CT仿真内窥镜与钡餐检查在早期胃癌鉴别中的应用比较

Comparison of CT virtual endoscopy and barium meal examination in differential diagnosis of early gastric cancer

目的:探讨CT仿真内窥镜(CTVE)与钡餐检查在早期胃癌鉴别中的应用价值。方法:回顾性分析于我院临床科室就诊行CTVE或钡餐检查的220例患者的临床资料,其中行CTVE和钡餐检查的患者各110例,分析CTVE及钡餐诊断早期胃癌与术后病理结果诊断的一致性,并比较两者诊断准确度、敏感度、特异度、阳性预测值、阴性预测值。结果:经配对卡方检验可知,CTVE诊断早期胃癌与病理诊断结果比较无统计学意义(P>0.05),两种检验诊断早期胃癌一致性极佳(P<0.05)。经配对卡方检验可知,钡餐诊断早期胃癌与病理诊断结果比较无统计学意义(P>0.05),两种检验诊断早期胃癌一致性较好(P<0.05)。以病理诊断结果为准,CTVE诊断早期胃癌敏感度、特异度、准确度、阳性预测值、阴性预测值均高于钡餐诊断,差异有统计学意义(P<0.05)。结论:与钡餐诊断相比,CTVE诊断早期胃癌一致性更好,且准确度、敏感度、特异度、阳性预测值、阴性预测值均较高,具有较好的临床应用价值。

Objective： To evaluate the value of CT virtual endoscopy（ CTVE） and barium meal examination in the differential diagnosis of early gastric cancer. Methods： The clinical data of 220 patients who underwent CTVE or barium meal examination in our department were analyzed retrospectively. CTVE and barium meal examination were performed in 110 patients. The consistency of CTVE diagnosis and postoperative pathological diagnosis was analyzed. The consistency between the diagnosis of barium meal and the pathological findings after operation was compared. The diagnostic accuracy,sensitivity,specificity,positive predictive value and negative predictive value of CTVE and barium meal examination were compared. Results： Paired chi square test showed that CTVE diagnosis of early gastric cancer and pathological diagnosis were not statistically significant（ P〈0. 05）. The two tests showed excellent agreement with early diagnosis of gastric cancer（ P〈0. 05）. The paired chi square test showed that there was no statistical significance in the diagnosis of early gastric cancer by barium meal examination（ P〈0. 05）. The two tests showed a good agreement in the diagnosis of early gastric cancer（ P〈0. 05）. According to the pathological diagnosis,the sensitivity,specificity,accuracy,positive predictive value and negative predictive value of CTVE in early gastric cancer were higher than that of barium meal（ P〈0. 05）. Conclusion： Compared with barium meal diagnosis,CTVE has better consistency in diagnosis of early gastric cancer,and has higher accuracy,sensitivity,specificity,positive predictive value or negative predictive value,which has better clinical value.