螺旋CT诊断胆囊癌淋巴结转移假阳性率的影响因素分析OA
Analysis on the influencing factors for false-positive rate of spiral CT in diagnosing lymph node metastasis of gallbladder cancer
目的:探讨螺旋CT在胆囊癌淋巴结转移诊断中假阳性率的影响因素,以提升诊断准确性.方法:回顾性选取2022年1月至2025年1月汉中市三二〇一医院收治的96例原发性胆囊癌患者的临床资料,所有患者均行术前腹部增强CT检查及术后病理检查,以病理结果作为"金标准"将其分为假阳性组(32例,CT提示淋巴结转移但病理阴性)和真阴性组(64例,CT和病理均阴性).比较假阳性组与真阴性组在淋巴结短径(门静脉期CT测量)、糖类抗原19-9(CA19-9)水平(术前1周内检测)、胆囊壁厚度(门静脉期CT测量)、肿瘤最大径(门静脉期CT测量)及医生诊断经验(基于不同职称)等方面的差异.结果:术前评估显示,假阳性组淋巴结短径＞10 mm的占比为87.50%(28/32),高于真阴性组的15.63%(10/64),差异有统计学意义(x2=45.632,P＜0.001).假阳性组CA19-9水平＞37 U/ml、胆囊壁厚度＞5 mm及肿瘤最大径＞4 cm的占比均高于真阴性组,差异有统计学意义(x2=13.562、19.276、18.294,P＜0.05).多因素分析显示,年龄、肿瘤最大径＞4 cm、淋巴结短径＞10 mm、CA19-9＞37 U/ml及胆囊壁厚度＞5 mm均为假阳性的独立影响因素(OR=1.114、4.592、8.903、6.271、4.063,P＜0.05).结论:螺旋CT诊断胆囊癌淋巴结转移时,假阳性率受患者年龄、肿瘤特征及影像学指标等多因素影响,综合评估这些因素可优化诊断流程,减少误诊.
Objective:To investigate the influencing factors for false-positive rate of spiral computed tomography(CT)in diagnosing lymph node metastasis of gallbladder cancer,so as to increase diagnostic accuracy.Methods:A total of 96 patients with primary gallbladder cancer,who admitted to Hanzhong 3201 Hospital between January 2022 and January 2025,were enrolled in this analysis.All participants underwent preoperative contrast-enhanced CT examination on abdomen and postoperative pathological examination.Using pathological findings as gold standard,patients were divided into a false-positive group(n=32,CT findings indicated lymph node metastasis but pathological results were negative)and a true-negative group(n=64,both CT and pathological assessment were negative results).The differences of short diameter of lymph nodes(was measured by CT at portal venous phase),carbohydrate antigen 19-9(CA19-9)level(was determined within one week before surgery),thickness of gallbladder wall(was measured by CT at portal venous phase),maximal diameter of tumor(was measured by CT at portal venous phase),and diagnostic experience of physicians(based on different professional titles)and so on were compared between false-positive group and true-negative group.Results:Preoperative assessment revealed that the lymph node of false-positive group(short diameter>10 mm)was 87.50%(28/32),which was significantly higher than that of true-negative group[15.63%(10/64)],and the difference was significant(x2=45.632,P<0.001).The CA19-9 level of false-positive group were>37 U/ml,thickness of gallbladder wall were>5 mm,and maximal diameter(>4 cm)of tumor of false-positive group were higher than those of true-negative group,and the differences were significant(x2=13.562,19.276,18.294,P<0.05).Multivariate logistic regression analysis further identified age of patients,the maximum size of tumor>4 cm,short diameter of lymph node>10 mm,CA19-9 level>37 U/mL,thickness of gallbladder wall>5 mm,and diagnostic experience of physicians were independent influence factors for false-positive(OR=1.114,4.592,8.903,6.271,4.063,P<0.05).Conclusions:The false-positive rate in spiral CT diagnosis of lymph node metastasis of gallbladder cancer is influenced by patient age,tumor characteristics,and imaging indicators.A comprehensive assessment of these factors can help optimize the diagnostic workflow and reduce misdiagnoses.
王丰;祝伟程;许华
汉中市三二〇一医院影像科 汉中 723000宝鸡市中医医院影像科 宝鸡 721001汉中市三二〇一医院影像科 汉中 723000
医药卫生
胆囊癌淋巴结转移螺旋CT假阳性率影响因素
Gallbladder cancerLymph node metastasisSpiral computed tomography(CT)False-positive rateInfluencing factor
《中国医学装备》 2026 (8)
23-27,5
陕西省2021年科技计划(2021SF-044)Shaanxi Province 2021 Science and Technology Program Project(2021SF-044)
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