多层螺旋CT在结肠癌诊断及术前分期中的临床价值分析

Clinical Value of Multi-Slice Spiral CT in Diagnosis and Preoperative Staging of Colon Cancer

目的:探讨多层螺旋CT对结肠癌患者术前诊断和分期中的临床应用价值,旨在为结肠癌患者临床治疗方案的确定提供有效的诊断方法。方法:回顾性分析2015年5月至2017年4月64例经手术后病理确诊为结肠癌患者的临床资料,所有受试者术前均接受多层螺旋CT(MSCT)增强扫描及腹部B超检查,以术后病理分期为金标准,对比MSCT及腹部B超对结肠癌的诊断符合率及淋巴结转移检出率;同时将MSCT分期与病理分期相比,评估MSCT对结肠癌术前分期的诊断准确率。结果:与病理诊断结果比较,MSCT诊断符合率及淋巴结转移检查率均高于腹部B超检查(98.44%vs 71.88%,80.77%vs 53.84%),差异均具有统计学意义(P<0.05);与病理分期结果比较,MSCT T分期阳性诊断符合率为92.19%(59/64),N分期阳性诊断符合率为80.77%(21/26),经诊断一致性检验(Kappa T分期=0.894,Kappa N分期=0.858),Kappa≧0.75一致性较好。结论:多层螺旋CT增强扫描能够准确诊断结肠癌及评估术前分期,具有较高的临床应用价值。

Objective： To explore the clinical value of multi-slice spiral CT in preoperative diagnosis and staging of colorectal cancer patients,and to select effective diagnostic methods for the determination of clinical treatment. Methods：The clinical data of 64 cases of colon cancer diagnosed pathologically in our hospital from May 2015 to April 2017 were analyzed retrospectively,All subjects before operation underwent MSCT scan with enhanced plain scan and abdominal B-ultrasonography,The postoperative pathologic staging as the gold standard,the positive rate of colorectal cancer detection rate,the detection rate of lesion and the detection rate of lymph node metastasis were compared with MSCT and abdominal B-ultrasonography. At the same time,the MSCT examination was compared with the pathological stage to evaluate the diagnostic accuracy of MSCT for preoperative staging of colon cancer. Results： Compared with the pathological results,MSCT diagnostic coincidence rate and lymph node metastasis rate were higher than abdominal B-ultrasound（ 98. 44% vs 71. 88%,80. 77% vs 53. 84%）,the difference were statistically significant（ P〈0. 05）; Compared with the pathological examination,the coincidence rate of MSCT T staging was 92. 19%（59/64）,the positive rate of N staging was 80. 77%（21/26）,The diagnostic consistency test showed good agreement（ Kappa T stage = 0. 894,Kappa N staging = 0. 858）. Conclusion： Enhanced scan with multi-slice spiral CT scan can accurately diagnose colon cancer and assess the preoperative staging,and it has a high clinical value.