The Diagnosis Criteria Of Metastatic Lymph Node In The Mediastinal Of Esophageal Carcinoma: Compare Computed Tomographic With Pathology

ObjectiveTo find the standard to diagnose lymph node metastasis in the mediastinal of esophageal carcinoma patients by comparing the size of lymph node in multi-slice spiral computed tomographic with pathology. MethodsSelect 305 patients in our hospital who underwent multi-slice spiral computed tomographic scan before surgery at least seven days, observe and record the location, short-axis diameter and number of ever lymph node seen within view, and compare with pathological data, and then: 1. Calculate the best short-axis diameter to diagnose lymph node metastasis inside the thorax. 2. Calculate the best short-axis diameter to diagnose lymph node metastasis in supraclavicular. 3. Calculate the best short-axis diameter to diagnose lymph node metastasis in tracheoesophageal groove. ResultsThe study includeds 1043 lymph nodes which were seen in multi-slice spiral computed tomographic and proved by surgery and pathology, with 203 positive and 840 negative pathologically.1. The best short-axis diameter to diagnose lymph node metastasis inside the thorax of esophageal carcinoma.The best standard to diagnose the metastasis of lymph node is larger than 8. 0mm, and the areas under the ROC curve is 0.766, and with the standard the sensitivity, specificity and accuracy are 54.5%, 87.9%, 82.0%, Youden index is 0.424. When the standard to diagnose the metastasis of lymph node is 10.0mm, the sensitivity, specificity and accuracy are 19.6%, 95.8%, 82.4%, Youden index is 0.154. When the standard to diagnose the metastasis of lymph node is 5.0mm, the sensitivity, specificity and accuracy are 93. 7%, 21. 4%, 34. 2%, Youden index is 0.151.2. The best short-axis diameter to diagnose lymph node metastasis in supraclavicular of esophageal carcinoma.The best standard to diagnose the metastasis of lymph node is larger than 4.7mm, and the areas under the ROC curve is 0.785, and with the standard the sensitivity, specificity and accuracy are 76.9%, 72.5%, 73.6%, Youden index is 0.494. When the standard to diagnose the metastasis of lymph node is 10.0mm, the sensitivity, specificity and accuracy are 0, 1, 75.4%, Youden index is 0.000. When the standard to diagnose the metastasis of lymph node is 5.0mm, the sensitivity, specificity and accuracy are 69.2%, 80.0%, 77.4%, Youden index is 0.492.3. The best short-axis diameter to diagnose lymph node metastasis in tracheoesophageal groove of esophageal carcinoma.The best standard to diagnose the metastasis of lymph node is larger than 5.8mm, and the areas under the ROC curve is 0.755, and with the standard the sensitivity, specificity and accuracy are 61.7%, 78.8%, 74.3%, Youden index is 0.405. When the standard to diagnose the metastasis of lymph node is 10. 0mm, the sensitivity, specificity and accuracy are 8.5%, 97.7%, 74.3%, Youden index is 0.062. When the standard to diagnose the metastasis of lymph node is 5.0mm, the sensitivity, specificity and accuracy are 72.3%, 65.2%, 67.0%, Youden index is 0.375. Conclusions1. The best short-axis diameter to diagnose lymph node metastasis inside the thorax of esophageal carcinoma is 8.0mm.2. The best short-axis diameter to diagnose lymph node metastasis in supraclavicular of esophageal carcinoma is 4.7mm.3. The best short-axis diameter to diagnose lymph node metastasis in tracheoesophageal groove of esophageal carcinoma is 5.8mm.