Department of Radiology, Netherlands Cancer Institute, Amsterdam, The Netherlands.
GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands.
Abdom Radiol (NY). 2021 Sep;46(9):4096-4105. doi: 10.1007/s00261-021-03057-0. Epub 2021 Apr 27.
To evaluate the diagnostic accuracy of imaging features to predict lymph node status of colon cancer using CT.
This was a retrospective study from 2 tertiary hospitals in South Korea and Netherlands. 317 Colon cancer patients who underwent primary surgical treatment were included. Number of lymph nodes according to the anatomical location, size, cluster, degree of attenuation, shape, presence of internal heterogeneity and ill-defined margin of the lymph node were assessed and compared according to histological lymph node status.
The largest short diameter of lymph node and presence of internal heterogeneity of lymph node showed significant association with malignant lymph node status (P < 0.001 and P = 0.041, respectively). The ROC curve analysis revealed AUC of 0.703 for the largest short diameter of lymph node (P < 0.001), and AUC of the presence of internal heterogeneity was 0.630 (P < 0.001). In addition, our study showed that a total number of lymph nodes, regardless of size, (P = 0.022) and number of lymph nodes in peritumoral area (P < 0.001) and along the mesenteric vessels (P < 0.001) on CT demonstrated significant association with malignant status of lymph nodes in colon cancer.
There were significant associations between lymph node status and imaging features of lymph nodes on CT in colon cancer patients. The largest short diameter of lymph node and presence of internal heterogeneity can be used to predict the malignant status of lymph node in colon cancer patients. Also, the number of lymph nodes near the colonic tumor should be considered in assessment of colon cancer lymph node involvement on CT.
使用 CT 评估影像学特征预测结肠癌淋巴结状态的诊断准确性。
这是一项来自韩国和荷兰 2 家三级医院的回顾性研究。纳入了 317 例接受原发性手术治疗的结肠癌患者。根据淋巴结的解剖位置、大小、簇状、衰减程度、形状、内部异质性和边界模糊程度，评估并比较了淋巴结的数量，并根据组织学淋巴结状态进行了比较。
淋巴结的最大短径和淋巴结内部异质性的存在与恶性淋巴结状态显著相关（P<0.001 和 P=0.041，分别）。ROC 曲线分析显示，淋巴结最大短径的 AUC 为 0.703（P<0.001），淋巴结内部异质性的 AUC 为 0.630（P<0.001）。此外，我们的研究表明，无论大小，淋巴结总数（P=0.022）和肿瘤周围区域（P<0.001）和沿肠系膜血管（P<0.001）的淋巴结数量与结肠癌淋巴结恶性状态显著相关。
在结肠癌患者中，淋巴结状态与 CT 上淋巴结的影像学特征之间存在显著相关性。淋巴结的最大短径和内部异质性的存在可用于预测结肠癌患者淋巴结的恶性状态。此外，在评估 CT 上结肠癌淋巴结受累时，还应考虑结肠肿瘤附近的淋巴结数量。
