Study progress in the diagnosis of lymph node metastasis of rectal cancer

doi:10.3877/cma.j.issn.2095-3224.2023.06.013

Abstract

Abstract:

The diagnosis strategy of lymph node metastasis of rectal cancer has always been a hot topic in the field of surgery. At present, the size and morphological changes of lymph nodes are usually used to judge whether lymph nodes have metastasis, but this method is not accurate. Recent studies have proposed that clinical risk factors such as lymph node metastasis prediction model, imaging omics model and convolutional neural network model can make better use of a variety of clinical tests and examination indicators of patients, improve the diagnostic efficiency of lymph node metastasis from rectal cancer, and contribute to the individualized treatment of rectal cancer. In this paper, the progress of diagnostic methods for lymph node metastasis of rectal cancer is reviewed, in order to explore the feasibility of a high-performance diagnostic model for lymph node metastasis of rectal cancer.

Key words: Rectal neoplasms, Lymphatic metastasis, Diagnosis

Hongjie Yang, Zhichun Zhang, Yi Sun. Study progress in the diagnosis of lymph node metastasis of rectal cancer[J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2023, 12(06): 512-518.

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References 58

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文献	MRI		ERUS		CT
文献	敏感度	特异度	敏感度	特异度	敏感度	特异度
Bipat S，2004^[21]	0.66（0.54~0.76）	0.76（0.59~0.87）	0.67（0.60~0.73）	0.78（0.71~0.84）	0.55（0.63~0.67）	0.74（0.67~0.80）
Li XT，2015^[22]	0.76（0.70~0.81）	0.77（0.72~0.81）	0.63（0.58~0.68）	0.80（0.77~0.83）	0.70（0.59~0.79）	0.75（0.67~0.81）

文献	MRI		ERUS		CT
文献	敏感度	特异度	敏感度	特异度	敏感度	特异度
Bipat S，2004^[21]	0.66（0.54~0.76）	0.76（0.59~0.87）	0.67（0.60~0.73）	0.78（0.71~0.84）	0.55（0.63~0.67）	0.74（0.67~0.80）
Li XT，2015^[22]	0.76（0.70~0.81）	0.77（0.72~0.81）	0.63（0.58~0.68）	0.80（0.77~0.83）	0.70（0.59~0.79）	0.75（0.67~0.81）

文献	例数	危险因素数量	危险因素	敏感度	特异度	AUC
Toiyama Y，2015^[36]	157	6	性别、肿瘤直径、肿瘤形态、组织类型、血清、ANGPTL2	0.72	0.75	0.80
Xu H，2021^[37]	341	8	T分期、N分期、CEA、CA19-9、ADC均值、EMVI、直肠癌环周切缘、组织学分级	0.68、0.68、0.73	0.87、0.78、0.80	0.79、0.77、0.76
Ogawa S，2015^[38]	176	4	T分期、N分期、年龄、BMI	0.72	0.77	0.79
Liu Y，2016^[39]	411	5	T分期、淋巴结短径、肿瘤分化程度、CEA、直肠癌环周切缘	0.85	0.56	0.76

文献	例数	危险因素数量	危险因素	敏感度	特异度	AUC
Toiyama Y，2015^[36]	157	6	性别、肿瘤直径、肿瘤形态、组织类型、血清、ANGPTL2	0.72	0.75	0.80
Xu H，2021^[37]	341	8	T分期、N分期、CEA、CA19-9、ADC均值、EMVI、直肠癌环周切缘、组织学分级	0.68、0.68、0.73	0.87、0.78、0.80	0.79、0.77、0.76
Ogawa S，2015^[38]	176	4	T分期、N分期、年龄、BMI	0.72	0.77	0.79
Liu Y，2016^[39]	411	5	T分期、淋巴结短径、肿瘤分化程度、CEA、直肠癌环周切缘	0.85	0.56	0.76

文献	例数	图像类型	ROI区域	临床危险因素	敏感度	特异度	AUC	C指数
Huang YQ，2016^[41]	326	CT	-	CEA、淋巴结状态	-	-	-	0.78
He J，2021^[45]	199	PET-CT	SUV>2.5	淋巴结短径、簇状淋巴结	0.72	0.73	0.73	-
Xian MF，2019^[49]	87	SWE	-	-	0.88	0.79	0.88	-
Yang YS，2021^[42]	139	MRI	原发病灶	CEA、淋巴结状态	0.85	0.82	0.90	-
Meng X，2019^[43]	345	MRI	原发病灶	淋巴结状态	0.73	0.57	0.70	-
Zhou X，2020^[44]	391	MRI	原发病灶	T分期，M分期	0.83	0.73	0.81	-
Eresen A，2020^[46]	390	CT	淋巴结	-	0.74	0.85	0.83	-
Chen LD2018^[50]	115	ERUS	原发病灶
		CT	原发病灶	CEA	-	-	-	0.86
		SWE	圆形区域
Zhu H，2019^[47]	215	MRI	淋巴结	-	0.95	0.60	0.81	-
Zhu H，2019^[47]	215	MRI	原发病灶	-	0.32	0.81	0.52	-
Li M，2020^[48]	766	CT	淋巴结	-	0.43	0.79	0.64	-
			原发病灶	-	0.60	0.56	0.60	-
			原发病灶+淋巴结	CA19-9、CEA等	0.65	0.78	0.76	-
Nakanishi R，2020^[51]	247	CT	侧方淋巴结	-	-	-	0.91	-

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