Computerized Tomography for Detecting Perivesical Infiltration and Lymph Node Metastasis in Invasive Bladder Carcinoma
Computerized Tomography for Detecting Perivesical Infiltration and Lymph Node Metastasis in Invasive Bladder Carcinoma
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DOI：
10.1159/000167836
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发表时间：
2008-01-01
影响因子：
1.6
通讯作者：
Beduk, Yasar
中科院分区：
文献类型：
--
作者：
Baltaci, Sumer;Resorlu, Berkan;Beduk, Yasar
目的：计算机断层扫描（CT）用于浸润性膀胱癌的术前分期。我们评估了CT在浸润性膀胱癌根治术和盆腔淋巴结切除术后检测膀胱周围浸润和淋巴结转移的作用。患者和方法：方法回顾性分析100例浸润性膀胱癌患者行根治性膀胱切除术的临床及病理资料。术前CT图像由一名不知道最终病理结果的放射科医师重新评估和解释，以确定膀胱外肿瘤扩散或淋巴结转移的证据。结果：100例患者中，CT显示57例有膀胱外肿瘤浸润。在这57例病例中，22例在最终病理分析中未显示膀胱外肿瘤累及的证据。在6例病例中，虽然在最终病理分析中确定了膀胱周围浸润，但术前CT显示无膀胱外肿瘤累及的证据。在膀胱外肿瘤扩散方面，CT分期与病理分期之间的差异有统计学意义（p < 0.001）。CT高度提示淋巴结转移9例，但仅4例经病理证实。另一方面，在9例患者中，病理诊断盆腔淋巴结转移，但CT上没有淋巴结肿大的证据。关于淋巴结受累，CT和病理结果之间存在中度一致性（p = 0.003，kappa = 0.29 +/- 0.14）。结论：CT对浸润性膀胱癌膀胱周围浸润和淋巴结转移的诊断准确性有限。CT提供的信息是不够的，我们迫切需要更可靠的分期技术。版权所有（C）2008 S. Karger AG，巴塞尔
Objectives: Computerized tomography (CT) is used in the preoperative staging of invasive bladder carcinoma. We evaluated the role of CT for detecting perivesical invasion and lymph node metastases in patients who had undergone radical cystectomy and pelvic lymphadenectomy for invasive bladder carcinoma. Patients and Methods: We retrospectively analyzed the clinical and pathological data of 100 patients with invasive bladder carcinoma who had undergone radical cystectomy. The preoperative CT images were reevaluated and interpreted by one uroradiologist blinded to the final pathological results for evidence of extravesical tumor extension or lymph node metastases. Results: Of the 100 patients, CT showed extravesical tumor involvement in 57. Of these 57 cases, 22 displayed no evidence of extravesical tumor involvement in the final pathological analysis. In 6 cases, although perivesical invasion was identified in the final pathological analysis, preoperative CT showed no evidence of extravesical tumor involvement. Regarding extravesical tumor spread, the differences between CT and pathological stages were statistically significant (p < 0.001). CT was highly suggestive of lymph node metastases in 9 cases, but only 4 were pathologically confirmed. On the other hand, in 9 patients pelvic lymph node metastasis were pathologically diagnosed, but there was no evidence of lymphadenopathy on CT. Regarding lymph node involvement, there was moderate concordance between CT and pathological findings (p = 0.003, kappa = 0.29 +/- 0.14). Conclusion: CT has limited accuracy in detecting perivesical infiltration and lymph node metastasis in invasive bladder carcinoma. The information provided by CT is insufficient and we urgently need more reliable staging techniques. Copyright (C) 2008 S. Karger AG, Basel