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目的探讨彩色多普勒超声在宫颈癌盆、腹腔淋巴结转移诊断中的应用。方法随机选择接受广泛性子宫切除+盆腹腔淋巴结清扫术治疗的宫颈癌患者(临床分期IA2-IIB期)84例,术前经彩色多普勒超声检查盆腹腔腔内淋巴结情况,术后对切除的子宫及清扫淋巴结标本进行病理检查,最后与手术病理结果进行对照分析,以评估宫颈癌淋巴结转移的超声检查诊断价值。结果 84例宫颈癌患者中,有75例经彩色多普勒超声检查结果与手术病理相符,其中均为阳性者60例,均为阴性者15例,其检测的灵敏度为90.90%,特异性为83.33%,漏诊率为9.1%;误诊率为16.67%;Youden指数为0.7423。且检测盆腔转移淋巴结的灵敏度为84.93%,特异度为81.18%,均低于检测髂总动脉和/或腹主动脉旁淋巴结灵敏度94.11%及特异度100%。结论采用彩色多普勒超声检查可检测转移的淋巴结,对宫颈癌病情预后估计及治疗方案的选择有重要的应用价值。且对髂总动脉旁和/或腹主动脉旁转移淋巴结的检测更具灵敏度及特异度,需引起临床医师警惕和高度重视。
Objective To investigate the application of color Doppler ultrasound in the diagnosis of cervical cancer pelvic and abdominal lymph node. Methods Eighty-four patients with cervical cancer (clinical stage IA2-IIB) undergoing radical hysterectomy and pelvic lymph node dissection were randomly selected. The abdominal cavity lymph nodes were examined by color Doppler ultrasonography before operation, Of the uterus and lymph node specimens for pathological examination, and finally the results of surgical and pathological control analysis to assess the diagnostic value of cervical lymph node metastasis by ultrasonography. Results Among the 84 cases of cervical cancer, 75 cases were confirmed by color Doppler ultrasonography and pathology. Among them, 60 cases were positive and 15 cases were negative respectively. The detection sensitivity was 90.90% and the specificity was 83.33%, misdiagnosis rate was 9.1%; misdiagnosis rate was 16.67%; Youden index was 0.7423. The sensitivity of detecting pelvic lymph node metastasis was 84.93% and the specificity was 81.18%, which were lower than 94.11% and 100% specificity of detecting common iliac artery and / or para-aortic lymph nodes. Conclusions Color Doppler ultrasonography can detect metastatic lymph nodes and has important value in estimating the prognosis of cervical cancer and selecting treatment options. And to the common iliac artery and / or para-aortic lymph node metastasis more sensitive and specific detection, clinicians need to be vigilant and highly valued.