CAJ | 학술논문

目的观察胸部增强计算机断层显像(CT)联合血管内皮生长因子C(VEGF-C)的表达检测对肺门和(或)纵隔淋巴结转移的诊断价值.方法 2008年3月至2010年3月北京大学肿瘤医院胸外二科87例非小细胞肺癌(NSCLC)患者,术前行胸部增强CT扫描,并接受标准肺癌根治手术及系统性淋巴结清扫,术后病理检查为判断淋巴结是否转移金标准.术后采用免疫组化方法检测VEGF-C在癌组织中的表达.回顾性分析CT和VEGF-C对淋巴结转移的预测作用,并比较其灵敏度、特异度和准确性等.结果对淋巴结转移的诊断,CT的灵敏度为75.0％,特异度为59.6％,准确性66.7％.肺癌组织中VEGF-C的表达阳性率为78.2％ (68/87),其中强阳性占13.8％(12/87),其对淋巴结转移的诊断灵敏度为97.5％,特异度为38.3％,准确性为65.5％.当CT联合VEGF-C诊断时,其灵敏度为80.0％,特异度为70.2％,准确性为74.7％.结论 CT检查联合VEGF-C表达检测能提高NSCLC肺门及纵隔淋巴结转移诊断的特异性和准确性,优于CT或VEGF-C单独应用,提示应用CT扫描进行临床N分期时,如能同时对癌组织进行VEGF-C检测,可能会提高分期的准确性.
목적 관찰흉부증강계산궤단층현상(CT)연합혈관내피생장인자C(VEGF-C)적표체검측대폐문화(혹)종격림파결전이적진단개치.방법 2008년3월지2010년3월북경대학종류의원흉외이과87례비소세포폐암(NSCLC)환자,술전행흉부증강CT소묘,병접수표준폐암근치수술급계통성림파결청소,술후병리검사위판단림파결시부전이금표준.술후채용면역조화방법검측VEGF-C재암조직중적표체.회고성분석CT화VEGF-C대림파결전이적예측작용,병비교기령민도、특이도화준학성등.결과 대림파결전이적진단,CT적령민도위75.0％,특이도위59.6％,준학성66.7％.폐암조직중VEGF-C적표체양성솔위78.2％ (68/87),기중강양성점13.8％(12/87),기대림파결전이적진단령민도위97.5％,특이도위38.3％,준학성위65.5％.당CT연합VEGF-C진단시,기령민도위80.0％,특이도위70.2％,준학성위74.7％.결론 CT검사연합VEGF-C표체검측능제고NSCLC폐문급종격림파결전이진단적특이성화준학성,우우CT혹VEGF-C단독응용,제시응용CT소묘진행림상N분기시,여능동시대암조직진행VEGF-C검측,가능회제고분기적준학성.
Objective To explore the diagnostic value of preoperative enhanced computed tomography (CT) plus vascular endothelial growth factor C (VEGF-C) expression in hilar and mediastinal lymph nodes metastasis of non-small cell lung cancer.Methods A total of 87 patients with non-small cell lung cancer (NSCLC) received preoperative chest enhanced CT scans and underwent standard radical operation and systematic lymph node dissection.Pathologic examination was selected as the gold standard to determine lymph node metastasis.The immunohistochemical method was used to detect the expression of VEGF-C.The predicting values of chest enhanced CT,VEGF-C expression and their combination for the diagnosis of hilar and medastinal lymph nodes metastasis were evaluated through comparing the sensitivity,specificity and accuracy.Results The sensitivity of CT scan was 75.0％,specificity 59.6％ and accuracy 66.7％.The positive expression rate of VEGF-C was 78.2％ (68/87) and strong positive rate 13.8％ (12/87).The sensitivity of VEGF-C was 97.5％,specificity 38.3％ and accuracy 65.5％.The combination of CT and VEGF-C had a better accuracy (74.7％) and the sensitivity and specificity were 80.0％ and 70.2％ respectively.Conclusion Compared with CT scan or VEGF-C expression alone,the combination of CT and VEGF-C improves the specificity and accuracy of diagnosing lymph nodes metastasis in NSCLC.If this combination method is employed before therapy,the accuracy of clinical nodal staging may be enhanced.