增强CT检测淋巴结形态预测肝癌区域淋巴结转移的作用分析

Value of Lymph Node Morphology Delineated on Contrast-Enhanced Scan in Predicting Regional Lymph Node Metastasis of Hepatocellular Carcinoma

目的:探究增强计算机断层扫描(Computed tomography,CT)淋巴结形态对肝癌区域淋巴结转移的预测价值.方法:选取2020年3月-2022年6月于我院诊治的86例肝癌患者作为研究对象.术前均未行新辅助放化疗,均接受增强CT扫描.以病理结果作为诊断淋巴结转移的金标准,将患者分为转移组和未转移组.分析增强CT的形态学标准与传统标准对淋巴结转移诊断价值,并采用受试者工作特征曲线(Receiver operating characteristic curve,ROC)评估两种标准与金标准一致性.结果:86例肝癌患者,淋巴结转移组有38例;未转移有48例.增强CT淋巴结形态敏感度、特异度、准确率及阳性预测值、阴性预测值均高于传统标准.形态学标准与金标准诊断淋巴结转移一致性良好(Kappa值=0.764).结论:增强CT淋巴结形态对肝癌区域淋巴结转移的敏感度、特异度、准确率、阳性预测值、阴性预测值较传统标准更高,与金标准具有良好一致性.

Objective:To evaluate the value of lymph node morphology delineated on contrast-enhanced computed tomography(CT)scan in predicting regional lymph node metastasis of hepatocellular carcinoma.Methods:Eighty-six patients with hepatocellular carcinoma in our hospital from March 2020 to June 2022 were selected.None underwent neoadjuvant chemoradiotherapy before surgery,and all were subjected to the contrast-enhanced scans.Using pathological findings as the gold standard,patients were divided into metastasis group and non-metastasis group.The diagnostic value of the morphological criteria of contrast-enhanced CT scans versus traditional criteria for lymph node metastasis was evaluated,and the consistency between two criteria and gold standard was assessed using receiver operating characteristic curve(ROC).Results:Among the 86 patients with hepatocellular carcinoma,there were 38 cases with lymph node metastasis and 48 cases without metastasis.The sensitivity,specificity,accuracy and positive predictive value and negative predictive value of morphological criteria on contrast-enhanced CT scans were higher than those of traditional criteria.Morphological criteria revealed good consistency with the gold standard for diagnosing lymph node metastasis(Kappa=0.764).Conclusion:The lymph node morphology delineated on contrast-enhanced scan yields good sensitivity,specificity,accuracy,positive predictive value,and negative predictive value for regional lymph node metastasis of hepatocellular carcinoma,and are all higher than those of traditional standards,which shows good consistency with the gold standard.