多层螺旋CT对术前非小细胞肺癌分期的诊断价值

发布时间：2018-03-03 21:02

本文选题：癌　切入点：非小细胞肺　出处：《中国医学影像学杂志》2015年09期 　论文类型：期刊论文

【摘要】：目的比较非小细胞肺癌患者术前多层螺旋CT(MSCT)诊断的临床TNM分期和术后病理TNM分期的一致性,评价MSCT对肺癌TNM分期的诊断价值。资料与方法收集行外科手术治疗、经病理证实为非小细胞肺癌的92例患者,比较MSCT对非小细胞肺癌TNM分期结果与手术病理TNM分期结果,评价MSCT诊断各组淋巴结转移的敏感度、特异度和准确度。结果 CT-T分期结果与病理T分期结果一致性比较满意(Kappa=0.727,P0.05),总符合率为83.7%;CT-N分期结果与病理N分期结果一致性比较满意(Kappa=0.635,P0.05),总符合率为79.3%;CT-TNM分期结果与病理TNM分期结果一致性比较满意(Kappa=0.680,P0.05),总符合率为75.0%。CT诊断淋巴结转移的敏感度、特异度、阳性预测值、阴性预测值、准确度分别为71.1%、85.2%、77.1%、80.7%、79.3%。CT诊断4组、5组、6组、10组淋巴结转移的准确率较低,其中4组淋巴结转移的假阳性率最高,10组淋巴结转移假阴性率最高。结论 MSCT用于诊断术前非小细胞肺癌TNM分期有重要的临床价值,可作为评估患者能否手术、选择最佳治疗方案及预测预后的主要依据,MSCT诊断淋巴结转移的重要特征是提高肺癌CT-TNM分期准确性的关键。
[Abstract]:Objective to evaluate the diagnostic value of MSCT in TNM staging of lung cancer by comparing the clinical TNM staging and pathological TNM staging in patients with non-small cell lung cancer (NSCLC) before and after operation. 92 patients with non-small cell lung cancer (NSCLC) were confirmed by pathology. The sensitivity of MSCT in the diagnosis of lymph node metastasis in each group was evaluated by comparing the results of TNM staging with that of TNM staging in operation and pathology of NSCLC, and evaluating the sensitivity of MSCT in diagnosis of lymph node metastasis. Results the agreement between CT-T staging and pathological T staging was satisfactory (P 0.05). The total coincidence rate was 83.70.635P0.05 and 79.3% respectively. The consistent results of TNM staging were satisfactory, and the total coincidence rate was 75.0. CT sensitivity in the diagnosis of lymph node metastasis. The accuracy of specificity, positive predictive value, negative predictive value and accuracy were 71.1 and 85.2, respectively. The accuracy of CT in diagnosing lymph node metastasis in 4 groups was lower than that in other groups. The false positive rate of lymph node metastasis in 4 groups was the highest and the false negative rate of lymph node metastasis in 10 groups was the highest. Conclusion MSCT has important clinical value in the diagnosis of preoperative TNM staging of non-small cell lung cancer, and it can be used to evaluate whether the patients can be operated on. The key to improve the accuracy of CT-TNM staging of lung cancer is to select the best treatment scheme and to predict the prognosis according to the important features of MSCT in the diagnosis of lymph node metastasis.
【作者单位】：新疆医科大学附属肿瘤医院CT室;
【分类号】：R734.2;R730.44

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