Furnell E C, Wellner R
Albers-Schönberg-Institut, Abt. f. Strahlendiagnostik, A. K. St. Georg Hamburg.
Rontgenblatter. 1988 Feb;41(2):68-71.
In view of the steep decline in the number of lymphangiographies (LAG) performed, the authors try to correlate the relevance of this radiological staging method with that of computed tomography and the histological results of lymphadenectomy. The diagnostic accuracy of both methods (LAG and CT) is comparable (71.4% and 70.6%, respectively). In respect of specificity, CT is superior to LAG (this superiority is due to the method employed) to the tune of 88.2% for CT vs. 58.8% for LAG. If there is a large proportion of early tumour stages, CT is inferior to LAG with regard to sensitivity (52.6% and 63.2%, respectively). Lymphangiography can no longer be recommended in case of intrapelvic urological and gynaecological tumours. It is only indicated, as before, in staging diagnosis of seminomas of stage No of after CT and of Hodgkin's lymphomas of stage II B. In non-seminomas LAG is exclusively a service performed for the benefit of the surgeon wishing to have a contrast medium staining of the lymph nodes. In future, LAG can be offered only in centres having a sufficiently large group of oncological patients to look after.
鉴于淋巴管造影术(LAG)的实施数量急剧下降,作者试图将这种放射学分期方法的相关性与计算机断层扫描及淋巴结切除术的组织学结果进行关联。两种方法(LAG和CT)的诊断准确性相当(分别为71.4%和70.6%)。在特异性方面,CT优于LAG(这种优势归因于所采用的方法),CT的特异性为88.2%,而LAG为58.8%。如果早期肿瘤阶段占比很大,在敏感性方面CT不如LAG(分别为52.6%和63.2%)。对于盆腔内的泌尿外科和妇科肿瘤,不再推荐使用淋巴管造影术。如同以前一样,它仅适用于CT检查后对Ⅰ期精原细胞瘤以及ⅡB期霍奇金淋巴瘤的分期诊断。在非精原细胞瘤中,LAG仅仅是为希望对淋巴结进行造影剂染色的外科医生提供的一项服务。未来,只有在拥有足够大量肿瘤患者需要照料的中心才能开展LAG检查。