增强CT测量淋巴结短径联合淋巴细胞比值在宫颈癌淋巴结转移中的评估分析  

Evaluation and analysis of short diameter of lymph nodes measured by enhanced CT combined with neutrophil to lymphocyte ratio in lymph node metastasis of cervical cancer

作　　者：李光媚 陈水红 吴海燕 LI Guangmei;CHEN Shuihong;WU Haiyan(Department of Radiology,Yongkang Maternity and Child Care Hospital,Yongkang,Zhejiang Province 321300,China;Department of Laboratory,Yongkang Maternity and Child Care Hospital,Yongkang,Zhejiang Province 321300,China;Department of Radiology,Ningbo First Hospital,Ningbo,Zhejing Province 315000,China)

机构地区：[1]永康市妇幼保健院放射科,浙江永康321300 [2]永康市妇幼保健院检验科,浙江永康321300 [3]宁波市第一医院放射科,浙江宁波315000

出　　处：《实用放射学杂志》2024年第1期69-73,共5页Journal of Practical Radiology

基　　金：浙江省科技厅基金项目(LY18H060492)。

摘　　要：目的探讨增强CT测量淋巴结短径联合中性粒细胞与淋巴细胞比值(NLR)在宫颈癌淋巴结转移中的评估价值。方法选取82例宫颈癌患者,按照淋巴结是否发生转移分为转移组(n=13)和未转移组(n=69);对比2组患者临床病理特征,分析NLR与临床病理的关系,采用logistic多因素回归分析宫颈癌淋巴结转移的影响因素;对比2组增强CT扫描淋巴结短径及血清中NLR,受试者工作特征(ROC)曲线,采用DeLong检验比较曲线下面积(AUC)分析其对宫颈癌淋巴结转移的评估价值,并对比上述指标单独检测与联合检测的诊断效能。结果转移组增强CT扫描淋巴结短径、NLR分别为(0.686±0.120)cm、2.23±0.41,未转移组分别为(0.602±0.106)cm、1.76±0.30,2组间差异有统计学意义(P<0.05);转移组和未转移组年龄、生长方式及脉管浸润均无显著差异(P>0.05),临床分期、肿瘤最大径、NLR及增强CT淋巴结短径比较,均有统计学意义(P<0.05);NLR与临床分期、盆腔淋巴结转移、增强CT扫描淋巴结短径均有关(P<0.05);临床分期Ⅲ期、肿瘤最大径≥4cm、NLR>1.80及增强CT淋巴结短径≥0.632cm均是宫颈癌发生淋巴结转移的独立危险因素(P<0.05);ROC曲线分析显示,二者联合检测宫颈癌的AUC为0.871,高于增强CT淋巴结短径、血清NLR单独检测(0.645、0.795),且其特异度优于单独检测,增强CT淋巴结短径及血清NLR的最佳截断值分别为0.630cm、1.91。结论增强CT淋巴结短径、血清NLR可较好地预测宫颈癌发生淋巴结转移,且二者联合检测可提高评估效能。Objective To investigate the value of short diameter of lymph nodes combined with neutrophil to lymphocyte ratio(NLR)in evaluating lymph node metastasis of cervical cancer by enhanced CT.Methods A total of 82 patients with cervical cancer were selected and divided into metastatic group(n=13)and non-metastatic group(n=69)according to whether lymph node metastasis occurred.The clinicopathological features of the two groups were compared,and the relationship between NLR and clinicopathology was analyzed.Logistic regression was used to analyze the influencing factors of lymph node metastasis of cervical cancer.The short diameter of lymph nodes and serum NLR were compared between the two groups.Receiver operating characteristic(ROC)curve,DeLong test and compare the area under the curve(AUC)analysis was used to evaluate the value of lymph node metastasis in cervical cancer.The diagnostic efficacy of the above indexes were compared between the two groups.Results The short diameter of lymph nodes and NLR in the metastatic group were(0.686±0.120)cm and 2.23±0.41 respectively,while thosein the non-metastatic group were(0.602±0.106)cm and 1.76±0.30 respectively.The difference between the two groups was statistically significant(P<0.05);There was no significant difference in age,growth pattern and vascular infiltration between the metastatic group and the non-metastatic group(P>0.05).There were significant differences in clinical stage,maximum diameter of tumor,NLR and short diameter of enhanced CT lymph nodes(P<0.05);The NLR was related to clinical stage,pelvic lymph node metastasis,and the short diameter of lymph nodes on enhanced CT scan(P<0.05);Clinical stage II,maximum diameter of tumor≥4 cm,NLR>1.80 and short diameter of enhanced CT lymph nodes≥0.632 cm were independent risk factors for cervical cancer lymph node metastasis(P<0.05);The ROC curve analysis showed that the AUC of the combined detection of cervical cancer was 0.871,higher than that of the enhanced CT lymph nodes short diameter and serum NLR(0.645,0

关 键 词：淋巴结短径 中性粒细胞与淋巴细胞比值 宫颈癌 淋巴结转移 计算机体层成像 

分 类 号：R737.33[医药卫生—肿瘤] R814.42[医药卫生—临床医学]