64排螺旋CT与组织病理对胃癌患者TNM分期的对照研究

Comparison of TNM staging on 64 row spiral CT and pathological staging of gastric carcinoma

目的比较胃癌患者术前64排螺旋CT判定的TNM分期与术后组织病理TNM分期的差异。方法经手术组织病理证实胃癌患者166例,术前均行64排螺旋CT检查(平扫+增强)并判定TNM分期,以组织病理TNM分期为金标准,比较术前64排螺旋CT判定的TNM分期与金标准的一致性。结果 64排螺旋CT判定T分期、N分期、M分期与组织病理TNM分期的符合率分别为69.3%、72.9%、95.8%,64排螺旋CT判定的T分期及N分期与手术组织病理结果一致性一般(Kappa=0.59,0.58,P=0.000),与M分期一致性较好(Kappa=0.75,P=0.000)。结论 64排螺旋CT增强扫描结合多平面重建对胃癌术前TNM分期尤其是M分期诊断有较高价值。

Objective To compare the difference between TNM stage of gastric cancer on 64 row spiral CT proved by gastroscopy before operation and the pathological TNM stage after operation. Methods A total of 166 cases of pathologically confirmed gastric carcinoma received preoperation CT scan. The pathological TNM stage was as the gold standard. The coherence of preoperative signs on CT was compared with the gold standard. Results The coherence rates of T-stage, N-stage and M-stage on CT and histopathologic result were 69.3%, 72.9% and 95.8%, T-stage and N-stage had a good coherence （Kappa = 0. 59, 0. 58, P= 0. 000）. M-stage had a very good coherence （Kappa = 0. 75, P= 0. 000）. Conclusion Enhanced 64 row spiral CT scan combined with multiplanar reconstruction has a great value to the preoperative TNM staging of gastric cancer, especially to M-stage.