摘要
目的探讨食管癌患者术前增强多层螺旋CT(MSCT)显示淋巴结肿大对患者预后的意义及其影响。方法搜集单中心692例食管癌手术患者,分析患者术前和术后淋巴结转移情况,并分析术前MSCT扫描显示淋巴结肿大对患者预后的影响,应用SPSS 19.0统计软件进行统计学分析。结果全组患者淋巴结转移度为8.2%,淋巴结转移率为31.9%。与术后病理结果相比,本组患者术前MSCT诊断淋巴结转移的灵敏度、特异度、一致性、阳性预测值、阴性预测值和Youden指数分别为56.6%(125/221)、88.5%(417/471)、78.3%(542/692)、69.8%(125/179)、81.36%(417/513)和0.451(灵敏度+特异度-1)。且N分期与MSCT扫描显示淋巴结肿大具有显著相关性(r=0.480,P=0.000)。全组患者1、3、5年生存率分别为84.2%、56.2%和47.4%。MSCT扫描显示淋巴结肿大组(178例)和未显示淋巴结肿大组(514例)患者的1、3、5年生存率分别为77.4%、29.9%、22.0%和86.6%、65.2%、56.1%,差异有显著性(χ^(2)=66.276,P=0.000),COX多因素分析结果显示患者性别、T分期、N分期和MSCT显示淋巴结肿大情况为患者预后的独立性指标(P值均为0.000)。结论食管癌术前增强MSCT对患者的预后有一定的预测作用,也是患者的独立性预后影响因素,临床医师应对该类患者进行重视。
Objective To investigate the significance and effect of preoperative enhanced multi-slice CT(MSCT)showing lymphadenopathy on the prognosis of patients.Methods Data of692 post-operative esophageal cancer patients were collected at our center,to analyze the lymph node metastasis before and after surgery,and the effect of preoperative MSCT scan on the prognosis of patients with enlarged lymph nodes was analyzed.SPSS19.0 statistical software was used for statistical analysis.Results The degree of lymph node metastasis was 8.2%,and the rate of lymph node metastasis was 31.9%.Compared with postoperative pathological results,the sensitivity,specificity,consistency,positive predictive value,negative predictive value and Youden index of preoperative MSCT diagnosis of lymph node metastasis in this group of patients were 56.6%(125/221),88.5%(417/471),78.3%(542/692),69.8%(125/179),81.36%(417/513)and 0.451(sensitivity+specificity-1),respectively.Moreover,there was a significant correlation between N stage and lymph node enlargement as shown by MSCT scan(r=0.480,P=0.000).The 1-year,3-year and 5-year survival rates were 84.2%,56.2%and 47.4%,respectively.The 1-,3-,and 5-year survival rates of patients with lymphadenopathy(178 cases)and those without lymphadenopathy(514 cases)were 77.4%,29.9%,22.0%,and 86.6%,65.2%,and 56.1%,respectively and the difference is significant(χ^(2)=66.276,P=0.000).The results of COX multivariate analysis showed that the patient’s gender,T stage,N stage and MSCT showed that lymph node enlargement was an independent indicator of the patient’s prognosis(all P values were 0.000).Conclusion The enhanced MSCT scan of esophageal cancer before surgery has a certain predictive effect on the prognosis of patients,and it is a factor influencing the independent prognosis of patients.Clinicians should pay close attention to such patients.
作者
高红梅
池书平
沈文斌
时高峰
GAO Hongmei;CHI Shuping;SHEN Wenbin(Imaging Center,Shijiazhuang First Hospital,Shijiazhuang,Hebei Province 051000,P.R.China)
出处
《临床放射学杂志》
北大核心
2021年第2期248-251,共4页
Journal of Clinical Radiology
关键词
食管肿瘤/食管癌
手术治疗
术前淋巴结肿大
多螺旋CT检查
预后
Esophageal neoplasms/esophageal cancer
Surgical treatment
Preoperative lymphadenopathy
Multi-slice CT examination
Prognosis
