Zhu Yao, Zhang Shi Lin, Ye Ding Wei, Yao Xu Dong, Jiang Zhao Xia, Zhou Xiao Yan
Department of Urology, Cancer Hospital, Fudan University, Fudan University, Shanghai, China.
Onkologie. 2008 Feb;31(1-2):37-41. doi: 10.1159/000112462. Epub 2008 Jan 22.
The aim of this study was to evaluate the role of computed tomography (CT), Cloquet's node, and disease burden of inguinal lymph nodes (LNs) in predicting pelvic lymph node metastases (LNM) of penile cancer.
Bilateral inguinal lymph node dissection was performed in 73 penile cancer patients and revealed that 33 groin basins exhibited inguinal LNM.
Of the 33 groin basins, 16 (48.5%) had pelvic LNM. The sensitivity of pelvic CT in detecting metastatic LNs was 37.5%, and the specificity was 100%. Cloquet's node had a sensitivity of 30.0% and a specificity of 94.1% in pelvic CT-negative groin basins. Pathological characteristics of the inguinal LNs - number of positive LNs, lymph node ratio (number of positive LNs/total number removed), extranodal extension and the expression of p53 - were significantly associated with pelvic LNM. Furthermore, enlarged inguinal LNs = 3 in preoperative CT imaging and lymph node size = 3.5 cm in long diameter were prognostic factors for pelvic LNM (p = 0.001 and 0.003, respectively).
Pelvic CT imaging and tumor status of Cloquet's node is of limited use in predicting microscopic pelvic LNM. Pathological characteristics of the inguinal LNs remain the essential indicators of pelvic LNM.
本研究旨在评估计算机断层扫描（CT）、克洛凯淋巴结及腹股沟淋巴结疾病负担在预测阴茎癌盆腔淋巴结转移（LNM）中的作用。
对73例阴茎癌患者进行双侧腹股沟淋巴结清扫，结果显示33个腹股沟区域存在腹股沟淋巴结转移。
在33个腹股沟区域中，16个（48.5%）存在盆腔淋巴结转移。盆腔CT检测转移淋巴结的敏感性为37.5%，特异性为100%。在盆腔CT检查为阴性的腹股沟区域，克洛凯淋巴结检测盆腔淋巴结转移的敏感性为30.0%，特异性为94.1%。腹股沟淋巴结的病理特征——阳性淋巴结数量、淋巴结比率（阳性淋巴结数量/切除的淋巴结总数）、结外扩展及p53表达——与盆腔淋巴结转移显著相关。此外，术前CT成像显示腹股沟淋巴结肿大≥3个以及淋巴结长径≥3.5 cm是盆腔淋巴结转移的预后因素（p值分别为0.001和0.003）。
盆腔CT成像及克洛凯淋巴结的肿瘤状态在预测微观盆腔淋巴结转移方面作用有限。腹股沟淋巴结的病理特征仍是盆腔淋巴结转移的重要指标。
