彩色多普勒超声对宫颈癌盆腔淋巴结转移的诊断价值

Value of Color Doppler Ultrasound in the Diagnosis of Pelvic Lymph Nodes Metastases in Patients with Carcinoma of Cervix

目的探讨彩色多普勒超声在检测宫颈癌盆腔淋巴结转移中的超声表现及诊断价值。方法选取81例宫颈癌患者为研究对象,采用仪器为GE-Logic7型彩色超声显像仪,扫查范围包括整个盆腔,检测淋巴结的数目、大小、边缘及内部回声情况。以淋巴结病理学检查结果为金标准,判断超声诊断的准确性。结果 81例患者中经腹超声检查结果与病理结果相符者73例,其中均为阳性者61例,假阳者3例,均为阴性者12例,假阴性者5例,检测灵敏度为92.4%,特异性为80.0%,阳性预测值为95.3%,阴性预测值为70.6%,检测准确率为90.1%。经腹超声检查盆腔淋巴结转移结果与病理结果相符者68例,其中均为阳性者59例,假阳者3例,均为阴性者9例,假阴性者10例,检测灵敏度为85.5%,特异性为75.0%,阳性预测值为95.2%,阴性预测值为47.4%,检测准确率为84.0%。经腹超声检查髂总和/或腹主动脉旁淋巴结转移与病理结果相符者18例,其中均为阳性者15例,假阳者1例,均为阴性者3例,假阴性者2例,检测灵敏度为88.2%,特异性为75.0%,阳性预测值为93.8%,阴性预测值为60.0%,检测准确率为85.7%。结论采用多普勒彩超对宫颈癌盆腔淋巴结转移情况进行诊断具有检查方便、无创伤、重复性好、价格低廉且准确率较高等优点,在宫颈癌临床手术方案的制定以及预后评估中具有重要临床意义。

Objective To observe the diagnosis value of color Doppler ultrasound in the metastases of pelvic lymph nodes in patients with carcinoma of cervix. Methods 81 patients with carcinoma of cervix treated were selected. Based on GE-Logic7 color ultrasound imaging device,the factors like number,size,edge of lymph nodes and internal echo in the pelvic cavity were detected. According to the golden standard of pathological examination on the lymph nodes,the diagnosis accuracy was estimated. Results There were 73 cases that the test results based on transabdominal ultrasound was consistent with pathological examination including 61 positive cases,3 false positive cases,12 negative cases and 5 false negative cases; the detection sensitivity was 92. 4%; the specificity was 80. 0%; the positive predictive value was 95. 3%; the negative predictive value was 70. 6%; the detection accuracy rate was 90. 1%. There were 68 cases that the test results of pelvic lymph node metastasis based on transabdominal ultrasound was consistent with pathological examination including 59 positive cases,3 false positive cases,9 negative cases and 10 false negative cases; the detection sensitivity was 85. 5%; the specificity was 75. 0%; the positive predictive value was95. 2%; the negative predictive value was 47. 4%; the detection accuracy rate was 84. 0%. There were 18 cases that the test results of lymph node metastasis of iliac artery / aorta abdominalis based on transabdominal ultrasound was consistent with pathological examination including 15 positive cases,1 false positive cases,3 negative cases and 2 false negative cases; the detection sensitivity was 88. 2%; the specificity was 75. 0%; the positive predictive value was 93. 8%; the negative predictive value was60. 0%; the detection accuracy rate was 85. 7%. Conclusion For patients with carcinoma of cervix,the color Doppler ultrasound in the diagnosis of metastases of pelvic lymph nodes is easy to operate without trauma,good repeatability,low price,and higher accuracy,etc. It has an important clinical meaning in the establishment of clinical operation in carcinoma of cervix and prognosis evaluation.