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目的:分析直肠癌淋巴结转移的相关CT表现,探讨与N分期相关的影像学规律。方法:选择2007年3月~2012年3月在我院进行盆腔CT检查,确诊为直肠癌的病例70例作为研究对象,其中男38例,女32例。对切除标本进行淋巴结切片检查,以病理学诊断转移淋巴结阳性数为标准,按照美国癌症联合会(AJCC)N分期定义分为pN0、pN1、pN2组。对所有病人图像进行复阅,观察盆腔淋巴结数目、大小。结果:所有淋巴结转移阳性病例在CT均有淋巴结显示,pN0、pN1及pN2组CT检出的最大淋巴结径线随转移程度进展逐渐增大,分别为(4.28±2.68)mm、(7.56±2.24)mm和(10.49±2.36)mm,差异有统计学意(P<0.01);pN0、pN1及pN2组CT检出淋巴结数目随转移程度进展逐渐增多,平均数目分别为(3.15±2.68)枚、(5.44±3.19)枚、(8.72±3.25)枚,差异具有统计学意义(P<0.01)。结论:直肠癌淋巴结有无转移及转移程度不仅与淋巴结大小有关,还与通过CT检出的淋巴结数目有关。对淋巴结大小、数量的综合分析对CT直肠癌N分期的准确性有很高的借鉴。
OBJECTIVE: To analyze the CT findings of lymph node metastasis in rectal cancer and to investigate the imaging regularity associated with N staging. Methods: From March 2007 to March 2012, 70 cases of pelvic CT examination and pelvic CT examination in our hospital were selected as research objects, including 38 males and 32 females. Lymph node biopsy was performed on the resected specimens. The pathological diagnosis of metastatic lymph nodes as the standard, according to the American Cancer Society (AJCC) N stage is divided into pN0, pN1, pN2 group. The images of all patients were reviewed and the number and size of pelvic lymph nodes were observed. Results: All lymph node positive cases showed lymph nodes in CT. The maximum lymph node diameter detected by CT in pN0, pN1 and pN2 groups gradually increased with the degree of metastasis (4.28 ± 2.68 mm, (7.56 ± 2.24) mm, mm and (10.49 ± 2.36) mm, the difference was statistically significant (P <0.01). The number of lymph nodes detected by CT in pN0, pN1 and pN2 groups gradually increased with the progression of metastasis, the average numbers were (3.15 ± 2.68) 5.44 ± 3.19) pieces, (8.72 ± 3.25) pieces, the difference was statistically significant (P <0.01). CONCLUSIONS: The degree of lymph node metastasis and metastasis in rectal cancer is not only related to the size of lymph nodes, but also related to the number of lymph nodes detected by CT. A comprehensive analysis of the size and number of lymph nodes has a good reference for the accuracy of N staging of CT rectal cancer.