多排螺旋CT对胃癌T分期的诊断价值

Diagnostic Value of Multi-Slice Spiral CT in T Staging of Gastric Cancer

目的探讨多排螺旋CT在胃癌T分期中的诊断价值。方法选取2014年1月至2019年6月镇江市第一人民医院收治的75例术前经胃镜证实为胃癌的患者,均接受多排螺旋CT三期增强扫描,分析多排螺旋CT对早期胃癌及进展期胃癌的检出情况、胃癌T分期的诊断准确情况、淋巴结转移的诊断准确性、预测可切除性的准确率等。结果多排螺旋CT对早期胃癌及进展期胃癌的检出率分别为66.7%(14/21)、100.0%(54/54),总诊断符合率为90.7%(68/75)。多排螺旋CT对胃癌T分期总体诊断的准确率为90.7%(68/75),其中对T 1、T 2、T 3、T 4期诊断的准确率分别为76.5%(13/17)、92.0%(23/25)、95.2%(20/21)、100.0%(12/12)。多排螺旋CT对淋巴结转移的准确率为95.0%(57/60),其中胃周淋巴结34例,准确率为94.4%(34/36);腹腔动脉旁、肠系膜根部、腹主动脉等部位淋巴结24例,准确率为95.8%(23/24)。多排螺旋CT对切除性的评估准确率为89.3%(67/75),对胃癌N分期的总体诊断准确率为78.7%(59/75),其中N 0期47例,准确率为85.5%;N 1期9例,准确率为60.0%;N 2期3例,准确率为60.0%。结论多排螺旋CT对胃癌的诊断、分期、可切除性判断均具有较高价值,可为临床诊疗提供有效参考。

Objective To explore the diagnostic value of multi-slice spiral CT in T staging of gastric cancer.Methods Seventy-five patients with gastric cancer admitted to Zhenjiang First People's Hospital from Jan.2014 to Jun.2019 confirmed by gastroscopy before operation were included in the study.All patients received three-phase enhanced multi-slice spiral CT scan,and the detection of early gastric cancer and advanced gastric cancer,the accuracy of T staging,lymph node metastasis diagnosis and the resectability prediction by multi-slice spiral CT were analyzed.Results The detection rates of early gastric cancer and advanced gastric cancer by multi-slice spiral CT were 66.7%(14/21)and 100.0%(54/54)respectively,and the total diagnostic compliance rate was 90.7%(68/75).The overall diagnostic accuracy rate of multi-slice spiral CT in the T staging was 90.7%(68/75),among which the accuracy rate of T 1,T 2,T 3 and T 4 stage was 76.5%(13/17),92.0%(23/25),95.2%(20/21)and 100.0%(12/12).The accuracy rate of the lymph node metastasis was 95.0%(57/60),including 34 cases of perigastric lymph nodes with an accuracy rate of 94.4%(34/36),24 cases of lymph nodes in peri-celiac artery,mesenteric root and abdominal aorta with an accuracy rate of 95.8%(23/24).The accuracy rate in the evaluation of resectability was 89.3%(67/75),and the overall diagnostic accuracy rate of N staging of gastric cancer was 78.7%(59/75),including 47 cases of N 0 stage with an accuracy rate of 85.5%,9 cases of N 1 stage with an accuracy rate of 60.0%,3 cases of N 2 stage with an accuracy rate of 60.0%.Conclusion Multi-slice spiral CT has a high value in the diagnosis,staging and resectability of gastric cancer,which can provide effective reference for the clinical diagnosis and treatment.