胃窗超声造影、多层螺旋CT及两者联合诊断胃癌的价值比较

Comparative study of oral contrast ultrasonography, multislice CT and their combination in diagnosing gastric cancer

目的:探讨胃窗超声造影(OCU)、多层螺旋CT(MSCT)及两者联合诊断胃癌的价值。方法:60例经胃镜活检和术后证实的胃癌患者术前均行OCU、MSCT检查,将TNM分期情况与术后病理进行对照分析。结果:T分期总准确率OCU为80.00%(48/60)、MSCT为71.67%(43/60)、两者联合为88.33%(53/60),3者对胃癌T分期的诊断差异无统计学意义(P>0.05),但对于胃癌的T1、T2分期OCU(62.5%、77.8%)较MSCT(37.5%、55.6%)准确率高。N分期总准确率OCU为61.67%(37/60)、MSCT为73.33%(44/60)、两者联合为85.00%(51/60),3者对胃癌N分期的诊断差异有统计学意义(P<0.05),其中N3分期准确率OCU为35.00%(7/20)、MSCT为75.00%(15/20),两者诊断差异有统计学意义(P<0.05)。M分期单用两种检查及联合检查无显著差异。结论:OCU与MSCT联合诊断,可提高胃癌术前TNM分期,对拟定手术方式或治疗方案具有重要的参考价值。

Objective: To study the value of using oral contrast ultrasonography(OCU),multislice computed tomography(MSCT),and the combination of the two methods in diagnosing gastric cancer.Methods: Sixty cases of gastric cancer confirmed by endoscopic biopsies and surgeries were examined by OCU and MSCT before surgery.Imaging TNM staging and postoperative pathology were compared.Results: For the total accuracy of T staging,OCU was 80.00%(48/60),MSCT was 71.67%(43/60),and their combination was 88.33%(53/60).The difference of these three methods for T staging was not statistically significant(P>0.05).However,for T1 and T2 staging,OCU(62.50%,77.78%) was more accurate than MSCT(37.50%,55.56%).For the total accuracy of N staging,OCU was 61.67%(37/60),MSCT was 73.33%(44/60),and their combination was 85.00%(51/60).The difference of these three methods for N staging was statistically significant(P<0.05).For the accuracy of N3 staging,OCU was 35.00%(7/20),MSCT was 75.00%(15/20),and their difference was statistically significant(P<0.05).There was no significant difference among OCU,MSCT and their combination for M staging.Conclusions: The combination of OCU and MSCT can improve the accuracy of TNM staging for gastric cancer,and have important reference value for designing surgery or treatment programs.