基于MSCT增强扫描的结肠癌肿瘤体积与淋巴结转移的相关性分析

Correlation analysis between tumor volume of colon cancer measured on CT enhancement scan and lymph node metastases

目的:应用MSCT腹部增强扫描,探讨结肠癌肿瘤体积与淋巴结转移的相关性。方法:回顾性收集74例结肠癌患者的临床、病理及CT增强扫描资料,测量结肠癌门静脉期肿瘤体积,分析有、无淋巴结转移患者间的临床、病理及肿瘤体积的差异,使用t检验分析不同N分期肿瘤体积的差异,通过绘制ROC曲线分析结肠癌肿瘤体积对N分期的诊断效能。结果:有、无淋巴结转移患者的年龄、性别、部位、T分期分布差异均无统计学意义(均P>0.05),肿瘤分化程度、肿瘤体积差异均有统计学意义(均P<0.05);肿瘤体积随N分期进展逐渐增大(r=0.342,P<0.01),Mann-Whitney U检验显示肿瘤体积在N_(0)与N_(1)期、N_(0)与N_(1)~2期、N_(0)~1与N_(2)期之间差异均有统计学意义(均P<0.05),N_(1)与N_(2)期之间差异无统计学意义(P>0.05)。在诊断结肠癌N分期ROC曲线中,肿瘤体积对区别N_(0)与N_(1)期、N_(0)与N_(1)~2期及N_(0)~1与N_(2)期的最高敏感度与特异度分别达69.60%、68.70%,AUC最高可达0.68。结论:基于MSCT腹部增强扫描的结肠癌肿瘤体积测量对术前预测淋巴结转移及N分期有一定帮助。

Objective:To explore the correlation between tumor volume of colon cancer and lymph node metastases by MSCT enhancement scan.Methods:The clinical data,pathologic findings and MSCT images of 74 with colon cancer were retrospectively identified.The tumor volume of colon cancer in venous phase was measured.The differences of the clinical data,pathologic findings and tumor volume were analyzed between lymph node metastases and non-metastases.T-test was used to analyze the differences of tumor volume in different N-stages,and the diagnostic efficiency of tumor volume to N staging was analyzed by ROC curve.Results:The comparison between lymph node metastases and non-metastases showed age,sex,location and T-stage had no statistical differences(all P>0.05),while the differentiation and volume of tumor had statistical differences(both P<0.05).Gross tumor volume increased with N staging(r=0.342;P<0.01).The Mann-Whitney U test showed that gross tumor volume was statistically different between N0 and N1,N0 and N1~2,N0~1 and N2 stage(all P<0.05),was not statistically different between N1 and N2 stage(P>0.05).ROC curve analysis illustrated that tumor volume had a highest sensitivity of 69.60%,a highest specificity of 68.70%,a largest AUC of 0.68 in distinguish different N stages.Conclusions:Gross tumor volume of colon cancer measured on MSCT enhancement scan has a capability in predicting lymph node metastases and distinguishing N-stages.