多层螺旋CT显像对结直肠癌术后再分期、区域淋巴结转移及疗效的评估价值  

Value of Multi-slice Spiral CT Imaging for Postoperative Re-staging,Regional Lymph Node Metastasis and Efficacy Evaluation of Colorectal Cancer

作　　者：王振 高星 王金勇 WANG Zhen;GAO Xing;WANG Jinyong(Hebi People's Hospital,Hebi,458030)

机构地区：[1]河南省鹤壁市人民医院,458030

出　　处：《实用癌症杂志》2022年第7期1125-1127,1139,共4页The Practical Journal of Cancer

基　　金：河南省科技攻关项目(编号:LHGJ20191221)。

摘　　要：目的研究多层螺旋CT显像对结直肠癌术后再分期、区域淋巴结转移及疗效的评估价值。方法选取行多层螺旋CT检查的结直肠癌术后患者65例,收集患者入院时及术后CT检查资料,对比术后再分期变化,观察区域淋巴结转移情况。随访2年,对比术后CT阳性和阴性患者的无进展生存时间(PFS)。结果多层螺旋CT对术前Ⅰ/Ⅱ期的再分期改变率为9.26%(5/54),术前Ⅲ期的再分期改变率为36.4%(4/11);对升结肠的再分期改变率为14.3%(1/7),对乙状结肠的再分期改变率为14.3%(4/28),对直肠的再分期改变率为12.0%(3/25),对直乙交界的再分期改变率为20.0%(1/5)。CT对结直肠癌N分期的符合率为76.9%(50/65),Kappa值为0.79,对N期诊断的灵敏度、特异度和准确度分别为84.62%、71.79%和84.62%。CT诊断结直肠癌M分期的符合率为89.2%(58/65),Kappa值为0.75,对M期诊断的灵敏度、特异度和准确度分别为89.13%、89.47%和89.23%。随访2年,CT诊断为阳性的患者中位PFS显著短于阴性患者(16.5月vs 20.6月,P<0.05)。结论CT在结直肠癌术后再分期、区域淋巴结转移及疗效评估中具有重要价值。Objective To study the value of multi-slice spiral CT imaging for postoperative re-staging,regional lymph node metastasis and efficacy evaluation of colorectal cancer.Methods 65 patients with postoperative colorectal cancer underwent multi-slice spiral CT examination were enrolled.Collect the CT examination data at admitted and postoperated,and compare the changes of postoperative re-staging,and observed the regional lymph node metastasis.Compare the progression-free survival(PFS)of patients with positive and negative postoperative CT scans during 2 years follow-up.Results The restaging rate of multi-slice spiral CT for preoperative stageⅠ/Ⅱwas 9.26%(5/54),for stageⅢwas 36.4%(4/11);The restaging rate for ascending colon was 2.0%(1/7),for sigmoid colon was 14.3%(4/28),for rectum was 12.0%(3/25),and for straight B junction was 20.0%(1/5).The coincidence rate of CT for N stage of colorectal cancer was 76.9%(50/65),the Kappa value was 0.79,and the sensitivity,specificity and accuracy for N stage diagnosis were 84.62%,71.79%and 84.62%,respectively.The coincidence rate of CT in the diagnosis of colorectal cancer M staging was 89.2%(58/65),the Kappa value was 0.75,and the sensitivity,specificity and accuracy of diagnosis for M stage were 89.13%,89.47%and 89.23%,respectively.After 2 years of follow-up,the median PFS with positive CT diagnosis was significantly shorter than that of negative patients(16.5 months vs 20.6 months,P<0.05).Conclusion CT has an important value in postoperative re-staging,regional lymph node metastasis and efficacy evaluation of colorectal cancer after surgery.

关 键 词：CT 结直肠癌 再分期 区域淋巴结转移 疗效评估 

分 类 号：R735.3[医药卫生—肿瘤]