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目的探讨CT检出淋巴结数目、大小与淋巴结转移的关系。方法对65例根治性手术切除的贲门癌螺旋CT检出淋巴结情况进行回顾性分析。利用PACS工作站进行图像阅读,将CT检出淋巴结数目及大小情况按照有无转移进行统计学比较,利用ROC曲线,分析应用CT检出淋巴结数目及大小指标诊断贲门癌淋巴结转移的敏感性和特异性。结果(1)转移组CT检出淋巴结数目平均为(14.20±7.72)枚,明显多于非转移组(6.86±3.37)枚。(2)No.1、3、7组淋巴结转移组与非转移组CT检出数目差异具有统计学意义。(3)ROC曲线分析,检出淋巴结总数8枚作为判断转移的最佳截割点,敏感性82.4%,特异性71.4%;No.1、3、7组共检出5枚淋巴结作为判断转移的最佳截割点,敏感性82.4%,特异性71.4%;CT检出最大淋巴结直径为12mm作为判断转移的最佳截割点,敏感性80.4%,特异性78.6%。(4)联合检出8枚淋巴结和最大淋巴结直径为12mm标准进行串联试验,敏感性72.5%,特异性92.9%。结论(1)淋巴结的总检出数与淋巴结转移有一定的相关性;(2)No.1、3、7组为贲门癌转移好发组,当三组检出总数>5枚时提示转移可能;(3)结合CT检出淋巴结数目、大小等相关影像学指标进行综合分析,有助于提高贲门癌淋巴结转移CT诊断的特异性。
Objective To investigate the relationship between the number and size of lymph nodes and lymph node metastasis detected by CT. Methods 65 cases of radical resection of cardia cancer spiral CT examination of lymph nodes were retrospectively analyzed. Using PACS workstation for image reading, the number and size of lymph nodes detected by CT were statistically compared with those without metastasis, and the sensitivity and specificity of using ROC curve to analyze the number and size of lymph nodes detected by CT in diagnosis of lymph node metastasis of cardia cancer . Results (1) The average number of lymph nodes detected by CT in metastasis group was (14.20 ± 7.72), which was significantly higher than that in non-metastasis group (6.86 ± 3.37). (2) There was a significant difference in the number of CT detected in No.1, No.3 and 7 lymph node metastasis group and no metastasis group. (3) ROC curve analysis, the total number of detected lymph nodes 8 as the best cut point for judging metastasis, the sensitivity of 82.4% and specificity of 71.4%; No. 1, 3, 7 were detected in 5 lymph nodes as a judge transfer The sensitivity, specificity and specificity were 82.4% and 71.4%, respectively. The maximum lymph node diameter of 12 mm was the best cut-off point for CT. The sensitivity and specificity were 80.4% and 78.6% respectively. (4) The combined test of 8 lymph nodes and the maximum lymph node diameter of 12mm was performed in series, with sensitivity of 72.5% and specificity of 92.9%. Conclusions (1) The total number of lymph nodes and lymph node metastasis have a certain correlation; (2) No. 1, 3, 7 group for the cardia cancer metastasis of the hair group, when the three groups detected a total of more than 5 prompt transfer May; (3) combined with CT detection of lymph node number, size and other related imaging studies conducted a comprehensive analysis, help to improve the diagnosis of gastric cardia lymph node metastasis of specificity.