1. 深圳市南山区妇幼保健院放射科,广东,深圳,518067
2. 中山大学附属第一医院医学影像科,广东,广州,510080
网络首发:2017-07-20,
纸质出版:2017
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李新文, 宋晨宇, 蔡华崧, 等. 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[J]. 中山大学学报(医学科学版), 2017,38(4).
LI Xin-wen, SONG Chen-yu, CAI Hua-song, et al. Correlation between the Diameter of Superior Rectal Vein and Inferior Mesenteric Vein and the Lymph Node Metastasis of Rectal Carcinoma[J]. Journal of Sun Yat-sen University (Medical Sciences), 2017, 38(4).
李新文, 宋晨宇, 蔡华崧, 等. 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[J]. 中山大学学报(医学科学版), 2017,38(4). DOI:
LI Xin-wen, SONG Chen-yu, CAI Hua-song, et al. Correlation between the Diameter of Superior Rectal Vein and Inferior Mesenteric Vein and the Lymph Node Metastasis of Rectal Carcinoma[J]. Journal of Sun Yat-sen University (Medical Sciences), 2017, 38(4). DOI:
【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(P < 0.001,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(P > 0.05)。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。
【Objective】To measure the diameter of the superior rectal vein(SRV)& theinferior mesenteric vein(IMV)by CT and analyze their relationship with lymphatic metastasis of rectal carcinoma.And to discuss the feasibility of utilizing SRV to predict lymph node metastasis of rectal cancer.【Methods】The CT imaging and pathological data of 105 rectal carcinoma patients were ana? lyzed retrospectively. We measured and compared the diameter of every patient′s SRV & IMV by CT in the presence and absence of microvascular tumor thrombus,signet ring cell,lymph node metastasis and distant metastasis. The accuracy of predicting lymph node metastasis for rectal carcinoma by the diameter of SRV were evaluated by ROC curve.【Results】There were statistical differences in the diameters of SRV and IMV between rectal cancer group with lymph node metastasis(D = 4.34 mm,D = 5.00 mm)and without (D = 3.56 mm,D = 4.81 mm;P < 0.001,P = 0.023). The differences were significant in the diameter of SRV between rectal cancer group with microvascular tumor thrombus or signet ring cell and without(P = 0.019,P = 0.044). However,the diameter of IMV showed no statistical difference between rectal cancer group with microvascular tumor thrombus or signet ring cell and without(P = 0.605,P = 0.663). And there was no statistical difference in the diameter of SRV or IMV between rectal cancer patients with distant metastasis and without(P > 0.05). Regarding 3.75 mm as the cut-off value for the diameter of SRV to predict lymph node me? tastasis for rectal cancer patients,the sensitivity was 90.9% and the specificity was 82.0%. Regarding 4.65 mm as the cut-off value for the diameter of IMV to predict lymph node metastasis for rectal cancer patients,the sensitivity was 87.3% and the specificity was 38%.【Conclusions】It is completely feasible to utilize the diameter of SRV measured by CT to predict lymph node metastasis of rectal carcinoma with high sensitivity,accuracy,and relatively high specificity.
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