多层螺旋CT对进展期胃癌Lauren分型的价值研究

The Lauren classification of advanced gastric carcinoma using multi-slice computed tomography

目的:评估多层螺旋CT(Multi slice computed tomography,MSCT)对进展期胃癌Lauren分型的应用价值。方法:回顾性分析114例经手术病理证实的进展期胃癌的MSCT影像学表现,以Lauren分型标准分为肠型胃癌和弥漫型胃癌两组,比较两组进展期胃癌的肿瘤厚度、长径、门脉期CT值、强化方式、肿瘤表面有无溃疡情况、淋巴结分期。结果:肠型和弥漫型胃癌分别为50例和64例,两组厚度分别为(18.42±7.40)mm和(17.17±5.14)mm,差异无统计学意义(t=1.07,P=0.29);长径分别为(50.70±17.29)mm和(60.82±23.33)mm;门脉期CT值(黏液腺癌除外)分别为(75.75±15.81)HU和(85.80±18.17)HU;强化方式:(均匀∶不均匀=27∶23和21∶43);表面情况:(平坦∶溃疡=13∶37和32∶32);以上差异均有统计学意义,分别为(t=-2.57,P=0.01),(t=-3.05,P=0.00),(χ~2=5.17,P=0.02),(χ~2=6.77,P=0.01);淋巴结分期与病理对照符合率分别为84.00%与81.25%。结论:MSCT对进展期胃癌的Lauren分型有较大价值,两型进展期胃癌在肿瘤长径、门脉期CT值(黏液腺癌除外)、强化方式及肿瘤表面有无溃疡方面均有较大差异,CT对胃癌淋巴结分期有较高符合率。

Objective： To investigate the value of multi-slice computed tomography（MSCT） in Lauren classification of advanced gastric carcinoma. Methods： MSCT imaging findings of 114 patients with advanced gastric cancer proved by operation or gastroscopy biopsy were analyzed retrospectively. All cases were divided into two groups, intestinal-type（IT） and diffuse-type （DT）, according to Lauren classification standard. The thickness, long diameters, CT values of portal venous phase, enhancement patterns and surface of the tumor were compared between the two groups. Results： A total of 50 and 64 cases were found in IT and DT gastric carcinoma. The thickness of two groups were （18.42±7.40） mm and （17.17±5.14） mm, the difference was not statistically significant（t=1.07, P=0.29）. The long diameters were （50.70±17.29） mm and （60.82±23.33） mm, CT values in portal venous phase（except mucinous adenocarcinoma）（75.75±15.81） HU and （85.80±18.17） HU, enhancement types（homogeneous：inhomogeneous）=（27：23） and （21：43）, surface condition of the tumor（flat：ulcer）=（13：37） and （32：32）, the differences were statistically significant, respectively（t=-2.57, P=0.01）, （t=-3.05, P=0.00）, （χ2=5.17, P=0.02）, （χ2=6.77, P=0.01）. The coincidence rates of lymph node staging and pathological contrast were 84.00% and 81.25% respectively. Conclusion： MSCT has important value in Lauren classification of advanced gastric carcinoma. There are significant differences in the long diameters, CT values in portal venous phase（except mucinous adenocarcinoma）, enhancement types and surface characteristics between IT and DT gastric tumor. CT has high coincidence rate with lymph node staging in gastric cancer.