直肠上静脉和肠系膜下静脉直径与直肠癌淋巴结转移的相关性

发布时间：2018-06-11 12:50

本文选题：直肠癌 + 淋巴转移　；参考：《中山大学学报(医学科学版)》2017年04期

【摘要】：【目的】为了分析直肠上静脉及肠系膜下静脉的直径与直肠癌淋巴转移的相关性,在CT上测量直肠上静脉及肠系膜下静脉的直径,探讨利用直肠上静脉预测直肠癌淋巴结转移的可行性。【方法】回顾性分析105例直肠癌患者的CT及病理资料,在CT上测量直肠上静脉和肠系膜下静脉直径,比较两条静脉的直径在不同病理状态下(是否存在微血管癌栓、印戒细胞、淋巴结转移以及远处转移)的差异,采用ROC曲线分析利用直肠上静脉直径预测直肠癌淋巴结转移的准确性。【结果】直肠上静脉及肠系膜下静脉的直径在淋巴结转移组(分别为4.34 mm、5.00 mm)与无淋巴结转移组(分别为3.56 mm、4.81 mm)间的差异有统计学意义(P0.001,P=0.023)。直肠上静脉在是否存在微血管癌栓、印戒细胞间的差异有统计学意义(P=0.019,0.044),而肠系膜下静脉在是否存在微血管癌栓、印戒细胞间的差异无统计学意义(P值分别为0.605,0.663)。直肠上静脉与肠系膜下静脉的直径在是否伴远处转移间的差异均无统计学意义(P0.05)。以直肠上静脉直径3.75 mm、肠系膜下静脉直径4.65 mm为分界值,预测淋巴结转移的灵敏度分别为90.9%、87.3%,特异度分别为82.0%、38%。【结论】利用CT测量直肠上静脉的直径预测直肠癌的淋巴结转移是完全可行的,具有很高的敏感度、准确性和较高的特异度。
[Abstract]:[objective] to analyze the correlation between the diameter of superior rectal vein and inferior mesenteric vein and lymphatic metastasis of rectal cancer, the diameter of superior rectal vein and inferior mesenteric vein were measured on CT. To explore the feasibility of using superior rectal vein to predict lymph node metastasis of rectal cancer. [methods] the CT and pathological data of 105 patients with rectal cancer were analyzed retrospectively, and the diameter of superior rectal vein and inferior mesenteric vein were measured on CT. The diameters of the two veins were compared under different pathological conditions (whether there were microvascular tumor embolus, signet ring cells, lymph node metastasis, and distant metastasis). [results] the diameter of superior rectal vein and inferior mesenteric vein in lymph node metastasis group (4.34 mm ~ 5.00 mm) and no lymph node transformation were analyzed by ROC curve. There was significant difference between the migration group (3.56 mm / 4.81 mm) and the difference between the two groups (P 0.001 / P 0.023). There was significant difference between signet ring cells in the existence of microvascular tumor embolus in the superior rectal vein and in the inferior mesenteric vein with or without microvascular tumor embolus (P = 0.605, P = 0.663respectively). There was no significant difference in the diameters of superior rectal vein and inferior mesenteric vein between the superior rectal vein and the inferior mesenteric vein with distant metastasis (P 0.05). The diameter of superior rectal vein and inferior mesenteric vein were 3.75 mm and 4.65 mm, respectively. The sensitivity of predicting lymph node metastasis was 90.9 and 87.3, and the specificity was 82.00.Conclusion it is feasible to predict lymph node metastasis of rectal cancer by using CT to measure the diameter of superior rectal vein, which has high sensitivity, accuracy and specificity.
【作者单位】：深圳市南山区妇幼保健院放射科;中山大学附属第一医院医学影像科;
【基金】：国家自然科学基金项目(81571750) 广东省自然科学基金(2015A030313043;2014A030311018) 广东省科技计划项目(2014A020212125)
【分类号】：R735.37

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