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目的分析胸中下段食管鳞癌隆突下淋巴结转移与CT影像学特征之间的相关性,为CT诊断提供依据。方法选取2012—2014年间手术切除的174例胸中下段食管鳞癌患者,分析隆突下淋巴结转移与影像学CT扫描淋巴结特点的关系。结果全组共清扫4 862枚淋巴结,平均每例清扫淋巴结(27.94±11.6)枚,转移淋巴结306枚,转移率57.47%(100/174),转移度为6.29%(306/4862)。其中,隆突下淋巴结转移率为17.24%(30/174),转移度为6.57%(44/670)。隆突下淋巴结转移与CT扫描淋巴结的短长径之比及淋巴结短径具有相关性(rs=-0.448,P<0.001;rs=0.378,P=0.002)。隆突下淋巴结转移的CT诊断与术后病理具有一致性(Kappa=0.628,P<0.001),一致率为89.66%,特异性为94.44%,敏感度为66.67%,误诊率为5.56%,漏诊率为33.33%,阳性预测值为71.43%,阴性预测值为93.15%。结论 (1)胸中下段食管鳞癌隆突下淋巴结转移与CT中淋巴结的短长径之比及淋巴结短径具有相关性;(2)术前CT扫描隆突下淋巴结转移与术后病理具有一致性。
Objective To analyze the correlation between lymph node metastasis and CT features of lower thoracic esophageal squamous cell carcinoma and provide the basis for CT diagnosis. Methods A total of 174 patients with lower thoracic esophageal squamous cell carcinoma who were surgically resected between 2012 and 2014 were selected to analyze the relationship between lymph node metastasis and features of CT lymphadenectomy. Results A total of 4 862 lymph nodes were dissected, with an average of 27.94 ± 11.6 per lymphatic nodes and 306 lymph node metastases. The rate of metastasis was 57.47% (100/174) and the rate of metastasis was 6.29% (306/4862). Among them, the lymph node metastasis rate was 17.24% (30/174) and the degree of metastasis was 6.57% (44/670). There was a correlation between lymph node metastasis and short-length CT scan diameter and lymph node short diameter (rs = -0.448, P <0.001; rs = 0.378, P = 0.002). The CT diagnosis of subcortical lymph node metastasis was consistent with postoperative pathology (Kappa = 0.628, P <0.001). The coincidence rate was 89.66%, the specificity was 94.44%, the sensitivity was 66.67%, the misdiagnosis rate was 5.56% The rate was 33.33%, positive predictive value was 71.43%, negative predictive value was 93.15%. Conclusions (1) There is a correlation between lymph node metastasis in lower thoracic esophageal squamous cell carcinoma and short-length lymph node and short-length lymph node in CT. (2) Preoperative lymph node metastasis under CT scan is consistent with postoperative pathology Sex.