병리학적으로 림프절 전이가 없었던 조기위암 환자의 위주변 림프절에 대한 수술 전 다중검출기 CT 소견

Abstract

Purpose: To find the determinant of lymph node (LN) manifestations on preoperative multidetector CT (MDCT) in early gastric cancer (EGC) patients with pN0. Materials and Methods: One hundred and eighty-six consecutive patients with pT1pN0, the largest perigastric LN on preoperative MDCT, were categorized into two groups according to 8 different parameters [short (SD) and long diameter (LD) 4/6/8 mm, average attenuation 100 Hounsfield unit, short-to-long diameter-ratio (SLR) 0.7], and correlated with the size, gross type, depth of invasion and microscopic type of their primary lesions by the chi-square test and multiple logistic regression analysis. Results: When the primary lesion was larger than 3 cm, the LNs were larger in 4 parameters (SD or LD, 4/6 mm; p ＜ 0.05); gross type IIb patients showed smaller LNs in 5 parameters (SD 4/6 mm, LD 4/6/8 mm; p ＜ 0.05); and patients with microscopically-undifferentiated lesions showed larger LNs in SD 4 mm or LD 8 mm by the chi-square test and multiple logistic regression analysis. The depth of invasion showed no significant difference in LN size. No factors revealed significant difference in LN attenuation or SLR. Conclusion: Benign regional LN enlargement is more frequent in EGC patients with larger size primary lesions or lesion with poor microscopic differentiation. However, this condition is less frequent in gross type IIb patients.