多层螺旋CT成像及胃镜在胃癌诊断中的效果比较

Comparison of multislice spiral CT imaging and gastroscopy in the diagnosis of gastric cancer

目的探讨多层螺旋CT(MSCT)成像技术与胃镜在胃癌诊断中的应用效果比较。方法回顾性选取2019年8月至2021年8月间上海市松江区九亭医院收诊的行胃镜及MSCT检查的55例胃癌患者,观察患者癌肿病灶、淋巴结、局部浸润及远处转移情况,并与胃镜活检检查结果和病理检查结果进行比较。结果以手术病理检测结果作为金标准,55例患者均诊为胃癌,MSCT检出率为100.0%(55例),胃镜检出率为81.8%(45例),MSCT检出率高于胃镜,差异有统计学意义(P<0.05)。手术病理检查结果发现,肿块型9例,浸润溃疡型18例,局限溃疡型19例,弥散浸润型9例。MSCT检出判断准确率为69.1%(38例),胃镜检出判断准确率为60.0%(33例),MSCT判断准确率高于胃镜,差异有统计学意义(P<0.05)。手术病理检查结果发现,T1期9例、T2期18例、T3期25例、T4期3例;胃镜检查轴位T1、T2、T3、T4期检出准确率分别为55.6%、55.6%、68.0%和100.0%;MSCT检查中,轴位结合MPR T1、T2、T3、T4期检出准确率分别为77.8%、77.8%、88.0%和100.0%。MSCT诊断T1及T2期检出准确率高于胃镜,差异有统计学意义(P<0.05)。结论MSCT对胃癌诊断具有较高的应用价值,相比胃镜检出率高,准确率高,有重要的临床价值。

Objective To compare the efficacy of multi-slice spiral CT(MSCT) versus gastroscopy in the diagnosis of gastric cancer. Methods A retrospective analysis was performed on 55 gastric cancer patients who underwent gastroscopy and MSCT at Jiuting Hospital from August 2019 to August 2021. Cancer lesions, lymph nodes, local infiltration and distant metastasis were observed and compared with the results of gastroscopy biopsy and pathological examination. Results When the results of pathological examination were taken as the gold standard, 55 patients were diagnosed with gastric cancer. The detection rate was 100%(55 patients) for MSCT which was significantly higher than 81.8% of gastroscopy(P<0.05). Based on the results of pathological examination, 9 patients had gastric cancer of mass type gastric cancer, 18 patients had invasive and ulcerative type gastric cancer, 19 patients had local ulcerative type gastric cancer and 9 patients had diffuse infiltrative type gastric cancer. The accuracy of MSCT was 69.1%(38 patients), which was higher than 60.0%(33 patients) of gastroscopy for gastric cancer(P<0.05). Based on the results of pathological examination, 9 patients had stage T1 cancer, 18 patients had stage T2 cancer, 25 patients had stage T3 cancer and 3 had stage T4 cancer(all P<0.05). The detection accuracy was 55.6%, 55.6%, 68.0% and 100.0%, respectively for gastroscopy for the diagnosis of stage T1, T2, T3 and T4 gastric cancer. The detection accuracy was 77.8%, 77.8%, 88.0% and 100.0%, respectively for MSCT plus MPR for the diagnosis of stage T1, T2, T3 and T4 gastric cancer. The detection accuracy of MSCT was higher than that of for gastroscopy for the diagnosis of stage T1 and T2 gastric cancer(P<0.05). Conclusion MSCT has high application value in the diagnosis of gastric cancer. Compared with gastroscopy, the detection rate and accuracy of MSCT was high, which has important clinical value.