术前颈部淋巴结超声评估食管癌选择性三野清扫术的价值  

The Value of Preoperative Cervical Lymph Node Ultrasonography in Evaluating the Value of Selective Three-field Dissection for Esophageal Cancer

作　　者：左磊 梅新宇[1] 吴汉然 ZUO Lei;MEI Xin-yu;WU Han-ran(Department of Thoracic Surgery,Anhui Provincial Hospital Affiliated to Anhui Medical University,Hefei 230001,Anhui,China)

机构地区：[1]安徽医科大学附属安徽省立医院胸外科,安徽合肥230001

出　　处：《医学信息》2021年第14期87-91,共5页Journal of Medical Information

基　　金：吴阶平医学基金会临床科研专项资助基金项目(编号:320.2730.1899)。

摘　　要：目的探讨术前颈部淋巴结超声评估食管癌选择性三野淋巴结清扫术的价值。方法回顾性分析2018年1月~2019年9月我院收治的60例彩超发现颈部淋巴结的食管鳞癌手术患者临床资料,根据颈部淋巴结病理结果分为阳性组(n=28)和阴性组(n=32),比较两组一般资料及淋巴结彩超特征,并采用多因素Logistic回归分析颈部淋巴结转移的预测因素,ROC曲线分析彩超参数评估淋巴结的诊断效能。结果阳性组和阴性组肿瘤位置、右喉返神经旁淋巴结病理以及pN分期比较,差异有统计学意义(P<0.05),而两组年龄、性别、肿瘤浸润深度(T分期)以及分化程度(G分期)方面比较,差异无统计学意义(P>0.05);阳性组和阴性组淋巴结长径、淋巴结短径、LAR以及血流类型比较,差异有统计学意义(P<0.05),而两组的淋巴结回声类型、边界、皮质增厚、皮髓质分界、淋巴门结构比较,差异无统计学意义(P>0.05)。多因素Logistic回归分析显示,右喉返淋巴结病理和短径是颈部淋巴结转移的独立因子。ROC曲线分析显示,淋巴结短径的AUC为0.866,淋巴结长径的AUC为0.762,LAR的AUC为0.780,截断值中短径为6.5 mm,长径为11.5 mm,LAR为0.7;且以短径>6.5 mm诊断淋巴结转移的准确率最高,达到80%,其次为短径联合LAR,而短径联合LAR诊断的特异性最高。结论术前颈部淋巴结超声在食管癌选择性三野淋巴结清扫术中具有较好的评估效率,可作为食管癌三野清扫术前评估的常规检查。Objective To investigate the value of preoperative cervical lymph node ultrasound in the evaluation of selective three-field lymph node dissection for esophageal cancer.Methods A retrospective analysis of the clinical data of 60 patients with esophageal squamous cell carcinoma who had cervical lymph nodes detected by color Doppler ultrasound admitted to our hospital from January 2018 to September 2019.According to the pathological results of cervical lymph nodes,they were divided into positive group(n=28)and negative group(n=32).The general data and lymph node color ultrasound characteristics of the two groups were compared,and multivariate Logistic regression was used to analyze the predictive factors of cervical lymph node metastasis.ROC curve analysis color Doppler ultrasound parameters to evaluate the diagnostic efficacy of lymph nodes.Results There was a statistically significant difference in tumor location,right recurrent laryngeal nerve lymph node pathology,and pN staging comparison between the positive group and the negative group(P<0.05).There was no statistically significant difference between the two groups in terms of age,gender,depth of tumor invasion(T stage)and degree of differentiation(G stage)(P>0.05);There was a statistically significant difference between the long diameter of the lymph node,the short diameter of the lymph node,the LAR,and the blood flow type between the positive group and the negative group(P<0.05).There was no statistically significant difference between the two groups of lymph node echo types,borders,cortical thickening,cortical and medullary boundaries,and lymphatic hilum structure(P>0.05).Multivariate Logistic regression analysis showed that the pathology of the right recurrent laryngeal lymph node and short diameter were independent factor.ROC curve analysis showed that the AUC of the short diameter of the lymph node was 0.866,the AUC of the long diameter of the lymph node was 0.762,the AUC of the LAR was 0.780,the cut-off value was 6.5 mm for the short and medium diamete

关 键 词：食管鳞癌 颈部淋巴结 彩色多普勒超声 

分 类 号：R735.1[医药卫生—肿瘤]