多层螺旋CT对原发性卵巢癌分期的临床应用价值研究

发布时间：2018-03-10 05:33

本文选题：多层计算机体层摄影术　切入点：卵巢癌　出处：《吉林大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:本文通过回顾性分析确诊为原发性卵巢癌的50名患者的影像学资料,将患者原发灶、周围侵犯及远处转移的影像学表现进行综合、客观的统计学处理,评价多层螺旋CT平扫及增强对卵巢癌术前分期的诊断价值,探讨其对原发性卵巢癌分期的临床应用价值。方法:搜集2015年1月至2017年1月在我院就诊、接受全面手术分期并行多层螺旋CT全腹平扫+增强扫描的原发性卵巢癌患者50名。请2名有经验的放射科医师进行影像图像分析,做出影像分期诊断。主要观察内容有肿瘤原发灶位置、形态及与周围组织关系、各个部位腹膜转移、淋巴结转移、远处转移等,将具体结果与手术病理结果进行对照,分别计算CT对卵巢癌原发灶、子宫输卵管侵犯、其他盆腔组织侵犯、腹膜转移、淋巴结转移、腹水以及远处转移诊断的准确性、敏感性及特异性,使用spss19.0软件计算CT分期与手术分期的吻合系数及CT诊断总分期的ROC曲线总面积,对CT分期和手术分期的吻合度和CT总分期的诊断价值进行统计学分析。结果:术后病理证实50例原发性卵巢癌患者中卵巢浆液性癌36例,卵巢粘液性癌4例,子宫内膜样癌2例,透明细胞癌2例,颗粒细胞癌3例,卵巢甲状腺肿类癌1例,卵巢癌肉瘤1例,支持-间质细胞瘤1例。手术病理分期I期9例,II期6例,III期27例,IV期8例。CT术前分期I期8例,II期7例,III期28例,IV期6例。多层螺旋CT对单双侧判断、子宫输卵管侵犯、其他盆腔组织侵犯、腹膜转移、淋巴结转移、腹水及远处转移诊断的准确性为84%~100%,敏感性为50%~100%,特异性为75%~100%。CT分期与手术分期的吻合系数为κ=0.746,p0.001,吻合度较强且具有统计学意义;CT诊断总分期ROC曲线下面积为0.925,p0.001,诊断价值较高且具有统计学意义。结论:多层螺旋CT是卵巢癌术前分期的有效检查方法,对卵巢癌患者术前评估有重要临床应用价值,对手术分期有一定补充作用,可以有效预防手术分期不足及过度分期现象。
[Abstract]:Objective: to analyze retrospectively the imaging data of 50 patients with primary ovarian cancer, and to analyze the imaging findings of primary tumor, peripheral invasion and distant metastasis. To evaluate the diagnostic value of multislice spiral CT scan and enhancement in preoperative stage of ovarian cancer, and to evaluate its clinical value in staging of primary ovarian cancer. Methods: from January 2015 to January 2017, the patients were treated in our hospital. A total of 50 patients with primary ovarian cancer underwent staging and enhanced multislice spiral CT scanning. Two experienced radiologists were asked to perform image analysis. Imaging staging diagnosis was made. The main contents were the location of primary tumor, morphology and relationship with surrounding tissues, peritoneal metastasis, lymph node metastasis, distant metastasis and so on. The specific results were compared with the results of surgery and pathology. The accuracy, sensitivity and specificity of CT in the diagnosis of primary ovarian cancer, hysteropian tube invasion, other pelvic invasion, peritoneal metastasis, lymph node metastasis, ascites and distant metastasis were calculated. Spss19.0 software was used to calculate the coincident coefficient between CT staging and operative staging, and the total area of ROC curve in CT diagnosis of the total stage. Results: there were 36 cases of ovarian serous carcinoma and 4 cases of ovarian mucinous carcinoma. There were 2 cases of endometrial carcinoma, 2 cases of clear cell carcinoma, 3 cases of granular cell carcinoma, 1 case of ovarian goiter carcinoid and 1 case of ovarian cancer sarcoma. One case of Sertoli stromal cell tumor, 9 cases of stage I, 6 cases of stage II, 27 cases of stage III, 8 cases of stage IV, 8 cases of stage I before CT staging, 7 cases of stage II, 7 cases of stage III, 6 cases of stage IV. Multi-slice spiral CT was used to judge unilateral bilateral, hysterosalpinx invasion. Other pelvic invasion, peritoneal metastasis, lymph node metastasis, The accuracy of diagnosis of ascites and distant metastases was 84 / 100, the sensitivity was 50 / 100, the specificity was 75 / 100. the coefficient of anastomosis between CT staging and surgical staging was 0.746p0.001, the area under the ROC curve of CT was 0.925 / p0.001, and the diagnostic value was 0.925p0.001. Conclusion: multislice spiral CT is an effective method for preoperative staging of ovarian cancer. It has important clinical application value for preoperative evaluation of ovarian cancer, and has certain supplementary effect on surgical staging, which can effectively prevent the insufficiency of surgical staging and the phenomenon of excessive staging.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R737.31;R730.44

【相似文献】