扩散加权成像评估结直肠癌区域淋巴结转移预后相关因素分析

发布时间：2018-03-24 06:02

  本文选题：结直肠肿瘤　切入点：淋巴转移　出处：《中国医学影像学杂志》2015年07期

【摘要】：目的扩散加权成像(DWI)能显著提高对未出现体积增大的转移淋巴结的诊断能力,本研究旨在评估结直肠癌区域淋巴结转移DWI表现是否有助于评估患者的预后,并分析与预后有关的因素。资料与方法 47例结直肠癌患者行DWI检查后均行手术治疗,对照术后病理结果,确定区域转移性(DWI阳性)和非转移性(DWI阴性)淋巴结。比较DWI阳性和阴性患者5年无病生存率和整体生存率。评估患者各相关因素与预后的相关性,相关因素包括有无DWI诊断区域淋巴结转移(DWI阳性淋巴结)、DWI阳性最大淋巴结的短轴直径和长轴直径、DWI阳性淋巴结的数量。结果 47例患者中,DWI诊断区域淋巴结转移10例(21%),DWI阳性表现为淋巴结受侵犯,呈高信号。DWI阴性患者5年无病生存率和整体生存率明显高于DWI阳性患者(P0.05)。最大转移淋巴结的短轴直径与发生远处转移有相关性(AUC=0.77,P0.05),最高准确率为76%时的短轴直径为9 mm。最大转移淋巴结的短轴直径、长轴直径与整体生存率有相关性(AUC=0.84、0.75,P0.05),最高准确率为85%时的短轴直径为9 mm,最高准确率为76%时的长轴直径为11mm。DWI阳性最大淋巴结短轴直径≤9 mm患者的5年无病生存率和整体生存率高于短轴直径9 mm患者(P0.05);长轴直径≤11 mm患者的5年无病生存率和整体生存率高于长轴直径11 mm患者(P0.05)。全部DWI阳性淋巴结均被切除的患者5年无病生存率高于DWI阳性淋巴结未被完全切除的患者(P0.05)。结论 DWI阴性的患者预后更好;在DWI阳性患者中,转移淋巴结较小的患者预后更好。
[Abstract]:Objective Diffusion-weighted imaging (DWI) can significantly improve the diagnostic ability of metastatic lymph nodes without volume increase. The purpose of this study was to evaluate whether DWI findings of regional lymph node metastasis in colorectal cancer can help to evaluate the prognosis of patients. Data and methods 47 patients with colorectal cancer were treated by DWI and compared with the pathological results. DWI positive and non-metastatic DWI negative lymph nodes were determined. The 5-year disease-free survival rate and overall survival rate of DWI positive and negative patients were compared, and the correlation between the relevant factors and prognosis was evaluated. The related factors included the number of DWI positive lymph nodes with short axis diameters and long axis diameters with or without DWI diagnosis of regional lymph node metastasis. Results in 47 patients, regional lymph node metastasis was diagnosed by DWI. In 10 cases, lymph node involvement was found on DWI. The 5-year disease-free survival rate and overall survival rate in patients with hyperintense. DWI negative were significantly higher than those in DWI positive patients (P 0.05). There was a correlation between the short axis diameter of the largest metastatic lymph nodes and distant metastasis. 9 mm. short axis diameter of the largest metastatic lymph node, The long axis diameter was correlated with the overall survival rate. The highest accuracy rate was 9 mm in the short axis diameter at 85 and the long axis diameter in the 11mm.DWI positive lymph node was 鈮，

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