T2期胃癌的临床病理特征和CT评估

Clinicopathological Features and CT Evaluation of Patients with T_2 Gastric Cancer

目的探讨T2期胃癌的临床病理特征及CT评估。资料与方法选取141例行胃切除术的T2期胃癌患者,对其临床病理特征及CT分期进行分析。结果在141例患者中,60例(42.6%)肿瘤浸润至浅肌层,72例(51.1%)肿瘤浸润至深肌层,9例(6.4%)肿瘤浸润至浆膜下。与浸润至深肌层患者相比,浸润至浅肌层者的肿瘤体积更小,分化程度更高。两组间在患者性别、年龄、肿瘤部位、肿瘤的大体形态、淋巴结转移及病理分期等方面差异均无统计学意义。CT对T2期胃癌患者T分期、N分期及M分期的准确率分别为92.2%、72.3%和92.3%;对于转移淋巴结判断的敏感性为77.9%,特异性为65.6%。综合判断CT对于胃癌TNM分期的准确性为68.8%。结论T2期胃癌患者的临床病理特征明确,浸润至浅肌层的肿瘤体积更小,分化程度更高。CT在T2期胃癌患者的TNM分期上的准确性较高。

Objective To discuss the clinicopathological features and CT evaluation of patients with T2 gastric cancer. Materials and Methods 141 patients who underwent gastrectomy for T2 gastric cancer were selected for this retrospective study. The clinicopathologic findings and CT staging of these patients were analyzed retrospectively. Results Of 141 patients with gastric cancer, 60 patients （42.6%） had tumors invading the superficial muscularis propria （smp）. 72 patients （51.1% ） had tumors invading the deep muscularis propria （dmp）. The remaining 9 patients （6.4%） had tumors invading the subserosa （ss）. Compared with dmp gastric cancer, smp gastric cancer was associated with smaller tumor size and higher tumor differentiation. There was no significant difference among the groups between with age, sex, tumor location, tumor gross figure, lymph node metastasis and tumor staging. The accuracy of MDCT in T, N and M stage of T2 gastric cancer were 92.2%, 72.3% and 92.3%. The MDCT had a sensitivity of 77.9%, a specificity of 65.6% in predicting lymph node metastasis. The total accuracy in determining TNM staging was 68.8%. Conclusion The clinicopathological features of intermediate stage T2 gastric cancer is specific, smp gastric cancer is associated with smaller tumor size and higher tumor differentiation. The MDCT has higher accuracy in determining TNM staging of gastric cancer.