Stephenson N J, Sandeman T F, McKenzie A F
Radiology Department, Royal Melbourne Hospital, Victoria, Australia.
Australas Radiol. 1995 Feb;39(1):54-7. doi: 10.1111/j.1440-1673.1995.tb00232.x.
A retrospective study was performed of 183 newly diagnosed seminoma cases and 73 newly diagnosed non-seminomatous germ cell tumours (NSGCT) presenting from 1985 to 1989 to a tertiary referral cancer hospital. The purpose was to assess the contribution of bipedal lymphography (LG) to the management of these patients. As the main value of LG is in detecting small retroperitoneal lymph node (LN) metastases, analysis concentrated upon early stage disease, specifically N0 and N1a LN disease. Comparison between LG results, abdominopelvic computed tomography (APCT), final clinical stage and treatment outcome was performed. We found that with the LG and APCT criteria used (filling defects > 2 mm and LN diameter > 20 mm, respectively), LG was much more sensitive in disease detection. However, with modern techniques APCT can reliably detect disease 10 mm or greater. In addition, tumour marker status, primary tumour vascular invasion status and initial clinical examination were each more important in staging NSGCT disease than LG alone. Thus, LG is now rarely used in our institution but we will have to monitor our excellent survival data to confirm that this change in policy is warranted.
对1985年至1989年期间转诊至一家三级癌症专科医院的183例新诊断精原细胞瘤病例和73例新诊断非精原生殖细胞肿瘤（NSGCT）进行了一项回顾性研究。目的是评估双足淋巴造影（LG）对这些患者治疗的贡献。由于LG的主要价值在于检测小的腹膜后淋巴结（LN）转移，分析集中在早期疾病，特别是N0和N1a期LN疾病。对LG结果、腹盆腔计算机断层扫描（APCT）、最终临床分期和治疗结果进行了比较。我们发现，按照所使用的LG和APCT标准（分别为充盈缺损>2mm和LN直径>20mm），LG在疾病检测方面更敏感。然而，采用现代技术时，APCT能够可靠地检测出10mm或更大的病灶。此外，在NSGCT疾病分期方面，肿瘤标志物状态、原发肿瘤血管侵犯状态和初始临床检查各自比单独使用LG更为重要。因此，LG目前在我们机构很少使用，但我们必须监测我们出色的生存数据，以确认这种政策变化是合理的。
