影像联合腋窝淋巴结切除在腹膜后淋巴瘤诊断中的意义

Significance of Imaging Combined with Axillary Lymphadenectomy in the Diagnosis of Retroperitoneal Lymphoma

摘要: 目的：分析影像联合腋窝淋巴结切除在腹膜后淋巴瘤诊断中的有效性及准确性。方法：对2019年1月至2022年1月三峡大学第一临床医学院宜昌市中心人民医院医疗美容科行腋窝淋巴结切除的232例患者的临床、影像及病理学资料进行回顾性分析。结果：232例患者中，男121例、女111例；年龄分布14~84岁；对232例患者行常规腋窝淋巴结活检术，术前完善相关血液生化检查、胸部与上腹部彩色超声多普勒及CT检查等，依据病理学检查结果和影像学资料对本组数据进行整理分析。影像学检查对于评价腹膜后淋巴瘤患者的灵敏度为72.99%，特异度为56.84%，准确度为66.38%，阳性预测值为70.92%，阴性预测值为59.34%，阳性似然比为1.67，阴性似然比为0.47。232例浅表淋巴结活检最终临床诊断结果中，提示为淋巴瘤的有92例(39.66%)，其他疾病140例(60.34%)。结论：影像学检查(彩超联合CT)是评价淋巴瘤的一项敏感指标，影像学联合腋窝淋巴结切除对于腹膜后淋巴瘤患者的病理分型是一个有效的诊断方式。

Abstract: Objective: To analyze the efficacy and accuracy of imaging combined with axillary lymph node re-section in the diagnosis of retroperitoneal lymphoma. Methods: The clinical, imaging and patholog-ical data of 232 patients who underwent lymph node resection in the Department of Medical Cos-metology, First Clinical Medical College of China Three Gorges University from January 2019 to Jan-uary 2022 were retrospectively analyzed. Results: Among the 232 patients, 121 were males and 111 were females. Age distribution 14~84 years old; routine superficial lymph node biopsy was performed for 232 patients, and the relevant blood biochemical examinations, color ultrasound Doppler and CT examination of the chest and upper abdomen were completed before surgery, and the data of this group were sorted and analyzed according to the results of pathological examination and imaging data. The sensitivity of color ultrasound combined with CT examination for the evalua-tion of patients with retroperitoneal lymphoma was 72.99%, the specificity was 56.84%, the accu-racy was 66.38%, the positive predictive value was 70.92%, the negative predictive value was 59.34%, the positive likelihood ratio was 1.67, and the negative likelihood ratio was 0.47. Among the final clinical diagnosis results of superficial lymph node biopsy of 232 cases, 92 cases (39.66%) showed lymphoma and 140 cases (60.34%) of other diseases. Conclusion: Imaging (color ultrasound combined with CT) is a sensitive index for the evaluation of lymphoma, and imaging combined with axillary lymph node resection is an effective diagnostic method for the pathological classification of patients with retroperitoneal lymphoma.