计算机断层扫描用于检测早期食道状细胞癌中淋巴结转移的价值
Yunqing Zeng1, Yaping Liu1, Jinhou Li1,2
1Department of Gastroenterology, Qilu Hospital of Shandong University, Jinan, Shandong, China.
Annals of surgical oncology
|November 25, 2024
概括
计算机断层扫描 (CT) 可以在高特异性早期食道状细胞癌 (ESCC) 中检测到大约一半的淋巴结转移 (LNM). 建议进行常规的手术前CT,以评估这些患者的LNM风险.
科学领域:
- 在瘤学瘤学.
- 放射学 放射学是一门学科.
- 胃肠病学 胃肠病学
背景情况:
- 计算机断层扫描 (CT) 在早期食道状细胞癌 (ESCC) 中检测淋巴结转移 (LNM) 的作用受到争议.
- 精确的分期是指导ESCC治疗决策的关键.
研究的目的:
- 评估CT在早期ESCC中检测LNM的诊断性能.
- 确定在早期ESCC中对LNM评估进行例行手术前CT的必要性.
主要方法:
- 对625名早期ESCC患者 (粘膜或粘膜下) 的回顾性分析.
- 将原始CT报告与最终病理学报告进行比较,以评估CT对LNM的诊断准确性.
- 对CT检测LNM的灵敏度,特异性,精度,PPV和NPV的计算.
主要成果:
- 在T1 ESCC中检测LNM时,CT显示了41.0%的灵敏度和83.2%的特异性.
- 在粘膜癌 (T1a) 和膜癌 (T1b) 之间,诊断性能有所不同.
- 在没有淋巴血管侵袭 (LVI) 的LNM中,CT灵敏度较低 (33.3%),而在LVI患者中则较低 (58.3%).
结论:
- 在早期的ESCC中,CT可以以高特异性识别近一半的LNM病例.
- 在LVI病例中,CT性能有所改善.
- 常规的手术前CT被认为是必要的,以评估早期ESCC患者的LNM风险.
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