CT在胃癌诊治中的作用

Application of CT in Diagnosis and Treatment of Gastric Carcinoma

探讨CT在胃癌诊断和治疗中的价值。材料和方法：对25例术后作CT随访及56例术前经CT检查的胃癌患者资料分别进行手术近、远期疗效和手术切除率分析。另对47例胃癌CT所见进行术前手术切除可能性预测。分析同期13例胃肠道影和／或内镜未能确诊者的CT检查结果，对照手术以探讨CT对胃癌的诊断价值。结果：胃癌患者术前未经CT检查，作“手术切除可能性”预测，无选择性地手术，其切除率仅53．57％。五年生存率28．0％，且均已有远处转移灶出现。经CT预测后选择的手术者中切除率可达90．91％，CT估计准确率为90．63％。13例胃肠造影和／或内镜未能作出诊断（幽门狭窄，胃壁占位，贲门部肿块）者中，11例（胃癌3例，溃疡1例，平滑肌瘤2例，平滑肌肉瘤1例，静脉曲张2例，胃外良性肿瘤2例）由CT作出正确诊断。结论：CT在胃癌的诊断、鉴别诊断、和术前判断手术切除可能性方面有用，可作为胃癌术前常规检查技术应用。

To explore the role of CT in diagnosis and treatment of gastric carcinoma. Materials andMethods: Analysed 56 cases (compared the preoperative CT findings with surgery in retrospectivegroup) and 25 cases (postoperative CT scan) of gastric carcinoma evaluating the surgical resectable rateand the curative effect. According to CT findings, the tumor resectability of other 47 cases (prorpectivegroup) were predicted before operation. The CT scans of another 13 cases, with gastric lesions detected,but the differential diagnosis couldn' t be Inade by GI series and/ or endoscopy, were also discussed.Results: The surgical resectale rate of retrospective group) in operated patients at random prerperative, was 53. 57%. The five - years survival rate of patients with gastric carinoma, without the CT scanwasn't preoperatively done, was 28. 0%. In cases of prospective group, the surgical resectable rate waspromoted to 90. 91%. 11/13 cases (3 gastric carcinoma, 1 ulcer, 2 leiomyomas, 1 leiomyosarcoma, 2varices and 2 extra-mural benign tumors) were arcurately diagnosed by CT, and proved by surgery.Conclusion: Preoperative CT scan is beneficial to the diagnosis. differential diagnosis, and valuation oftumor resecboility in gastric carcinoma, therefore should be used routinely.