基于第8版AJCC胰腺癌TNM分期的CT、MRI检查比较

CT versus MRI in TNM staging of pancreatic ductal adenocarcinoma based on the 8th AJCC

目的基于第8版美国癌症联合委员会胰腺癌TNM分期,比较CT与MRI对胰腺导管腺癌(PDAC)TNM分类、分期评估的准确性。方法回顾分析2013年10月至2019年10月连续于南京医科大学附属无锡第二医院诊治的105例PDAC患者资料。共纳入符合标准52例患者,其中男性32例,女性20例,年龄范围45~84岁,平均年龄66.1岁。以第8版美国癌症联合委员会胰腺癌TNM分期为参考标准,比较CT和MRI对PDAC TNM分类及分期的准确率。结果52例PDAC患者中,43例切除肿瘤最大直径(3.4±1.2)cm,CT、MRI测得肿瘤最大直径(3.3±1.2)cm、(3.3±1.4)cm。CT、MRI测得肿瘤最大直径与切除标本测量值比较,差异均无统计学意义(均P>0.05)。对照手术病理分类,CT评价T、N和M分类的准确率分别为97.7%(42/43)、79.1%(34/43)和9例均正确;MRI分别为97.7%(42/43)、76.7%(33/43)和9例中8例正确。CT与MRI准确率比较,差异无统计学意义(P>0.05)。对照病理分期,CT分期准确率为82.7%(43/52),MRI为76.9%(40/52),两者比较差异无统计学意义(P>0.05)。结论CT、MRI对PDAC的TNM分类、分期评估效果相仿,两种影像检查对T、M分类评估准确性更高。

ObjectiveTo compare CT with MRI on the accuracy in TNM staging of pancreatic ductal adenocarcinoma(PDAC)based on the 8th American Joint Committee on Cancer System and Pathological Staging.MethodsFrom October 2013 to October 2019,105 patients who had pathologically confirmed PDAC treated at the Affiliated Wuxi No.2 People’s Hospital of Nanjing Medical University were retrospectively studied.Of 52 patients who met the inclusion criteria,there were 32 males and 20 females,with age ranging from 45 to 84 years(mean 66.1 years).Based on the 8th American Joint Committee on Cancer System and Pathological Staging,CT was compared with MRI in their accuracies in categorizing TNM and staging of PDAC.ResultsForty-three of 52 patients who underwent curative resection had a mean tumor size of(3.4±1.2)cm,compared with tumor sizes of(3.3±1.2)cm and(3.3±1.4)cm on CT and MRI,respectively.No significant differences were observed between gross pathological examination and CT(P>0.05)or MRI(P>0.05).The accuracy of T,N,and M categories on CT versus(vs)MRI was 97.7%(42/43)vs 97.7%(42/43),79.1%(34/43)vs 76.7%(33/43),and 100%(9/9)vs 88.9%(8/9),respectively.No significant differences were observed between the two modalities(P>0.05).The overall accuracy of PDAC staging on CT vs MRI was 82.7%(43/52)vs 76.9%(40/52),respectively.There was also no significant difference between the two modalities(P>0.05).ConclusionBoth CT and MRI had similar accuracies in categorizing TNM and staging of PDAC.However,the accuracies of T and M stages were higher than that of the N stage for these two imaging modalities.