摘要
目的探讨增强CT测量结肠癌肿瘤大小与脉管癌栓(LVI)的相关性。方法回顾性分析手术后经病理组织学和免疫组化检查确诊为结肠癌患者75例。根据术后病理结果将结肠癌分为LVI阳性组(19例)及LVI阴性组(56例)。所有患者术前均行增强CT检查。在增强CT影像上采用4种方法测量肿瘤大小,包括肿瘤长度(Tlen)、肿瘤最大直径(Tdia)、肿瘤最大面积(Tare)及肿瘤体积(Tvol)。将测量参数进行组内相关系数(ICC)一致性检验。比较2组患者临床特征和肿瘤大小的差异,并分析与LVI的相关性。运用受试者工作特征(ROC)曲线下面积(AUC)分析4种测量方法预测LVI阳性的临床价值。结果 4种方法测量的肿瘤大小均具有很好的一致性及可重复性(ICC>0.90)。Tlen(rs=0.392)、Tdia(rs=0.355)、Tare(rs=0.406)、Tvol(rs=0.500)、肿瘤位置(rs=0.407)、肿瘤分化程度(rs=0.291)、T分期(rs=0.303)、N分期(rs=0.328)与LVI发生均有相关性。Tlen(AUC=0.760,95%CI:0.635~0.885)、Tdia(AUC=0.735,95%CI:0.611~0.859)、Tare(AUC=0.770,95%CI:0.637~0.902)、Tvol(AUC=0.832,95%CI:0.726~0.937)均对LVI阳性有一定诊断价值,其中以Tvol诊断效能最佳,阈值为40.200 cm3,敏感度68.4%,特异度83.9%,准确度81.3%。结论Tlen、Tdia、Tare及Tvol 4种肿瘤大小测量方法均能有效评估结肠癌脉管癌栓侵犯情况,其中Tvol的相关性及诊断效能最好。
Objective To investigate the correlation between tumor size and lymphovascular invasion(LVI)detected by enhanced computed tomography(CT)image in patients with colon cancer.Methods The retrospective study consisted of 75 patients diagnosed colon cancer by postoperation histopathological and immunohistochemical testing in our hospital.According to the postoperative pathology,patients with colon cancer were divided into the LVI positive group(n=19)and the LVI negative group(n=56).All patients underwent enhanced CT examination,and the tumor size could be measured on CT images.Tumor size was measured by four methods,including tumor length(Tlen),tumor maximum diameter(Tdia),tumor maximum cross-sectional area(Tare)and tumor volume(Tvol)on enhanced CT.The measured parameters were checked by intraclass correlation coefficient(ICC).The clinical characteristics of the patients and tumor size were compared between the two groups to analyze the relationship with LVI.Receiver operating characteristic curve(ROC)was used to analyze the diagnostic efficiency of four measurement methods to predict positive LVI.Results The tumor size measured by the four methods showed good consistency and repeatability(ICC>0.90).The degree of tumor differentiation(rs=0.291),T stage(rs=0.303),N stage(rs=0.328),tumor location(rs=0407),Tlen(rs=0.392),Tdia(rs=0.355),Tare(rs=0.406)and Tvol(rs=0.500)were correlated with the occurrence of LVI.Tlen(AUC=0.760,95%CI:0.635-0.885),Tdia(AUC=0.735,95%CI:0.611-0.859),Tare(AUC=0.770,95%CI:0.637-0.902),Tvol(AUC=0.832,95%CI:0.726-0.937)showed a certain diagnostic value for positive LVI.Tvol showed the best diagnostic performance with a threshold of 40.200 cm3,a sensitivity of 68.4%,a specificity of 83.9%and an accuracy of 81.3%.Conclusion Four tumor measurement methods Tlen,Tdia,Tare and Tvol can effectively evaluate lymphovascular invasion in colon cancer,Among them,Tvol has the best correlation and diagnostic efficacy.
作者
牟安娜
蒲红
印隆林
张天悦
李杭
MOU An-na;PU Hong;YIN Long-lin;ZHANG Tian-yue;LI Hang(Department of Radiology,Sichuan Academy of Medical Sciences and Sichuan Provincial People’s Hospital,Chengdu 610072,China)
出处
《天津医药》
CAS
北大核心
2020年第12期1214-1218,共5页
Tianjin Medical Journal
基金
四川省科技计划项目(2019YFS0437)。
关键词
结直肠肿瘤
腺癌
体层摄影术
螺旋计算机
脉管癌栓
增强CT
肿瘤大小
colorectal neoplasms
adenocarcinoma
tomography,spiral computed
lymphovascular invasion
enhanced CT
tumor size
