Zhou Jun, Zhu Shang-Yong, Liu Ruo-Chuan, Luo Feng, Shu De-Xi
First College of Clinical Medical Science, China Three Gorges University, Nanning, Guangxi, China.
Ultrasound Med Biol. 2009 Oct;35(10):1596-600. doi: 10.1016/j.ultrasmedbio.2009.04.022. Epub 2009 Jul 25.
To demonstrate whether a calculated vascularity index (VI) can predict metastases of cervical lymph nodes, the VI values of the primary tumors were obtained by using 3-D sonography in 87 subjects with laryngeal cancer confirmed by laryngoscope and biopsy. N-staging of the subjects was determined by pathological nodal harvesting. The relationship between the VI and pathological N-staging was evaluated by correlation coefficient. To test the accuracy of the VI for predicting cervical lymph node involvement, a receiver operating characteristic (ROC) curve was constructed, and the best operating point was determined by Youden's index. For comparison, 2-D sonography was applied to detect metastatic cervical lymph nodes. The accuracy, sensitivity and specificity of the VI, 2-D sonography and a combination of the two methods for diagnosis of metastatic cervical lymph nodes were compared. There was a positive linear correlation between the VI and pN-staging (r=0.740, p<0.001). The area under the ROC curve for the VI was 0.919. The best operating point of the VI was 4.4565, which derived higher sensitivity than that of 2-D sonography (95% vs. 81%, p=0.031), but lower specificity (75% vs. 95%, p=0.012). The combination of the two methods yielded a higher accuracy (97% vs. 85% and 89%, p=0.002 and 0.016), a higher sensitivity to 2-D sonography (95% vs. 81%, p=0.031) and a higher specificity to VI (98% vs. 75%, p=0.002). The VI of laryngeal cancer can be a useful factor for predicting metastases of cervical lymph nodes.
为了证明计算得出的血管生成指数（VI）能否预测颈部淋巴结转移，我们使用三维超声检查，对87例经喉镜和活检确诊为喉癌的患者的原发肿瘤VI值进行了测定。通过病理淋巴结清扫确定患者的N分期。采用相关系数评估VI与病理N分期之间的关系。为了检验VI预测颈部淋巴结受累的准确性，构建了受试者工作特征（ROC）曲线，并通过约登指数确定最佳工作点。作为比较，应用二维超声检查来检测颈部转移性淋巴结。比较了VI、二维超声检查以及两种方法联合使用对颈部转移性淋巴结诊断的准确性、敏感性和特异性。VI与pN分期之间存在正线性相关（r = 0.740，p < 0.001）。VI的ROC曲线下面积为0.919。VI的最佳工作点为4.4565，其敏感性高于二维超声检查（95%对81%，p = 0.031），但特异性较低（75%对95%，p = 0.012）。两种方法联合使用具有更高的准确性（97%对85%和89%，p = 0.002和0.016），对二维超声检查的敏感性更高（95%对81%，p = 0.031），对VI的特异性更高（98%对75%，p = 0.002）。喉癌的VI可作为预测颈部淋巴结转移的一个有用因素。
