TAP检测联合增强CT对食管癌术前淋巴结转移评估的临床意义  

The Significance of TAP Detection Combined with Enhanced CT in the Preoperative Evaluation of Lymph Node Metastasis of Esophagus Cancer

作　　者：肖中岳[1] 轩青霞 袁小志 XIAO Zhong-yue;XUAN Qing-xia;YUAN Xiao-zhi(The First Affiliated Hospital,and College of Clinical Medicine of Henan University of Science and Technology,Luoyang,China,471003;The Department of Ultrasound,Luoyang Maternal and Child Health Hospital,Luoyang,China,471023)

机构地区：[1]河南科技大学临床医学院,河南科技大学第一附属医院,中国洛阳471003 [2]洛阳市妇幼保健院超声科,河南洛阳471023

出　　处：《食管疾病》2021年第2期102-105,共4页Journal of Esophageal Diseases

基　　金：河南省医学科技攻关计划联合共建项目(2018020297)。

摘　　要：目的探讨术前增强CT联合肿瘤异常蛋白(TAP)检测评估食管癌淋巴结转移的临床意义。方法回顾性分析53例术前胸部增强CT提示食管癌淋巴结转移(最大淋巴结短径≥10 mm)患者的临床资料,以术后病理结果为金标准,对食管癌的影响因素进行卡方检验和秩和检验等分析,并使用ROC曲线评价TAP检测联合增强CT的诊断效能。结果术前增强CT诊断淋巴结转移的食管癌患者中,假阳性率为37.74%(20/53)。增强CT观察最大淋巴结短径(P=0.002)及术前TAP水平(P=0.014)均为临床判定食管癌淋巴结转移的影响因素。ROC曲线分析显示:以TAP≥121μm 2为术前临床判断淋巴结转移的最佳标准,曲线下面积为0.751,敏感度60.61%,特异度80.00%,准确率66.03%,尤登指数0.41。结合术前增强CT及血清TAP水平进行筛选后,假阳性率降至9.43%(5/53)。结论血清TAP升高是食管癌淋巴结转移的危险因素,结合术前血清TAP检测可以明显降低增强CT对术前食管癌淋巴结转移评估的假阳性率。Objective To investigate the clinical significance of Tumor Abnormal Protein(TAP)detection combine with enhanced CT in the evaluation of lymph node metastasis of esophagus cancer patients.Methods Clinical and TAP detection data of 53 esophagus cancer patients with chest enhanced CT findings as maximum lymph node short diameter≥10 mm were analyzed retrospectively.Chi-square test and rank-sum test were performed to identify the risk factors of lymph node metastasis in esophagus cancer patients.The diagnostic efficacy of TAP detection combine with enhanced CT was evaluated by ROC curve analysis,and the postoperative pathological results were taken as the gold standards.Results The false positive rate of esophagus cancer patients diagnosed with chest enhanced CT findings lymph node metastasis before surgery was 37.74%(20/53).CT observation of the maximum lymph node short diameter(P=0.002)and preoperative TAP level(P=0.014)were identified as risk factors for clinical determination of lymph node metastasis of esophageal cancer.ROC curve analysis showed that Tap≥121μm 2 was the best standard for preoperative clinical diagnosis of lymph node metastasis,the area under the curve was 0.751,sensitivity 60.61%,specificity 80.00%,accuracy 66.03%,and Uden index 0.41.After screening with preoperative enhanced CT diagnosis and serum TAP level,the false positive rate of lymph node metastasis decreased to 9.43%(5/53).Conclusion Elevated serum TAP is a risk factor for definite diagnosis of lymph node metastasis in esophagus cancer patients.The combination of preoperative serum TAP test can significantly reduce the false positive rate of enhanced CT for preoperative evaluation of lymph node metastasis of esophagus cancer.

关 键 词：食管癌TAP 淋巴结转移 增强CT 

分 类 号：R735.1[医药卫生—肿瘤]