Preoperative CT lymph node size as a predictor of nodal metastasis in resectable Colon cancer: a retrospective study of 694 patients.

IF 2.5 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY BMC Gastroenterology Pub Date : 2025-01-14 DOI:10.1186/s12876-025-03602-x

Tetsuro Kawazoe, Ryota Nakanishi, Koji Ando, Yoko Zaitsu, Kensuke Kudou, Yuichiro Nakashima, Eiji Oki, Tomoharu Yoshizumi

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Abstract

Purpose: This study aimed to investigate the efficacy of measuring lymph node size on preoperative CT imaging to predict pathological lymph node metastasis in patients with colon cancer to enhance diagnostic accuracy and improve treatment planning by establishing more reliable assessment methods for lymph node metastasis.

Methods: We retrospectively analyzed 1,056 patients who underwent colorectal resection at our institution between January 2004 and March 2020. From this cohort, 694 patients with resectable colon cancer were included in the study. We analyzed the relationship between lymph node size on preoperative CT imaging and lymph node metastasis identified on postoperative pathological examination.

Results: The optimal cutoff values for the maximum long diameter and short diameter of regional lymph nodes on preoperative CT were identified as 6.5 mm and 5.5 mm, respectively, with an AUC of 0.7794 and 0.7755, respectively. Notably, the predictive accuracy varied by tumor location. Higher cutoff values were observed in the right-sided colon (maximum long diameter: 7.7 mm, maximum short diameter: 5.9 mm) compared to the left-sided colon (maximum long diameter: 5.8 mm, maximum short diameter: 5.2 mm).

Conclusion: Lymph node size on preoperative CT is a significant predictor of pathological lymph node metastasis in colon cancer. Notably, the optimal cutoff values for predicting lymph node metastasis vary depending on the specific region within the colon.

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术前CT淋巴结大小预测可切除结肠癌淋巴结转移：一项694例患者的回顾性研究

目的：本研究旨在通过建立更可靠的淋巴结转移评估方法，探讨术前CT成像测量淋巴结大小对预测结肠癌患者病理性淋巴结转移的疗效，提高诊断准确性，改进治疗方案。方法：我们回顾性分析了2004年1月至2020年3月在我院接受结直肠切除术的1,056例患者。从这个队列中，694例可切除结肠癌患者被纳入研究。我们分析术前CT检查淋巴结大小与术后病理检查淋巴结转移的关系。结果：术前CT确定区域淋巴结最大长径和短径的最佳截断值分别为6.5 mm和5.5 mm， AUC分别为0.7794和0.7755。值得注意的是，预测准确性因肿瘤位置而异。与左侧结肠（最大长直径：5.8 mm，最大短直径：5.2 mm）相比，右侧结肠（最大长直径：7.7 mm，最大短直径：5.9 mm）的临界值更高。结论：术前CT淋巴结大小是预测结肠癌病理性淋巴结转移的重要指标。值得注意的是，预测淋巴结转移的最佳截止值取决于结肠内的特定区域。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

BMC Gastroenterology 医学-胃肠肝病学

CiteScore

4.20

自引率

0.00%

发文量

465

审稿时长

6 months

期刊介绍： BMC Gastroenterology is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of gastrointestinal and hepatobiliary disorders, as well as related molecular genetics, pathophysiology, and epidemiology.