Department of Radiology, Chi-Mei Hospital, Liuying N0.201, Taikang Village, Liuying Dist, Tainan City 736, Taiwan.
Colorectal Dis. 2013 Jul;15(7):807-11. doi: 10.1111/codi.12140.
The accuracy of computed tomography (CT) in detecting local invasion (T status) and nodal metastasis (N status) of colon cancer was determined.
Data on the preoperative CT scan of 153 lesions from 152 patients with colon cancer were reviewed retrospectively. Evaluation included the T stage and N stage of the TNM system. The results were compared with those obtained by histopathological examination of the resected tumour.
Of the 153 tumours, 117 (76.5%) were correctly classified as Stage T1 and T2 (33 tumours) and Stage T3 and T4 (84 tumours) by CT. The sensitivity and specificity were 70.2% and 79.2%, respectively, and the positive and negative predictive values were 85.7% and 60.0%. When analysed according to the individual T stage (Tx/Tis, T1, 2, 3, 4) and N stage (N0, 1, 2), the kappa coefficient with linear weighting was 0.208 (fair agreement) for T stage and 0.154 (slight agreement) for N stage. The estimation of tumour size showed good agreement with histopathology (Spearman correlation coefficient 0.865).
CT scanning of colonic cancer showed 75% accuracy in identifying T1 and T2 cancers combined, but gave poor agreement between CT and histopathology for individual T stages.
确定计算机断层扫描（CT）在检测结肠癌局部侵犯（T 分期）和淋巴结转移（N 分期）方面的准确性。
回顾性分析 152 例结肠癌患者 153 处病变的术前 CT 扫描资料。评估包括 TNM 分期系统的 T 分期和 N 分期。将结果与切除肿瘤的组织病理学检查结果进行比较。
在 153 个肿瘤中，117 个（76.5%）通过 CT 正确分类为 T1 和 T2 期（33 个肿瘤）和 T3 和 T4 期（84 个肿瘤）。CT 的敏感性和特异性分别为 70.2%和 79.2%，阳性预测值和阴性预测值分别为 85.7%和 60.0%。根据个体 T 分期（Tx/Tis、T1、2、3、4）和 N 分期（N0、1、2）进行分析时，T 分期的线性加权 Kappa 系数为 0.208（适度一致），N 分期的 Kappa 系数为 0.154（轻微一致）。肿瘤大小的评估与组织病理学具有良好的一致性（Spearman 相关系数 0.865）。
CT 扫描对识别 T1 和 T2 期结肠癌的准确率为 75%，但 CT 与组织病理学对各期 T 分期的一致性较差。
