Research Article
KOLON KANSERLERİNDE BİLGİSAYARLI TOMOGRAFİNİN LENF NODU TESPİTİNDEKİ ROLÜ The Role of Computed Tomography for the Detection of Lymph Node in Colon Cancers
Abstract
ÖZET
Amaç: Bilgisayarlı Tomografi malign hastalıkların tanı ve tedavisinde yaygın olarak kullanılan görüntüleme
yöntemidir. Kolon kanserinde metastatik lenf nodu varlığı prognozu belirlemede önemli kriterlerdendir. Biz
bu çalışmada kolon kanseri saptanan hastalarda; tomografik bulgularla, patoloji raporlarını karşılaştırmayı
amaçladık.
Gereç ve Yöntemler: Çalışmamızda; Nisan 2015 ile Nisan 2016 tarihleri arasında kolon kanseri tanısı ile
Ankara Atatürk Eğitim ve Araştırma Hastanesinde opere edilen hastaların dosya bilgileri incelendi. Kolon
kanseri nedeniyle genel cerrahi kliniğinde ameliyat edilen hastalardan, ameliyat öncesi tüm abdominal bilgisayarlı
tomografi incelemesi yapılan toplam 72 hasta çalışmaya dahil edildi. Hastaların tomografi ve patoloji
raporları retrospektif olarak incelendi. Bilgisayarlı tomografide görüntülenen lenf nodları (btN) patolojik
lenf nodu (pN) durumu ile karşılaştırıldı. Tomografinin patolojik lenf nodunu saptayabilme oranı araştırıldı.
Bulgular: Çalışmaya alınan 72 hastanın 36’sında btN+ saptandı. Patolojik olarak ise toplam 44 hastada pN+
olduğu görüldü. btN+ 36 hastanın 28’inde pN+ olduğu gözlendi. btN- 36 hastanın ise 16’sında pN+ olduğu
saptandı. Bilgisayarlı tomografinin l enf nodu tespitindeki; Duyarlılığı: %64, Özgüllüğü: %71, Pozitif Prediktif
Değeri: %77, Negatif Prediktif Değeri: %55 olarak hesaplandı. Ayrıca pN2 grubunda bilgisayarlı tomografide
lenf nodu saptanma oranının pN1 grubuna göre daha yüksek olduğu saptandı. (p<0.05)
Sonuç: Kolon kanserinin her aşamasında kullanılan bilgisayarlı tomografi bölgesel patolojik lenf nodlarını
saptayabilir. Fakat tomografinin henüz kolon kanserlerinde preop metastatik lenf nodu varlığını saptamada
yetersiz olduğu görüldü. Benzer çalışmalar sayesinde kolon kanserlerinde yeni tedavi modaliteleri geliştirilebileceği
kanaatindeyiz.
Anahtar Sözcükler: Kolon kanseri; Bilgisayarlı tomografi; Lenf nodu
ABSTRACT
Aim: Computed tomography is a common imaging method for the diagnosis and treatment of malignant
diseases. The presence of metastatic lymph nodes are important criterion in determining the prognosis of
colon cancer. In this study, we aim to compare tomographic findings and pathology reports in patients with
colon cancer.
Material and methods: In our study; the documents of patients examined who had surgery for colon
cancer in Ankara Atatürk Training and Research Hospital between April 2015 and April 2016. Totally 72
patients included to study who underwent surgery in the general surgery clinic for colon cancer. Patient’s
tomography and pathology reports were retrospectively analyzed. Lymph nodes on computed tomography
(btN) were compared with pathological lymph node (pN) status. Pathologic lymph node detection rate of
tomography was investigated.
Results: btN+ was detected in 36 of 72 patients included in the study. A total of 44 patients were
pathologically pN+. Of the 36 patients with btN+, 28 were observed pN+. In the btN-36 patients, 16 were
detected pN+. Computed tomography in the detection of lymph nodes; Sensitivity: %64, Specificity: %71,
Positive Predictive Value: %77, Negative Predictive Value: %55. In addition, lymph node detection rate of
tomography in the pN2 group was higher than pN1 group. (p<0.05)
Conclusion: Computed tomography which is used in all stages of colon cancer can detect regional
pathological lymph nodes. But tomography was found to be insufficient in detecting preoperative metastatic
lymph nodes in colon cancers. We believe that new treatment modalities can be developed in colon cancer
with similar studies.
Keywords: Colon cancer; Computed tomography; Lymph node
References
- 1. Gültekin M, Boztaş G, Sağlık Bakanlığı, Türkiye Halk Sağlığı Kurumu, Türkiye kanser istatistikleri, 2014. 2. Niekel MC, Bipat S, Stoker J, Diagnosticimaging of colorectal liver metastases with Ct, MR imaging, FDG Pet, and/or FDG Pet/Ct: a meta-analysis of prospective studies including patients who have not previously under göne treatment. Radiology. 2010;257:674–84. 3. Dighe S, Blake H, Koh MD, Swift I, Arnaout A, Temple L. Accuracy of multi detector computed tomography in identifying poor prognostic factors in colonic cancer. Br J Surg. 2010;97:1407–15. 4. Chamadol N, Ninpiethoon T, Bhudhisawasd V, Pairojkul C. The role of CT scan in preoperative staging of colorectal carcinoma. J MedAssocThai. 2005;88:1847–53. 5. S. Dighe, S. Purkayastha, I. Swift, P.P. Tekkis, A. Darzi, R. A’Hern, et al. Diagnostic precision of CT in local staging of colon cancers: a meta-analysis, Clinical Radiology. 2010;65:708-19. 6. Gunderson LL, Jessup JM, Sargent DJ, Greene FL, Stewart AK. Revised TN Categorization for colon cancer based on national survival outcomes data. Journal of Clinical Oncology. 2010; 28:264–71. 7. Elibol FD, Obuz F, Sökmen S, Terzi C, Canda AE, Sağol Ö, Sarıoğlu S. The role of multidetector CT in local staging and evaluation of retroperitoneal surgical margin involvement in colon cancer, Diagn Interv Radiol. 2016;22:5-12. 8. Rollvén E, Abraham-Nordling M, Holm T, Blomqvist L. Assessment and diagnostic accuracy of lymph node status to predict stage III colon cancer using computed tomography, Cancer Imaging. 2017 Jan 19;17:3. 9. O’Connell MJ, Colangelo LH, Beart RW, Petrelli NJ, Allegra CJ, Sharif S, et al. Capecitabine and oxaliplatin in the preoperative multi modality treatment of rectal cancer: surgical end points from National Surgical Adjuvant Breast and Bowel Project trial R-04. J ClinOncol. 2014; 32: 1927-34 10. Cunningham D, Allum WH, Stenning SP, Thompson JN, Van de Velde CJ, Nicolson M, et al. Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer. N Engl J Med. 2006; 355: 11-20.
Year 2019,
Volume: 9 Issue: 2, 48 - 51, 28.06.2019
Abstract
References
- 1. Gültekin M, Boztaş G, Sağlık Bakanlığı, Türkiye Halk Sağlığı Kurumu, Türkiye kanser istatistikleri, 2014. 2. Niekel MC, Bipat S, Stoker J, Diagnosticimaging of colorectal liver metastases with Ct, MR imaging, FDG Pet, and/or FDG Pet/Ct: a meta-analysis of prospective studies including patients who have not previously under göne treatment. Radiology. 2010;257:674–84. 3. Dighe S, Blake H, Koh MD, Swift I, Arnaout A, Temple L. Accuracy of multi detector computed tomography in identifying poor prognostic factors in colonic cancer. Br J Surg. 2010;97:1407–15. 4. Chamadol N, Ninpiethoon T, Bhudhisawasd V, Pairojkul C. The role of CT scan in preoperative staging of colorectal carcinoma. J MedAssocThai. 2005;88:1847–53. 5. S. Dighe, S. Purkayastha, I. Swift, P.P. Tekkis, A. Darzi, R. A’Hern, et al. Diagnostic precision of CT in local staging of colon cancers: a meta-analysis, Clinical Radiology. 2010;65:708-19. 6. Gunderson LL, Jessup JM, Sargent DJ, Greene FL, Stewart AK. Revised TN Categorization for colon cancer based on national survival outcomes data. Journal of Clinical Oncology. 2010; 28:264–71. 7. Elibol FD, Obuz F, Sökmen S, Terzi C, Canda AE, Sağol Ö, Sarıoğlu S. The role of multidetector CT in local staging and evaluation of retroperitoneal surgical margin involvement in colon cancer, Diagn Interv Radiol. 2016;22:5-12. 8. Rollvén E, Abraham-Nordling M, Holm T, Blomqvist L. Assessment and diagnostic accuracy of lymph node status to predict stage III colon cancer using computed tomography, Cancer Imaging. 2017 Jan 19;17:3. 9. O’Connell MJ, Colangelo LH, Beart RW, Petrelli NJ, Allegra CJ, Sharif S, et al. Capecitabine and oxaliplatin in the preoperative multi modality treatment of rectal cancer: surgical end points from National Surgical Adjuvant Breast and Bowel Project trial R-04. J ClinOncol. 2014; 32: 1927-34 10. Cunningham D, Allum WH, Stenning SP, Thompson JN, Van de Velde CJ, Nicolson M, et al. Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer. N Engl J Med. 2006; 355: 11-20.
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Details
| Primary Language | Turkish |
|---|---|
| Journal Section | Original Research |
| Authors | |
| Publication Date | June 28, 2019 |
| Published in Issue | Year 2019 Volume: 9 Issue: 2 |
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