目的探讨多层螺旋CT评价非小 细胞肺癌TNM分期与病理结果一致性。方 法 顾性分析我院2012年1月-2017年6月收 治的84例NSCLC患者，术前接受多层螺旋 CT检查，而后接受手术切除，所得组织送 实验室进行病理检查。结果 本组84例患 者中82例患者T分期与病理T分期结果一 致，总一致率83.33%，一致性非常满意 (Kappa=0.79)。CT-T4分期患者中1例患 者已病理证实病灶累及隔胸膜，但未侵 犯纵隔内脏，降为T3期。1CT-T3患者中1 例患者经病理证实为非主动脉受累，2例 诊断为T4期。CT-T2期患中5例患者术后 探及纵隔胸膜，3例患者术中探及心包诊 断为T3期。NSCLC患者中有18例患者发生 术后淋巴结转移,N分期患者与病理结果一 致(Kappa=0.51)。3CT-N0患者中病理已经 证实10例N1区淋巴癌转移，2例为纵隔内 淋巴结转移。CT-N1患者中经病理证实8例 患者未出现淋巴结转移，3例患者发生纵 隔内淋巴结转移，诊断为N2期。3例患者 术中探及肺门淋巴结转移，诊断为N1期。 MSCT对各组淋巴结转移的敏感度、特异 度、阳性预测值、阴性预测值及准确度均 不相同。结论 多层螺旋CT诊断非小细胞 肺癌TNM分期具有非常重要的意义，能作 为评估患者是否能接受手术治疗的重要依 据。

Objective To investigate the consistency between TNM staging and pathological results of non-small cell lung cancer (NSCLC) by multislice spiral CT. Methods Data of 84 patients with NSCLC treated in our hospital from January 2012 to June 2017 were retrospectively analyzed. All patients received preoperative multi-slice spiral CT examination and pathological examination. Results The total coincidence rate in T staging of CT and pathology was 83.33% (82/84, Kappa=0.79). 1 CT-T4 staging patients reduced to T3according to the pathological results. Among the 14 CT-T3 patients, one patient had non-aortic involvement confirmed by pathology, two patients were diagnosed as T4. Of patients with CT-T2, 5 patients involved mediastinal pleura after operation, and 3 patients involved pericardium during the operation were diagnosed as T3; Among NSCLC patients, 18 had postoperative lymph node metastases, and the T staging was consistent with the pathological findings (Kappa=0.51). The pathology of CT-N0 patients had confirmed 10 cases of lymph node metastasis in N1, and 2 cases of mediastinal lymph node metastasis. Of CT-N1 patients, no lymph node metastasis was found in 8 patients and 3 cases having mediastinal lymph node metastases were diagnosed as N2 stage. 3 cases involved intraoperative exploration and hilar lymph node metastasis were diagnosed as N1. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of MSCT were different in lymph node metastases of all groups. Conclusion Multi-slice spiral CT is of great significance in the diagnosis of TNM staging of non-small cell lung cancer, and it can be used as an important basis for assessing whether the patients can receive surgical treatment