摘要
目的探讨术前多层螺旋CT(MSCT)对非小细胞肺癌(NSCLC)分期和纵隔淋巴结转移(MLNM)的诊断价值。方法回顾性分析2022年03月-2024年04月收治的90例NSCLC患者的临床资料,术前均接受MSCT扫描,以病理学检查为金标准,比较术前MSCT扫描和病理活检对NSCLC患者T分期、N分期的诊断结果,比较术前MSCT扫描和病理检查对NSCLC患者MLNM的诊断结果,并分析术前MSCT对NSCLC分期和MLNM情况的准确率。结果术前MSCT扫描对T分期诊断总准确率为85.56%(77/90),对T_(1)~T_(4)分期诊断准确率分别为91.11%(83/90)、92.22%(83/90)、83.33%(75/90)、90.00%(81/90),敏感性分别为71.43%、78.95%、78.12%、84.00%,特异性分别为96.05%、95.77%、86.21%、92.31%,与病理检查诊断一致性较好(Kappa=0.792,P<0.001);术前MSCT诊断N分期总准确率为84.44%(76/90),对N0~N2诊断准确率分别为93.33%(84/90)、87.78%(79/90)、87.78%(79/90),敏感性分别为84.85%(28/33)、82.14%(23/28)、79.31%(25/29),特异性分别为98.24%(56/57)、90.32%(56/62)、85.25%(52/61),与病理检查的一致性检验结果较好(Kappa=0.746,P<0.001);术前MSCT诊断MLNM的总准确率为84.44%(77/90),对肿瘤转移和未转移诊断的敏感性为85.96%(49/57),特异性为84.85%(28/33),与病理检查的一致性检验结果较好(Kappa=0.684,P<0.001)。结论术前MSCT对NSCLC分期和MLNM具有一定的诊断价值,对手术方式的选择和纵隔淋巴结清扫具有指导意义。
Objective To evaluate the diagnostic value of preoperative multi-slice spiral CT(MSCT)in the staging of non-small cell lung cancer(NSCLC)and mediastinal lymph node metastasis(MLNM).Methods Clinical data of 90 patients with NSCLC from March 2022 to April 2024 were retrospectively analyzed.All patients received MSCT scan before surgery,and pathological examination was used as the gold standard to compare the diagnostic results of T stage and N stage of NSCLC patients by MSCT scan and pathological biopsy before surgery.The diagnostic results of MLNM in NSCLC patients were compared between preoperative MSCT scanning and pathological examination,and the accuracy rate of preoperative MSCT in NSCLC staging and MLNM was analyzed.Results The total diagnostic accuracy of preoperative MSCT scanning for T staging was 85.56%(77/90),and the diagnostic accuracy of T_(1)~T_(4) staging was 91.11%(83/90),92.22%(83/90),83.33%(75/90),90.00%(81/90),respectively.The sensitivity was 71.43%,78.95%,78.12%,84.00%,and the specificity was 96.05%,95.77%,86.21%,92.31%,respectively,which was consistent with pathological examination(Kappa=0.792,P<0.001).The total accuracy rate of N stage diagnosis by MSCT was 84.44%(76/90),and the diagnostic accuracy of N0-N2 was 93.33%(84/90),87.78%(79/90),87.78%(79/90),respectively.The sensitivity was 84.85%(28/33),82.14%(23/28),79.31%(25/29),the specificity was 98.24%(56/57),90.32%(56/62),85.25%(52/61),respectively.The consistency test results with pathological examination were good(Kappa=0.746,P<0.001).The total accuracy of preoperative MSCT diagnosis of MLNM was 84.44%(77/90),the sensitivity of the diagnosis of metastasis and non-metastasis was 85.96%(49/57),the specificity was 84.85%(28/33),and the consistency test results with pathological examination were good(Kappa=0.684,P<0.001).Conclusions Preoperative MSCT has certain diagnostic value for NSCLC staging and MLNM,and has guiding significance for the selection of surgical methods and mediastinal lymph node dissection.
作者
崔君
于明欣
韩欣平
王砚亮
CUI Jun;YU Mingxin;HAN Xinping(Department of Radiology,The Fifth People′s Hospital of Luoyang,Luoyang 471000,China)
出处
《航空航天医学杂志》
2024年第12期1409-1411,共3页
Journal of Aerospace medicine
基金
河南省医学科技攻关计划项目(LHGJ20210865)。
