非小细胞肺癌患者术前增强CT与淋巴结微转移的相关性研究
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摘要
目的探讨非小细胞肺癌患者术前增强CT相关结果与术中所取淋巴结微转移之间的关系。方法方便选取该院心胸外科2017年12月—2018年11月经根治性切除治疗的非小细胞肺癌患者50例,根据增强CT结果比较各组间淋巴结微转移的差异。结果肿瘤直径≥3 cm者为26例,淋巴结有微转移8例,直径<3 cm者24例,发现淋巴结微转移2例,两组间淋巴结微转移率差异有统计学意义(χ~2=38.75,P<0.05)。病灶轻度强化者为21例,淋巴结有微转移3例,病灶明显强化者29例,发现淋巴结微转移7例,两组间淋巴结微转移率差异有统计学意义(χ~2=15.83,P<0.05)。淋巴结最小直径≤1.0 cm者为35例,淋巴结有微转移4例,淋巴结最小直径>1.0 cm者15例,发现淋巴结微转移6例,两组间淋巴结微转移率差异有统计学意义(χ~2=45.16,P<0.05)。未发现淋巴结肿大者为33例,淋巴结有微转移5例,肺门淋巴结肿大者7例,发现淋巴结微转移1例,纵膈淋巴结肿大者5例,发现淋巴结微转移1例,肺门与纵膈淋巴结均肿大者5例,发现淋巴结微转移3例,各组间淋巴结微转移率差异有统计学意义(χ~2=52.89,P<0.05)。通过组间比较发现肿瘤大小、病灶强化程度、淋巴结最小直径及淋巴结肿大位置等各组间淋巴结微转移率差异有显著性。通过多因素分析发现,肿瘤大小、淋巴结最小直径与淋巴结肿大位置与淋巴结微转移之间有相关性,但肿瘤强化程度与之关系不大。结论术前增强CT检查结果中肿瘤大小、淋巴结最小直径与淋巴结肿大位置与淋巴结微转移之间存在一定相关性。
Objective To investigate the relationship between preoperative enhanced CT findings and lymph node micrometastasis in patients with non-small cell lung cancer. Methods Convenient select a total of 50 patients with non-small cell lung cancer who underwent radical resection from December 2017 to November 2018 in our hospital were enrolled. The differences in lymph node micrometastasis between groups were compared according to the results of enhanced CT. Results There were 26 cases with tumor diameter ≥3 cm, 8 cases with lymph node metastasis, 24 cases with diameter <3 cm, and 2 cases with lymph node micrometastasis. There was significant difference in lymph node micrometastasis rate between the two groups(χ~2=38.75, P <0.05). There were 21 cases with mild enhancement of lesions, 3 cases with micrometastasis in lymph nodes, 29 cases with obvious enhancement of lesions, and 7 cases with lymph node micrometastasis. There was significant difference in lymph node micrometastasis rate between the two groups(χ~2=15.83, P<0.05). There were 35 cases with lymph node minimum diameter ≤1.0 cm, 4 cases with lymph node micrometastasis, 15 cases with lymph node minimum diameter >1.0 cm, and 6 cases with lymph node micrometastasis, lymph node micrometastasis rate between the two groups. The difference was significant(χ~2=45.16, P<0.05). No cases of lymphadenopathy were found in 33 cases, lymph node micrometastasis in 5 cases, hilar lymph node enlargement in 7 cases, lymph node micrometastasis in 1 case, mediastinal lymph node enlargement in 5 cases, lymph node micrometastasis in 1 case, 5 cases of lung portal and mediastinal lymph nodes, and 3 cases of lymph node micrometastasis were found. There was significant difference in lymph node micrometastasis rate between groups(χ~2=52.89, P<0.05). Differences in lymph node micrometastasis between the groups, such as tumor size, lesion enhancement, lymph node minimum diameter, and lymph node enlargement, were found to be significant. Multivariate analysis revealed that there was a correlation between tumor size, lymph node minimum diameter and lymph node enlargement and lymph node micrometastasis, but the degree of tumor enhancement was not related. Conclusion There is a correlation between tumor size, lymph node minimum diameter and lymph node enlargement and lymph node micrometastasis in preoperative enhanced CT findings.
Objective To investigate the relationship between preoperative enhanced CT findings and lymph node micrometastasis in patients with non-small cell lung cancer. Methods Convenient select a total of 50 patients with non-small cell lung cancer who underwent radical resection from December 2017 to November 2018 in our hospital were enrolled. The differences in lymph node micrometastasis between groups were compared according to the results of enhanced CT. Results There were 26 cases with tumor diameter ≥3 cm, 8 cases with lymph node metastasis, 24 cases with diameter <3 cm, and 2 cases with lymph node micrometastasis. There was significant difference in lymph node micrometastasis rate between the two groups(χ~2=38.75, P <0.05). There were 21 cases with mild enhancement of lesions, 3 cases with micrometastasis in lymph nodes, 29 cases with obvious enhancement of lesions, and 7 cases with lymph node micrometastasis. There was significant difference in lymph node micrometastasis rate between the two groups(χ~2=15.83, P<0.05). There were 35 cases with lymph node minimum diameter ≤1.0 cm, 4 cases with lymph node micrometastasis, 15 cases with lymph node minimum diameter >1.0 cm, and 6 cases with lymph node micrometastasis, lymph node micrometastasis rate between the two groups. The difference was significant(χ~2=45.16, P<0.05). No cases of lymphadenopathy were found in 33 cases, lymph node micrometastasis in 5 cases, hilar lymph node enlargement in 7 cases, lymph node micrometastasis in 1 case, mediastinal lymph node enlargement in 5 cases, lymph node micrometastasis in 1 case, 5 cases of lung portal and mediastinal lymph nodes, and 3 cases of lymph node micrometastasis were found. There was significant difference in lymph node micrometastasis rate between groups(χ~2=52.89, P<0.05). Differences in lymph node micrometastasis between the groups, such as tumor size, lesion enhancement, lymph node minimum diameter, and lymph node enlargement, were found to be significant. Multivariate analysis revealed that there was a correlation between tumor size, lymph node minimum diameter and lymph node enlargement and lymph node micrometastasis, but the degree of tumor enhancement was not related. Conclusion There is a correlation between tumor size, lymph node minimum diameter and lymph node enlargement and lymph node micrometastasis in preoperative enhanced CT findings.
引文
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[7]陈华东,覃大明,余永江,等.术前增强CT检查最佳图像特征与老年非小细胞肺癌淋巴结转移的相关性研究[J].实用老年医学,2018,32(1):71-74.
[8]王德忠.术前增强CT检查与淋巴结转移相关性在非小细胞肺癌患者诊断中的研究[J].临床医药文献电子杂志,2017,4(38):7454.
[9]陆薇,梁克诚,吴汉刚,等.Ⅰ期非小细胞肺癌淋巴结中ck19、肺特异性蛋白X mRNA表达与微转移及预后的相关性研究[J].临床肺科杂志,2017,22(5):802-805.
[10]李晨蔚,李凯敏,王子善,等.LUNX与VEGFA基因联合检测对Ⅰ期非小细胞肺癌淋巴结微转移的临床意义[J].浙江医学,2017,39(6):442-444,448,497.
[2]Young-Jae Lee,Dae-Yeon Kim,Shin-Wha Lee,et al.Apostoperative scoring system for distant recurrence in nodepositive cervical cancer patients after radical hysterectomy and pelvic lymph node dissection with para-aortic lymph node sampling or dissection[J].Gynecologic Oncology,2017.
[3]M Mayoral,P Paredes,B Domènech,et al.18 F-FDG PET/CTand sentinel lymph node biopsy in the staging of patients with cervical and en dometrial cancer.Role of dual-timepoint imaging[J].Revista Espaǒnola de Medicina Nuclear e Imagen Molecular(English Edition),2017,36(1).
[4]Martin Espinosa-Bravo,Joaquin Navarro-Cecilia,Manuel Ramos Boyero,et al.Rubio.Intraoperative assessment of sentinel lymph node by one-step nucleic acid amplification in breast cancer patients after neoadjuvant treatment reduces the need for a second surgery for axillary lymph node dissection[J].The Breast,2017,31.
[5]Sae Byeol Choi,Hyung Joon Han,Pyoungjae Park,et al.Systematic review of the clinical significance of lymph node micrometastases of pancreatic adenocarcinoma following surgical resection[J].Pancreatology,2017.
[6]Konstantinos Blouhos,Konstantinos A.Boulas,Konstantinos Tsalis,et al.Recurrence of a pT2N0cM0 Lower Third Gastric Cancer with No.6 Lymph Node Micrometastasis after R0Extended Surgery.Should Adjuvant Therapy be Performed in Conventionally Node-Negative but Micrometastasis-Positive pT2 Gastric Cancer?[J].Journal of Gastrointestinal Cancer,2017,48(1).
[7]陈华东,覃大明,余永江,等.术前增强CT检查最佳图像特征与老年非小细胞肺癌淋巴结转移的相关性研究[J].实用老年医学,2018,32(1):71-74.
[8]王德忠.术前增强CT检查与淋巴结转移相关性在非小细胞肺癌患者诊断中的研究[J].临床医药文献电子杂志,2017,4(38):7454.
[9]陆薇,梁克诚,吴汉刚,等.Ⅰ期非小细胞肺癌淋巴结中ck19、肺特异性蛋白X mRNA表达与微转移及预后的相关性研究[J].临床肺科杂志,2017,22(5):802-805.
[10]李晨蔚,李凯敏,王子善,等.LUNX与VEGFA基因联合检测对Ⅰ期非小细胞肺癌淋巴结微转移的临床意义[J].浙江医学,2017,39(6):442-444,448,497.