胃癌螺旋CT术前评估及与手术病理分期对照研究

Dynamic CT in the Preoperative Staging of Gastric Cancer:Correlation with Surgical and Pathology Assessment

目的:应用螺旋CT行胃癌术前评估,并将CT分期与手术病理分期进行比较。方法:98例胃癌患者术前行腹部螺旋CT检查,并实施手术分期和病理分期。结果:所有患者行手术治疗,其中16例(16%)无法切除,82例(84%)手术切除。CT扫描中胃壁的厚度和浆膜的累及有相关性(P<0.001)。CT和手术预测病理分期的符合率分别为68%和52%。CT过度分期只有17%。结论:螺旋CT是胃癌患者术前检查的一种有效的方法,可预测胃癌病灶的可切除性,从而避免某些不必要的剖腹手术或使手术方案更加合理。CT过度分期的概率较低,其分期的准确率高于手术。

Objective：To study the dynamic spiral CT in the preoperative staging for patients with gastric cancer and correlated with surgical and pathology assessment. Methods： Dynamic CT of the abdomen was performed in 98 patients with gastric adenocareinoma before surgery, and the CT features were correlated with pathology findings. Results：Of the total 98 patients,tumor in 16 cases （16%） were non-reseetable,and in 82 cases （84%） had tumor reseeted. Wall thickness assessed in dynamic CT correlated with the risk of serosal involvement （P〈0. 001）. The accuracy of CT and surgery in demonstrating tumor staging were 64% and 52% respectively when correlated with pathology. CT overstaging was 17%. Conclusion： Dynamic CT is a useful modality in predicting the resectability of gastric carcinoma,and unnecessary laparatomy can be prevented.