暘性標準：假暘性21例，假陰性24例，CT 對縱隔淋巴結轉移的敏感性57.9%，特異性58.0%，暘性預測值61.1%，陰性預測值54.7%，準確率57.9%。按分組標準判斷：假暘性15例，假陰性23例，CT 對縱隔淋巴結轉移的敏感性59.6%，特異性70.0%，暘性預測值69.4%，陰性預測值60.3%，準確率64.5%。結論：隨著淋巴結長徑的增大，淋巴結轉移率逐漸升高。腺癌較鱗癌的淋巴結轉移率高，且長徑較小時轉移率就較高。CT 異常淋巴結﹥2箇較≤2箇淋巴結轉移率高，且長徑較小時轉移率就較高。
목적：탐토비소세포폐암（NSCLC）종격림파결전이 CT 여병리적일치성，위파구구화제공의거。방법：선택2009년1월-2011년11월재대련의과대학부속제이의원흉외과주원병우아원행흉부 CT 검사적178례 NSCLC 병례，기중107례존재종격림파결이상。남성75례，녀성32례。년령42-80세，중위년령62세。장 CT 현시적종격림파결안분구급대소기록，CT 현시이상림파결개수여병리양성개수，계산림파결전이솔，병관찰진양성、진음성、가양성、가음성、민감성、특이성、양성예측치、음성예측치급준학솔。결과：전부병례림파결대소여전이적관계：장경﹤10mm 전이솔17.6%，10-14mm 전이솔31.7%，15-19mm 전이솔58.8%，≥20mm 전이솔93.9%。장경≥15mm 위양성표준：가양성21례，가음성24례，CT 대종격림파결전이적민감성57.9%，특이성58.0%，양성예측치61.1%，음성예측치54.7%，준학솔57.9%。안분조표준판단：가양성15례，가음성23례，CT 대종격림파결전이적민감성59.6%，특이성70.0%，양성예측치69.4%，음성예측치60.3%，준학솔64.5%。결론：수착림파결장경적증대，림파결전이솔축점승고。선암교린암적림파결전이솔고，차장경교소시전이솔취교고。CT 이상림파결﹥2개교≤2개림파결전이솔고，차장경교소시전이솔취교고。
To explore the consistency of CT and pathology in non - small cell lung cancer(NSCLC) mediastinal lymph node metastasis. Methods:Selected 178 NSCLC patients who received the surgical operation and CT scan before operation in thoracic surgeon department of the Second Affiliated Hospital of Dalian Medical University from 2009 to 2011. 107 of them showed the abnormal mediastinal lymph node. 75 males and 32 females. Age:42 - 80 years old,the median age 62 years old. Recorded the number of lymph node on CT and pathological positive number, then calculated the metastasis rate,and observed the true positive,true negative,false positive,false negative,sensitivi-ty,specificity,positive predictive value,negative predictive value,accuracy. Results:The relationship between lymph node size and metastasis rate:The metastasis rate was 17. 6% when length ﹤ 10mm,the metastasis rate was 31. 7%when length 10 - 14mm,the metastasis rate 58. 8% when length 15 - 19mm,the metastasis rate 93. 9% when length≥20 mm. Length≥15 mm was lymph node metastasis:false positive 21 cases,false negative 24 cases. Sensitiity was 57. 9% ,specificity 82. 6% ,positive predictive value 61. 1% ,negative predictive value 80. 6% ,accuracy 74. 7% . Ac-cording to the divided standard:False positive 15 cases,false negative 23 cases. Sensitivity 59. 6% ,specificity 87. 6% ,positive predictive value 69. 4% ,negative predictive value 82. 2% ,accuracy 78. 7% . Conclusion:Along with the increase of lymph node length,the metastasis rate is increasing gradually. The lymph node metastasis rate of adenocarcinoma is higher than squamous carcinoma,even when the lymph node length is small. The lymph node me-tastasis rate when CT ﹥ 2 abnormal lymph node is higher than ≤2 abnormal lymph node,even when the lymph node length is small.
