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中華民國泌尿科醫學會雜誌

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篇名 電腦斷層攝影術診斷復發性膀胱癌淋巴結轉移之正確性評估
卷期 7:3
並列篇名 The Accuracy of CT Scan on the Assessment Pelvic Lymphadenopathy of Recurrent Bladder Cancer
作者 盧誌明陳偉權余家政吳東霖簡邦平李瀛輝黃榮慶沈崇松蘇拯誠
頁次 131-137
關鍵字 膀胱癌電腦斷層攝影復發bladder neoplasmsCTrecurrenceTSCI
出刊日期 199609

中文摘要

本研究將探討電腦斷層攝影術是否適合做為復發性膀胱癌的常規檢查方法。本研究以病歷回顧的方式,收集曾接受根除性膀胱切除術的膀胱癌患者的病歷,抄錄癌症期別、級別、病理檢查及電腦斷層攝影檢查報告,以瞭解電腦斷層攝影檢查診斷淋巴結轉移的正確性。並收集1994年3月之前發生復發性膀胱癌患者的病歷,以長期追蹤(二年以上)或病理檢查結果為黃金標準,以瞭解復發性膀胱癌患者的淋巴結轉移發生率,及電腦斷層攝影檢查診斷復發性膀胱癌患者淋巴結轉移的正確性。本研究計收入53位接受根除性膀胱切除術的合適患者,結果顯示:電腦斷層攝盼檢查診斷淋巴結轉移的整體正確性為84.9%,敏感度為28.6%、精確度為93.5%、陽性預測值為40%、陰性預測值為89.6%。精確度有隨期別或級別上升而下降的趨勢。本研究收入的六位復發性膀胱癌病人均無淋巴結轉移的癥象,就這六位病人而言,淋巴結轉移發生率為0%,電腦斷層攝影檢查診斷復發性膀胱癌患者淋巴轉移的敏感度與陽性預測值無法計算,精確度與陰性預測值均為100%。依據本路的初步結果,我們認為電腦斷層攝影術不適合做為復發性膀胱癌的常規檢查方法。

英文摘要

Since the use of computed tomography(CT) to stage the bladder cancer ts still controversial, the effect of CT on pelvic lymphadenopathy of recurrent bladder cancer was studed to determine whether that is an appropriate routine screening test for recurrent bladder cancer Seventy-five patients with bladder cancer who underwent radical cystectomy were entered into the first study. The following information was collected for each patient: stage, grade, CT report and report of pathology findings. The above data were expected to assist understanding of the accuracy of computed tomography on pelvic lymphadenopathy. In the second study, 222 cases diagnosed with "recurrence of bladder cancer" were collected before March 1994. The gold standard of pelvic lymph node metastasis was prolonged follow-up (more than two years) and] or pathology findings. The incidence of lymph node metastasis of recurrent bladder cancer and the accuracy of CT on lymphadenopathy of recurrent bladder cancer are reported in this paper. Fifty-three out of 79 patients underwent radical cystectomy. The overall sensitivity and specificity of CT scan on pelvic lymphadenopathy were 28.6% and 93.5%, respectively. Positive and negative predictive values are 40% and 89.6%, respectively. The tendency shows that specificity reduces if staging or grading increases. The six patients with recurrent bladder cancers had no pelvic lymphadenopathy. The sensitivity and positive predictive value of CT scan on this group could not be calculated, while the specificity and negative predictive value were both 100%. According to preliminary results, it is suggested that CT is not appropriate for detecting of pelvic lymphadenopathy of recurrent bladder cancer.