宝石能谱CT对宫颈癌区域淋巴结定性诊断中的价值

发布时间：2019-02-28 18:00

【摘要】：目的:探讨宝石能谱CT在宫颈癌区域淋巴结定性诊断中的价值。方法:2014年1-6月经病理学证实且行宝石能谱CT分期检查发现区域淋巴结肿大宫颈鳞状细胞癌34例,通过对比患者已知宫颈原发灶与区域肿大淋巴结进行能谱分析推测诊断出增大淋巴结是否为转移性癌。所有患者同时予18F-FDG PET-CT检查或穿刺活检,以PET-CT检查结果或穿刺活检病理学结果为诊断标准,以Yerushalmy模式计算宝石能谱CT在宫颈癌区域淋巴结定性诊断的敏感度、特异度、阳性预测值、阴性预测值、约登指数来评价判断淋巴结是否转移结果。绘制ROC曲线,计算曲线下面积比较不同方法的诊断准确性。结果:34例宫颈癌患者宝石能谱CT淋巴结诊断结果与标准诊断(即PET-CT诊断结果和病理学诊断结果)对照进行分析得出特异度为46.77%,灵敏度为92.17%,约登指数为0.39;分别对两种诊断结果做一致性检验和配对卡方检验,诊断结果基本一致(Kappa=0.428),诊断水平有差异(P0.001)。ROC曲线下面积为0.695(P0.001,CI:0.607~0.782)。结论 :宝石能谱CT对于宫颈癌分期诊断有较好的指导作用,但尚不能作为区域淋巴结定性诊断的依据。
[Abstract]:Objective: to evaluate the value of gemstone energy spectrum (CT) in the qualitative diagnosis of regional lymph nodes in cervical cancer. Methods: from January to June, 2014, 34 cases of cervical squamous cell carcinoma were diagnosed by pathologically confirmed and examined by gemstone energy spectrum CT staging. Energy spectrum analysis was performed to determine whether the enlarged lymph nodes were metastatic carcinoma or not by comparing the known primary cervical lesions with the regional enlarged lymph nodes. All patients were examined by 18F-FDG PET-CT or biopsy at the same time. The sensitivity of gemstone energy spectrum (CT) in qualitative diagnosis of lymph nodes in cervical cancer was calculated by Yerushalmy model based on the results of PET-CT or biopsy as the diagnostic criteria. Specificity, positive predictive value, negative predictive value and Jordan index were used to evaluate lymph node metastasis. Draw the ROC curve, calculate the area under the curve and compare the diagnostic accuracy of different methods. Results: the specificity and sensitivity were 46.77% and 92.17%, respectively, between the diagnostic results of gem energy spectrum CT lymph nodes and the standard diagnosis (i.e. PET-CT diagnosis and pathological diagnosis) in 34 cases of cervical cancer, and the sensitivity was 92.17% and the specificity was 46.77%, and the sensitivity was 92.17%. The Joden index is 0.39; The consistency test and paired chi-square test showed that the diagnostic results were basically consistent (Kappa=0.428) and the diagnostic level was different (P0.001). The area under the ROC curve was 0.695 (P 0.001, CI = 0.607, 0.782). Conclusion: gem energy spectrum CT has a good guiding role in staging of cervical cancer, but it can not be used as a basis for qualitative diagnosis of regional lymph nodes.
【作者单位】：青海红十字医院肿瘤放疗科;
【分类号】：R737.33

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