Diagnostic value of recurrent laryngeal nerve lymph node metastasis by multiplanar reconstruction of spiral CT in thoracic esophageal carcinoma_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

LIU Yu , ZOU Zhiqiang , XIN Ning , LI Chuanhai ,  ZHANG Mei

Department of Thoracic Surgery, The 960th Hospital of the Joint Service Support Force of the Chinese People's Liberation Army, Jinan, 250031, P.R.China;

Corresponding author：

ZHANG Mei, Email: zhangmeiMZ@163.com

Keywords：

Esophageal cancer; multiplanar reconstruction; recurrent laryngeal nerve; lymph node metastasis; diagnosis

DOI：

10.7507/1007-4848.202001076

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Objective To investigate the diagnostic value and the best criteria of multiplanar reconstruction (MPR) of spiral CT in recurrent laryngeal nerve lymph node metastasis.Methods We performed multiplanar reconstruction of the spiral CT data of 138 esophageal carcinoma patients admitted to our hospital between December 2016 and June 2019, including 113 males and 25 females with an average age of 47-85 (63.03±15.58) years. The short and long diameters of recurrent laryngeal nerve lymph nodes were measured respectively, and then ratio of short to long diameter was calculated. The three parameters were contrasted with the pathological results and the receiver operating characteristic (ROC) curves for the parameters were drawn.Results Of the 138 patients, 291 left recurrent laryngeal nerve lymph nodes were dissected with an average number of 0-14 (2.11±0.41) per patient and the metastasis rate was 16.70%; while 436 right ones were dissected with the average number of 0-17 (3.16±0.45) per patient and the metastasis rate was 21.00%. The total metastasis rate was 29.70%. In the diagnosis of lymph node metastasis, the areas under ROC curve for short and long diameters as well as the ratio of short to long diameter of left recurrent laryngeal nerve lymph nodes were 0.808, 0.779, 0.621, respectively, while those for the right ones were 0.865, 0.807, 0.637, respectively.Conclusion The metastasis rate of recurrent laryngeal nerve lymph nodes is high and the short diameter has a higher diagnostic value for recurrent laryngeal nerve lymph node metastasis.

Citation： LIU Yu, ZOU Zhiqiang, XIN Ning, LI Chuanhai, ZHANG Mei. Diagnostic value of recurrent laryngeal nerve lymph node metastasis by multiplanar reconstruction of spiral CT in thoracic esophageal carcinoma. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2020, 27(10): 1177-1181. doi: 10.7507/1007-4848.202001076 Copy

1.	赵宏光, 胡艳君, 毛伟敏, 等. 食管癌右喉返神经旁淋巴结转移的相关因素研究. 中华肿瘤杂志, 2010, 32(5): 387-390.
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6.	Mariette C, Piessen G. Oesophageal cancer: how radical should surgery be? Eur J Surg Oncol, 2012, 38(3): 210-213.
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11.	Kanemura T, Makino T, Miyazaki Y, <italic>et al</italic>. Distribution patterns of metastases in recurrent laryngeal nerve lymph nodes in patients with squamous cell esophageal cancer. Dis Esophagus, 2017, 30(1): 1-7.
12.	Yoon YC, Lee KS, Shim YM, <italic>et al</italic>. Metastasis to regional lymph nodes in patients with esophageal squamous cell carcinoma: CT versus FDG PET for presurgical detection prospective study. Radiology, 2003, 227(3): 764-70.
13.	吴汉然, 柳常青, 郭明发, 等. CT诊断胸段食管癌最小径>1 cm淋巴结转移的应用研究. 中华外科杂志, 2019, 57(8): 601-606.
14.	Peters TT, Castelijns JA, Ljumanovic R, <italic>et al</italic>. Diagnostic value of CT and MRI in the detection of paratracheal lymph node metastasis. Oral Oncol, 2012, 48(5): 450-455.
15.	Sugawara K, Yamashita H, Uemura Y, <italic>et al</italic>. Preoperative lymph node status on computed tomography influences the survival of pT1b, T2 and T3 esophageal squamous cell carcinoma. Surg Today, 2019, 49(5): 378-386.
16.	Liu J, Wang Z, Shao H, <italic>et al</italic>. Improving CT detection sensitivity for nodal metastases in oesophageal cancer with combination of smaller size and lymph node axial ratio. Eur Radiol, 2018, 28(1): 188-195.
17.	Li J, Chen S, Zhu G. Comparative study of computed tomography (CT) and pathological diagnosis toward mediastinal lymph node metastasis in esophageal carcinoma. Rev Assoc Med Bras, 2018, 64(2): 170-174.
18.	张倩倩, 申洪明, 李文武, 等. MSCT诊断胸段食管癌喉返神经链淋巴结转移及其临床意义. 中国医学影像技术, 2013, 29(1): 59-62.
19.	Saito H, Sato T, Miyazaki M. Extramural lymphatic drainage from the thoracic esophagus based on minute cadaveric dissections: fundamentals for the sentinel node navigation surgery for the thoracic esophageal cancers. Surg Radiol Anat, 2007, 29(7): 531-542.
20.	Okuda I, Kokubo T, Hoshihara Y, <italic>et al</italic>. Imaging diagnosis of esophageal carcinoma by computed tomography and magnetic resonance imaging. Nihon Geka Gakkai Zasshi, 2002, 103(4): 331-336.

1. 赵宏光, 胡艳君, 毛伟敏, 等. 食管癌右喉返神经旁淋巴结转移的相关因素研究. 中华肿瘤杂志, 2010, 32(5): 387-390.
2. Tabira Y, Yasunaga M, Tanaka M, <italic>et al</italic>. Recurrent nerve nodal involvement is associated with cervical nodal metastasis in thoracic esophageal carcinoma. J Am Coll Surg, 2000, 191(3): 232-237.
3. Stiles BM, Mirza F, Port JL, <italic>et al</italic>. Predictors of cervical and recurrent laryngeal lymph node metastases from esophageal cancer. Ann Thorac Surg, 2010, 90(6): 1805-1811.
4. 邹志强, 袁耒, 胡凤标, 等. 开放手术与腔镜下根治切除术治疗胸段食管鳞癌的病例对照研究. 中国胸心血管外科临床杂志, 2018, 25(1): 78-82.
5. Altorki N, Kent M, Ferrara C, <italic>et al</italic>. Three-field lymph node dissection for squamous cell and adenocarcinoma of the esophagus. Ann Surg, 2002, 236(2): 177-183.
6. Mariette C, Piessen G. Oesophageal cancer: how radical should surgery be? Eur J Surg Oncol, 2012, 38(3): 210-213.
7. Wu LF, Wang BZ, Feng JL, <italic>et al</italic>. Preoperative TN staging of esophageal cancer: comparison of miniprobe ultrasonography, spiral CT and MRI. World J Gastroenterol, 2003, 9(2): 219-224.
8. Japan Esophageal Society. Japanese classification of esophageal cancer, 11th edition: part Ⅰ. Esophagus, 2017, 14(1): 1-36.
9. 刘玉, 邹志强, 袁耒, 等. 胸段食管鳞癌喉返神经旁淋巴结转移规律探讨. 中华胸心血管外科杂志, 2018, 34(2): 79-82.
10. Ye K, Xu JH, Sun YF, <italic>et al</italic>. Characteristics and clinical significance of lymph node metastases near the recurrent laryngeal nerve from thoracic esophageal carcinoma. Genet Mol Res, 2014, 13(3): 6411-6419.
11. Kanemura T, Makino T, Miyazaki Y, <italic>et al</italic>. Distribution patterns of metastases in recurrent laryngeal nerve lymph nodes in patients with squamous cell esophageal cancer. Dis Esophagus, 2017, 30(1): 1-7.
12. Yoon YC, Lee KS, Shim YM, <italic>et al</italic>. Metastasis to regional lymph nodes in patients with esophageal squamous cell carcinoma: CT versus FDG PET for presurgical detection prospective study. Radiology, 2003, 227(3): 764-70.
13. 吴汉然, 柳常青, 郭明发, 等. CT诊断胸段食管癌最小径>1 cm淋巴结转移的应用研究. 中华外科杂志, 2019, 57(8): 601-606.
14. Peters TT, Castelijns JA, Ljumanovic R, <italic>et al</italic>. Diagnostic value of CT and MRI in the detection of paratracheal lymph node metastasis. Oral Oncol, 2012, 48(5): 450-455.
15. Sugawara K, Yamashita H, Uemura Y, <italic>et al</italic>. Preoperative lymph node status on computed tomography influences the survival of pT1b, T2 and T3 esophageal squamous cell carcinoma. Surg Today, 2019, 49(5): 378-386.
16. Liu J, Wang Z, Shao H, <italic>et al</italic>. Improving CT detection sensitivity for nodal metastases in oesophageal cancer with combination of smaller size and lymph node axial ratio. Eur Radiol, 2018, 28(1): 188-195.
17. Li J, Chen S, Zhu G. Comparative study of computed tomography (CT) and pathological diagnosis toward mediastinal lymph node metastasis in esophageal carcinoma. Rev Assoc Med Bras, 2018, 64(2): 170-174.
18. 张倩倩, 申洪明, 李文武, 等. MSCT诊断胸段食管癌喉返神经链淋巴结转移及其临床意义. 中国医学影像技术, 2013, 29(1): 59-62.
19. Saito H, Sato T, Miyazaki M. Extramural lymphatic drainage from the thoracic esophagus based on minute cadaveric dissections: fundamentals for the sentinel node navigation surgery for the thoracic esophageal cancers. Surg Radiol Anat, 2007, 29(7): 531-542.
20. Okuda I, Kokubo T, Hoshihara Y, <italic>et al</italic>. Imaging diagnosis of esophageal carcinoma by computed tomography and magnetic resonance imaging. Nihon Geka Gakkai Zasshi, 2002, 103(4): 331-336.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Diagnostic value of recurrent laryngeal nerve lymph node metastasis by multiplanar reconstruction of spiral CT in thoracic esophageal carcinoma

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