摘要
目的探讨研究非小细胞肺癌纵隔淋巴结转移的胸部CT影像体征及临床特征,以期提高非小细胞肺癌分期诊断与治疗的准确度。方法收集就诊治疗经病理确诊为非小细胞肺癌且术前CT影像资料完整的病例100例,术前患者经胸部CT扫描检查纵隔淋巴结转移情况,并与手术、病理结果进行比较,检测CT影像诊断非小细胞肺癌纵隔淋巴结转移的准确率。结果通过对100例患者的CT检查结果、手术结果与病理结果进行分析显示,其中CT显示为阳性的患者共62例,其中真阳性患者为47例,占75. 8%,假阳性为15例,占24. 2%; CT显示为阴性的患者共38例,其中真阴性患者为14例,占36. 8%,假阴性患者为24例,占63. 2%;对CT检查结果与手术及病理检查结果的灵敏度与特异度进行分析,结果显示,本实验中CT检查检测准确度为66. 2%,特异性为73. 7%。对CT检查结果与手术及病理检查结果进行一致性检验,二者的符合率为61%,Kappa指数为72. 4%。其中,上叶肺癌上纵隔淋巴结转移11. 0%(11/100例),下叶肺癌上纵隔淋巴结转移9. 0%(9/100),上叶肺癌下纵隔淋巴结转移6. 0%(6/100),下叶肺癌下纵隔淋巴结转移7. 0%(7/100)。对患者对CT检查结果的信任程度进行分析,其中72例患者表示信任,5例患者表示不信任,信任的患者占72%。结论 CT对非小细胞肺癌术前纵隔淋巴结状态进行评估,能够较为准确地判断淋巴结是否转移,为手术提供更好的参考,值得临床借鉴。
Objective To investigate CT image and clinical characteristics of non-small cell lung cancer(NSCLC)with mediastinal lymph node metastasis,in order to improve the accuracy of diagnostic classification and treatment for NSCLC.Methods A total of 100 patients with NSCLC who were diagnosed and treated in our hospital from 2014 to June 2017 were enrolled in the study.Before operation,the patients were examine by CT scanning to check mediastinal lymph node metastasis,and the examination results were compared with postoperative pathological examination results to evaluate the accuracy of CT image in diagnosis of NSCLC with mediastinal lymph node metastasis.Results The CT scanning results and postoperative pathological examination results showed that CT image was positive in 62 cases,in whom,true positive patients were 47 cases(75.8%),false positive patients were 15 cases(24.2%);CT image was negative in 38 cases,in whom,true negative patients were 14 cases(36.8%),false negative patients were 24 cases(63.2%).The accuracy and specificity of CT examination were 66.2%,73.7%,respectively,and the coincidence rate between CT results and postoperative pathological results 61%and the Kappa index was 72.4%,in which,superior lobe superior mediastinal lymph node metastasis accounted for 11.0%(11/100 cases),and inferior lobe superior lobe superior mediastinal lymph node metastasis accounted for 9.0%(9/100 cases),superior lobe inferior mediastinal lymph node metastasis accounted for 6.0%(6/100 cases),and inferior lobe inferior lobe superior mediastinal lymph node metastasis accounted for 7.0%(7/100 cases).The trust degree of patients for the the results of CT examination was analyzed,in whom,72 patients expressed trust,5 patients expressed distrust,and the patients who trusted the examination results accounted for 72%.Conclusion CT chest image can evaluste the mediastinal lymph node metastasis of patients with NSCLC before operation,which can accurately judge mediastinal lymph node metastasis so as to provide better clinical reference.
作者
张晓林
余建群
李春晴
吴雪健
郑体媛
苏理飞
ZHANG Xiaolin;YU Jianqun;LI Chunqing;WU Xuejian;ZHENHG Tiyuan;SU Lifei(Department of Radiology,West China Hospital of Sichuan University,Sichuang,Chengdu 610041,China)
出处
《河北医药》
CAS
2018年第21期3253-3256,共4页
Hebei Medical Journal
关键词
非小细胞肺癌
纵隔淋巴结转移
CT影像
non-small cell lung cancer
mediastinal lymph node metastasis
CT image
