Accuracy of computed tomography in nodal staging of colon cancer patients  

作　　者：Audrey H Choi Rebecca A Nelson Hans F Schoellhammer Won Cho Michelle Ko Amanda Arrington Christopher R Oxner Marwan Fakih Jimmie Wong Stephen M Sentovich Julio Garcia-Aguilar Joseph Kim 

机构地区：[1]Department of Surgery,City of Hope National Medical Center [2]Department of Biostatistics,City of Hope National Medical Center [3]Department of Medical Oncology,City of Hope National Medical Center [4]Department of Radiology,City of Hope National Medical Center

出　　处：《World Journal of Gastrointestinal Surgery》2015年第7期116-122,共7页世界胃肠外科杂志（英文版）（电子版）

摘　　要：AIM: To predict node-positive disease in colon cancer using computed tomography(CT).METHODS: American Joint Committee on Cancer stage Ⅰ-Ⅲ colon cancer patients who underwent curavtiveintent colectomy between 2007-2010 were identified at a single comprehensive cancer center. All patients had preoperative CT scans with original radiology reports from referring institutions. CT images underwent blinded secondary review by a surgeon and a dedicated abdominal radiologist at our institution to identify pericolonic lymph nodes(LNs). Comparison of outside CT reports to our independent imaging review was performed in order to highlight differences in detection in actual clinical practice. CT reviews were compared with final pathology. Results of the outside radiologist review, secondary radiologist review, and surgeon review were compared with the final pathologic exam to determine sensitivity, specificity, positive and negative predictive values, false positive and negative rates, and accuracy of each review. Exclusion criteria included evidenceof metastatic disease on CT, rectal or appendiceal involvement, or absence of accompanying imaging from referring institutions.RESULTS: From 2007 to 2010, 64 stageⅠ-Ⅲ colon cancer patients met the eligibility criteria of our study. The mean age of the cohort was 68 years, and 26(41%) patients were male and 38(59%) patients were female. On final pathology, 26 of 64(40.6%) patients had nodepositive(LN+) disease and 38 of 64(59.4%) patients had node-negative(LN-) disease. Outside radiologic review demonstrated sensitivity of 54%(14 of 26 patients) and specificity of 66%(25 of 38 patients) in predicting LN+ disease, whereas secondary radiologist review demonstrated 88%(23 of 26) sensitivity and 58%(22 of 38) specificity. On surgeon review, sensitivity was 69%(18 of 26) with 66% specificity(25 of 38). Secondary radiology review demonstrated the highest accuracy(70%) and the lowest false negative rate(12%), compared to the surgeon review at 67% accuracy and 31% false negative raAIM To predict node-positive disease in colon cancerusing computed tomography （CT）.METHODS： American Joint Committee on Cancer stageⅠ-Ⅲ colon cancer patients who underwent curavtiveintentcolectomy between 2007-2010 were identifiedat a single comprehensive cancer center. All patientshad preoperative CT scans with original radiologyreports from referring institutions. CT images underwentblinded secondary review by a surgeon and a dedicatedabdominal radiologist at our institution to identifypericolonic lymph nodes （LNs）. Comparison of outsideCT reports to our independent imaging review wasperformed in order to highlight differences in detection inactual clinical practice. CT reviews were compared withfinal pathology. Results of the outside radiologist review,secondary radiologist review, and surgeon review werecompared with the final pathologic exam to determinesensitivity, specificity, positive and negative predictivevalues, false positive and negative rates, and accuracyof each review. Exclusion criteria included evidence of metastatic disease on CT, rectal or appendicealinvolvement, or absence of accompanying imaging fromreferring institutions.RESULTS： From 2007 to 2010, 64 stageⅠ-Ⅲ coloncancer patients met the eligibility criteria of our study.The mean age of the cohort was 68 years, and 26 （41%）patients were male and 38 （59%） patients were female.On final pathology, 26 of 64 （40.6%） patients had nodepositive（LN＋） disease and 38 of 64 （59.4%） patientshad node-negative （LN-） disease. Outside radiologicreview demonstrated sensitivity of 54% （14 of 26patients） and specificity of 66% （25 of 38 patients） inpredicting LN＋ disease, whereas secondary radiologistreview demonstrated 88% （23 of 26） sensitivity and58% （22 of 38） specificity. On surgeon review, sensitivitywas 69% （18 of 26） with 66% specificity （25 of 38）.Secondary radiology review demonstrated the highestaccuracy （70%） and the lowest false negative rate （12%）,compared to the sur

关 键 词：COLON cancer LYMPH NODES Clinical STAGING COMPUTED tomography NEOADJUVANT therapy 

分 类 号：R735.35[医药卫生—肿瘤]