Richie J P, Garnick M B, Finberg H
J Urol. 1982 Apr;127(4):715-7. doi: 10.1016/s0022-5347(17)54013-6.
To assess the ability of computerized tomography to predict correctly the presence of retroperitoneal lymphadenopathy, a prospective study was performed on 30 patients with all stages of testis tumor. All patients underwent a computerized tomography scan within 1 week before retroperitoneal lymphadenectomy and the results then were correlated with gross and histologic findings. The computerized tomography scan suggested retroperitoneal lymphadenopathy in 14 patients, in 1 of whom no retroperitoneal lymphadenopathy was found at exploration (false positive, 7 per cent). The sensitivity (computerized tomography negative divided by true positive) was 90 per cent, for an over-all accuracy of 73 per cent. Most importantly, however, 7 of the 16 computerized tomography scans (44 per cent) interpreted as normal proved to be false negative. Of these 7 scans 5 were in patients with tumors classified as stage B2 or greater. We conclude that the computerized tomography scan, when positive, is highly likely to detect metastatic nodal involvement. However, the false negative rate, even in patients with tumor-filled lymph nodes 2 to 3 cm. in diameter, limits the reliability of a negative computerized tomography scan to exclude metastases. Technological improvements are needed to refine the technique and, thus, to reduce the false negative rate.
为评估计算机断层扫描正确预测腹膜后淋巴结病存在的能力，对30例各期睾丸肿瘤患者进行了一项前瞻性研究。所有患者在腹膜后淋巴结清扫术前1周内接受了计算机断层扫描，然后将结果与大体及组织学检查结果进行对比。计算机断层扫描提示14例患者存在腹膜后淋巴结病，其中1例在探查时未发现腹膜后淋巴结病（假阳性，7%）。敏感性（计算机断层扫描阴性除以真阳性）为90%，总体准确率为73%。然而，最重要的是，16例被计算机断层扫描判定为正常的病例中有7例（44%）被证明为假阴性。这7例扫描中有5例是肿瘤分期为B2期或更高的患者。我们得出结论，计算机断层扫描呈阳性时，极有可能检测到转移性淋巴结受累。然而，即使是在有直径2至3厘米的充满肿瘤的淋巴结的患者中，假阴性率也限制了计算机断层扫描阴性结果排除转移的可靠性。需要技术改进来完善该技术，从而降低假阴性率。
