淋巴管造影在前列腺癌盆腔淋巴结转移的表现及临床价值  

The signs and diagnostic value of lymphangiography in nodalmetastases of prostate cancer

作　　者：顾文权[1] 黄海栋[1] 王彬[1] 杜玉清[1] 

机构地区：[1]上海市浦东新区浦南医院放射科,上海200125

出　　处：《中医学报》2014年第B07期274-275,共2页Acta Chinese Medicine

基　　金：上海市浦东新区卫生系统重点学科群项目（编号：PWZxkq2011-02）

摘　　要：目的探讨前列腺癌盆腔淋巴结转移淋巴管造影的表现,评价淋巴管造影在诊断前列腺癌盆腔淋巴结转移的价值.方法：前列腺癌患者60例, 行足背淋巴管造影了解有无盆腔淋巴转移, 造影结果与细针穿剌抽吸或淋巴结活检病理结果比较. 结果：转移淋巴结癌转移阳性10例：淋巴结破坏5例,表现为部分或完全性破坏;淋巴结肿大4例,表现为淋巴结横径〉1.5cm;淋巴结完全不显影伴周围淋巴管阻塞、淋巴管中断、扩张、侧枝循环形成,24h后淋巴管内仍有造影剂储留1例;其中9例经细针穿剌抽吸细胞学检查、病理切片证实;4例可疑患者,经细针穿刺抽吸细胞学检查和前列腺癌根治术后病理证实无淋巴结转移;46例阴性者中, 经细针穿刺抽吸细胞学检查和病理证实假阴性4例. 结论：淋巴管造影对前列腺癌淋巴结转移有很高的诊断价值, 对可疑淋巴结细针穿剌抽吸细胞学检查可避免假阳性.ObjectiveTo investigate the signs of lymphangiography in nodal metastases of prostate cancer,evaluate the diagnostic value of on pelvic nodal metastases of prostatecancer. Methods：sixty cases of prostate cancer underwent instep lymphangiography to find out if there were pelvic nodal metastases.The results of lymphangiography were comparedwith the pathologic results of fine needle aspiration biopsy of lymph nodes. Results：In 4 suspicious cases no lymph node metastasis was found cytologically and pathologically,in 10cases testing positive for nodal metastases 9 were identified by cytology of fine needle aspiration biopsy and pathology： 5 cases lymph node destruction demonstrate poorly defined areaof incomplete filling node,4 cases lymph node enlarged depicts the transverse diameter larger than 1.5cm,1 cases lymph node depicts lymphatic channel disorders includingincompetence, obstruction, collateralization, chylous reflux and constrast medium store after 24h.while 46 cases with negative results,4 were false negative. Conclusions：Thelymphangiography plays an important role in diagnosis of nodal metastases of prostate cancer.Fine needle aspiration for suspected lymph nodes can minimize false positive result,nevertheless there is still false negative result in lymphangiography.

关 键 词：前列腺肿瘤 癌 淋巴管造影 

分 类 号：R737.25[医药卫生—肿瘤]