中国医学装备2026，Vol.23Issue(8)：23-27,5.DOI:10.3969/j.issn.1672-8270.2026.08.005
螺旋CT诊断胆囊癌淋巴结转移假阳性率的影响因素分析
Analysis on the influencing factors for false-positive rate of spiral CT in diagnosing lymph node metastasis of gallbladder cancer
摘要
Abstract
Objective:To investigate the influencing factors for false-positive rate of spiral computed tomography(CT)in diagnosing lymph node metastasis of gallbladder cancer,so as to increase diagnostic accuracy.Methods:A total of 96 patients with primary gallbladder cancer,who admitted to Hanzhong 3201 Hospital between January 2022 and January 2025,were enrolled in this analysis.All participants underwent preoperative contrast-enhanced CT examination on abdomen and postoperative pathological examination.Using pathological findings as gold standard,patients were divided into a false-positive group(n=32,CT findings indicated lymph node metastasis but pathological results were negative)and a true-negative group(n=64,both CT and pathological assessment were negative results).The differences of short diameter of lymph nodes(was measured by CT at portal venous phase),carbohydrate antigen 19-9(CA19-9)level(was determined within one week before surgery),thickness of gallbladder wall(was measured by CT at portal venous phase),maximal diameter of tumor(was measured by CT at portal venous phase),and diagnostic experience of physicians(based on different professional titles)and so on were compared between false-positive group and true-negative group.Results:Preoperative assessment revealed that the lymph node of false-positive group(short diameter>10 mm)was 87.50%(28/32),which was significantly higher than that of true-negative group[15.63%(10/64)],and the difference was significant(x2=45.632,P<0.001).The CA19-9 level of false-positive group were>37 U/ml,thickness of gallbladder wall were>5 mm,and maximal diameter(>4 cm)of tumor of false-positive group were higher than those of true-negative group,and the differences were significant(x2=13.562,19.276,18.294,P<0.05).Multivariate logistic regression analysis further identified age of patients,the maximum size of tumor>4 cm,short diameter of lymph node>10 mm,CA19-9 level>37 U/mL,thickness of gallbladder wall>5 mm,and diagnostic experience of physicians were independent influence factors for false-positive(OR=1.114,4.592,8.903,6.271,4.063,P<0.05).Conclusions:The false-positive rate in spiral CT diagnosis of lymph node metastasis of gallbladder cancer is influenced by patient age,tumor characteristics,and imaging indicators.A comprehensive assessment of these factors can help optimize the diagnostic workflow and reduce misdiagnoses.关键词
胆囊癌/淋巴结转移/螺旋CT/假阳性率/影响因素Key words
Gallbladder cancer/Lymph node metastasis/Spiral computed tomography(CT)/False-positive rate/Influencing factor分类
医药卫生引用本文复制引用
王丰,祝伟程,许华..螺旋CT诊断胆囊癌淋巴结转移假阳性率的影响因素分析[J].中国医学装备,2026,23(8):23-27,5.基金项目
陕西省2021年科技计划(2021SF-044)Shaanxi Province 2021 Science and Technology Program Project(2021SF-044) （2021SF-044）
