CT及MRI诊断早期结肠癌淋巴结转移研究

Diagnosis of lymph node metastasis in early colorectal cancer with computed tomography and magnetic resonance imaging

目的探讨CT及MRI诊断早期结肠癌淋巴结转移的价值。方法分析120例经病理确诊的早期结肠癌患者的肿瘤部位、浸润深度和淋巴结转移,对比患者术前CT及MRI检查与术后病理诊断结果。结果术后病理检查结果表明20例患者发生淋巴结转移,肿瘤均已浸润至黏膜下层。利用CT或MRI共检测到43例患者的淋巴结,其中病理诊断淋巴结转移的患者14例,病理诊断无淋巴结转移的患者29例。病理诊断淋巴结转移的患者其淋巴结利用CT及MRI检查的检出率和淋巴结短径明显大于无淋巴结转移的患者(P<0.05)。对所检出淋巴结的短径进行ROC曲线分析表明,4.1 mm可以作为CT或MRI诊断早期结肠癌淋巴结转移的最小短径评价标准,其敏感性为76.6%,特异性为78%。结论 CT或MRI诊断早期结肠癌淋巴结转移具有一定价值,4.1 mm可以作为CT或MRI诊断的最小短径标准。

Objective To explore the value of CT and MRI in the diagnosis of lymph node metastasis in early stage of colorectal cancer.Methods The tumor site,infiltration depth and lymph node metastasis in 120 patients with early stage of colon cancer were analyzed.Preoperative CT or MRI examinations and postoperative pathological diagnosis results were compared.Results The postoperative pathological examination showed that 20 patients with early stage of colon cancer had lymph node metastasis and tumor cells had infiltrated into the submucosal layer.CT or MRI detected the lymph nodes in 43 patients in which 14 patients were confirmed by pathological examination while 29 patients had no lymph node metastasis.The detection rate and short diameter of lymph node detected by CT or MRI in patients who were diagnosed as lymph node metastasis were significantly higher than that in patients without metastasis（ P 〈0. 05）.ROC curve analysis showed that 4. 1 mm can be used as a cut-off value for CT or MRI diagnosis of lymph node metastasis with76. 6% sensitivity and 78% specificity.Conclusion CT or MRI has a certain value in the diagnosis of lymph node metastasis in early stage of colorectal cancer.The 4. 1 mm short diameter of lymph nodes can be used as a cut-off value in the diagnosis.