目的 了解螺旋CT扫描联合癌组 织HMGN5免疫组织化学染色检测预测膀胱 癌患者盆腔淋巴结转移风险的价值。方法 回顾性的研究了2015年1月至2017年12月 期间行根治性膀胱全切、盆腔淋巴结清扫 的患者47例，采集CT扫描结果、术后盆腔 淋巴结病理结果，并对石蜡包埋的癌组织 进行HMG5免疫组织化学染色。统计CT扫描 结果、免疫组织化学染色结果与淋巴结转 移的关系。结果 术前CT扫描淋巴结阳性 的8例患者中，有6例病理证实存在淋巴结 转移；CT扫描淋巴结阴性的39例患者中， 有7例病理证实存在淋巴结转移。免疫组 织化学染色阳性的15例患者中，有12例病 理证实存在淋巴结转移；染色阴性的32例 患者中，有1例存在淋巴结转移。CT扫描 淋巴结和免疫组织化学染色均为阳性的6 例患者，有5例术后病理证实存在淋巴结 转移。CT扫描淋巴结和免疫组织化学染色 均为阴性的30例患者，术后病理无一例提 示淋巴结转移。螺旋CT扫描联合癌组织 HMGN5免疫组织化学染色检测预测盆腔淋 巴结转移的假阴性率明显低于单用螺旋CT 扫描。结论 螺旋CT扫描联合癌组织HMGN5 免疫组织化学染色检查可准确预测盆腔淋 巴结转移。建议患者术前使用螺旋CT扫描 联合HMGN5免疫组织化学染色检测，以指 导术中盆腔淋巴结清扫范围。

Objective To evaluate the predictive value of combination of computed tomography (CT) and immunohistochemical staining of bladder cancer tissue with HMGN5 protein to the risk of pelvic lymphonodus metastases. Methods 47 cases of bladder cancer who underwent radical cystectomy and pelvic lymph node dissection (PLND) between Jan 2015 to Dec 2017 were investigated, and the data of their CT of urinary system and pelvic cavity, pathology of pelvic lymph nodes and results of immunohistochemical staining of bladder cancer tissue with HMGN5 protein were collected and analyzed. Results The results of CT scanning of pelvic lymph nodes of 8 cases were positive, and 6 of them with pelvic lymphonodus metastases determined in pathology. The results of CT scanning of pelvic lymph nodes of 39 cases were negative, and 7 of them with pelvic lymphonodus metastases determined in pathology. The results of immunohistochemical staining of 15 cases were positive, and 12 of them with pelvic lymphonodus metastases determined in pathology. The results of immunohistochemical staining of 32 cases were negative, and 1 of them with pelvic lymphonodus metastases determined in pathology. Both of results of CT and immunohistochemical staining of 6 cases were postive, and 5 of them with pelvic lymphonodus metastases determined in pathology. Both of results of CT and immunohistochemical staining of 30 cases were negative, and none of them with pelvic lymphonodus metastasis determined in pathology. Conclusion Combination of computed tomography (CT) and immunohistochemical staining of bladder cancer tissue with HMGN5 protein may predict the risk of pelvic lymphonodus metastases. The two examinations should be suggested before radical surgeries, because the decisions of ranges of PLND may depend on the results.