CT检测心膈角淋巴结对结直肠癌腹膜转移的诊断价值

Diagnosis of CT Detection of Cardiophrenic Angle Lymph Node in Peritoneal Metastasis of Colorectal Cancer

目的探讨CT检测心膈角淋巴结（CPALN）对结直肠癌腹膜转移的诊断价值,以指导临床选择治疗方案并判断预后。资料与方法回顾性分析经手术病理证实的320例结直肠癌患者的术前CT资料,评价CPALN与腹膜转移的关系和CT检测CPALN对腹膜转移的诊断效能。结果 320例结直肠癌患者中,86例（26.9%）腹膜转移,其中63例（73.3%）CT发现CPALN;234例（73.1%）无腹膜转移,其中156例（66.7%）CT未发现CPALN,差异有统计学意义（χ2=40.4,P〈0.01）;CT检测CPALN诊断腹膜转移的敏感度、特异度、相对危险度估计比值比分别为73.3%、66.7%、5.478（95%CI 3.16~9.49）。单因素和多因素Logistic回归分析显示,CPALN与结直肠癌腹膜转移关系密切（P〈0.05）。结论 CT检测CPALN对诊断结直肠癌腹膜转移有一定的帮助,对临床医师选择治疗方案并判断预后有重要意义。

Purpose To explore the value of CT detection of cardiophrenic angle lymph node （CPALN） for the diagnosis of peritoneal metastasis of colorectal cancer, and to guide clinical therapy and prognosis. Materials and Methods Preoperative CT image data of 320 patients with colorectal cancer confirmed pathologically were retrospectively analyzed, the relationship between CPALN and peritoneal metastasis was evaluated, and the efficacy of CT for the detection of CPALN in the diagnosis of peritoneal metastasis was estimated. Results In 320 cases of patients with colorectal cancer, 86 （26.9%） cases were found with PC, among them CPALN were present in 63 （73.3%） cases; 234 cases （73.1%） without peritoneal metastasis, 156 cases of them （66.7%） CPALN was not found in CT, the difference was statistically significant （x2=40.4, P〈0.01）. The sensitivity, specificity, relative risk ratio of CPALN detected with CT for diagnosis of PC was 73.3%, 66.7% and 5.478 （95% CI 3.16-9.49） respectively, CPALN and peritoneal metastasis was significantly correlated when analyzed by univariate and multivariate Logistic regression analysis （P〈0.05）. Conclusion CT detection of CPALN may be helpful for the diagnosis of PC in patients with CRC, and is significant for clinical treatment and prognosis.