目的 探讨CT预测肌层浸润性膀胱尿路上皮癌（muscle-invasive bladder urothelial carcinoma，MIBUC）伴盆腔淋巴结转移的可行性。 方法 回顾性分析接受根治性全膀胱切除术加盆腔淋巴结清扫术的40例MIBUC患者的临床和影像学资料，对比分析CT检查的盆腔淋巴结情况与病理诊断结果之间的相关性。 结果 （1）以病理诊断结果为标准，CT检查发现MIBUC伴盆腔淋巴结转移的准确率为90%，灵敏度为75%，特异度为93.8%；（2）临床分期为T1、T2、T3、T4期的MIBUC患者，其盆腔淋巴结转移的发生率分别为0、9.1%、45.5%、100%。 结论 （1）CT影像学检查可较好地预测MIBUC是否伴盆腔淋巴结转移；（2）随着MIBUC临床分期的进展，盆腔淋巴结转移的发生率相应增高（P<0.05）。
Abstract
Objective To evaluate the diagnostic accuracy of computed tomography (CT) for pelvic lymph node metastasis in muscle-invasive bladder urothelial carcinoma (MIBUC). Methods The present study retrospectively assessed the clinical and imaging characteristics of 40 MIBUC patients who underwent radical cystectomy and pelvic lymphadenectomy. The relationship between CT imaging characteristics and pathological examination for pelvic lymph node metastasis was assessed in MIBUC patients. Results (1) Compared to pathological diagnosis, CT imaging examination for pelvic lymph node metastasis had an accuracy of 90%, a sensitivity of 75%, and a specificity of 93.8%. (2) The pelvic lymph node metastasis rate increased along with more advanced tumor stage (T1, 0; T2, 9.1%; T3, 45.5%; T4, 100%). Conclusions (1) CT imaging characteristics are of great importance for evaluating pelvic lymph node metastasis in MIBUC patients. (2) The probability of metastatic pelvic lymph nodes significantly increases with more advanced T stages in MIBUC patients (P<0.05).
关键词
膀胱癌 /
CT /
淋巴结转移
Key words
Bladder cancer; /
/
Computed Tomography; /
/
Pelvic lymph node metastasis
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参考文献
[1] Kaufman DS, Shipley WU, Feldman AS. Bladder cancer[J]. Lancet, 2009, 374(9685): 239-249.
[2] Letašiová S, Medveďová A, Šovčíková A, et al. Bladder cancer, a review of the environmental risk factors[J]. Environ Health, 2012, 11(Suppl 1): S11.
[3] Karl A, Carroll PR, Gschwend JE, et al. The impact of lymphadenectomy and lymph node metastasis on the outcomes of radical cystectomy for bladder cancer[J]. Eur Urol, 2009, 55(4): 826-835.
[4] Prout GR, Marshall VF. The prognosis with untreated bladder tumors[J]. Cancer, 1956, 9(3): 551-558.
[5] Touijer K, Fuenzalida RP, Rabbani F, et al. Extending the indications and anatomical limits of pelvic lymph node dissection for prostate cancer: improved staging or increased morbidity[J]. BJU Int, 2011, 108(3): 377-377.
[6] Park JC, Citrin DE, Agarwal PK, et al. Multimodal management of muscle-invasive bladder cancer[J]. Curr Probl Cancer, 2014, 38(3): 80-108.
[7] Ku JH, Kang M, Kim HS, et al. Lymph node density as a prognostic variable in node-positive bladder cancer: a meta-analysis[J]. BMC Cancer, 2015, 15(1): 447.
[8] Li Y, Diao F, Shi S, et al. Computed tomography and magnetic resonance imaging evaluation of pelvic lymph node metastasis in bladder cancer[J]. Chin J Cancer, 2018, 37(1): 3.
[9] Simone G, Papalia R, Ferriero M, et al. 601 Stage specific impact of extended versus standard pelvic lymph node dissection in radical cystectomy[J]. Eur Urol, 2012, 11(Suppl 1): e601, e601a-e601b.
[10] Bi L, Huang H, Fan X, et al. Extended vs non-extended pelvic lymph node dissection and their influence on recurrence-free survival in patients undergoing radical cystectomy for bladder cancer: a systematic review and meta-analysis of comparative studies[J]. BJU Int, 2014, 113(5b): E39-E48.
[11] Zainfeld D, Shah A, Daneshmand S. Enhanced recovery after surgery pathways: role and outcomes in the management of muscle invasive bladder cancer[J]. Urol Clin North Am, 2018, 45(2): 229-239
[12] Kim JH, Beets GL, Kim MJ, et al. High-resolution MR imaging for nodal staging in rectal cancer: are there any criteria in addition to the size[J]. Eur J Radiol, 2004, 52(1): 78-83.
基金
国家自然科学基金（81672893）；重庆市教育委员会科学技术研究项目（KJQN201800428）
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