MSCT在胃癌淋巴结转移诊断中的应用

Application of MSCT in diagnosis of lymph node metastasis of gastric cancer

目的探讨多层螺旋CT(MSCT)在胃癌淋巴结转移诊断中的应用价值。方法抽取周口市中医院2019年1月至2021年6月收治的胃癌患者76例,所有患者均行MSCT扫描检查,以术后病理N分期和远处转移结果作为"金标准",评估MSCT扫描结果与临床病理结果的一致性。结果76例胃癌患者中N0期9例,N1期33例,N2期21例,N3期13例,其中67例患者发生淋巴结转移,将病理与MSCT扫描结果进行比较,其诊断淋巴结转移的准确率为84.21%(64/76)。MSCT诊断胃癌N0、N1、N2和N3等各个分期的敏感度分别为77.78%(7/9)、87.88%(29/33)、85.71%(18/21)、76.92%(10/13),特异度分别为85.07%(57/67)、81.40%(35/43)、83.64%(46/55)、85.71%(54/63),与病理N分期结果一致性较好,诊断效能较高(P<0.05)。67例出现淋巴结转移的胃癌患者中M0期42例,M1期25例,将病理与MSCT扫描结果进行比较,诊断准确率为86.57%(58/67)。MSCT诊断胃癌远处转移M0期和M1期的敏感度分别为88.10%(37/42)、84.00%(21/25),特异度分别为84.00%(21/25)、88.10%(37/42),与病理远处转移结果一致性较好,诊断效能较高(P<0.05)。结论MSCT扫描可有效判定胃癌淋巴结转移情况,有利于临床制定精确的手术方案,改善患者预后。

Objective To investigate the application value of multi-slice spiral computed tomography(MSCT)in the diagnosis of lymph node metastasis of gastric cancer.Methods Seventy-six patients with gastric cancer admitted to Zhoukou Hospital of Traditional Chinese Medicine from January 2019 to June 2021 were selected.All patients underwent MSCT scan.The postoperative pathological N staging and distant metastasis results were used as the gold standard to evaluate the consistency of MSCT scan results with clinicopathological findings.Results Among the 76 patients with gastric cancer,there were 9 cases in N0 stage,33 cases in N1 stage,21 cases in N2 stage,and 13 cases in N3 stage;among them,67 cases were with lymph node metastasis.The accuracy rate of MSCT results in the diagnosis of lymph node metastasis was 84.21%(64/76),compared with pathological results.The sensitivities of MSCT in diagnosing N0,N1,N2 and N3 stage of gastric cancer were 77.78%(7/9),87.88%(29/33),85.71%(18/21)and 76.92%(10/13),respectively,and the specificities were 85.07%(57/67),81.40%(35/43),83.64%(46/55)and 85.71%(54/63),respectively,which were highly consistent with results of pathological N stage,with high diagnostic efficiency(P<0.05).Among the 67 patients with gastric cancer complicated by lymph node metastasis,there were 42 cases in M0 stage and 25 cases in M1 stage according to MSCT scan,and the diagnostic accuracy was 86.57%(58/67),compared with the pathological results.The sensitivities of MSCT in diagnosing distant metastasis M0 and M1 stage of gastric cancer were 88.10%(37/42)and 84.00%(21/25),respectively,and the specificities were 84.00%(21/25)and 88.10%(37/42),respectively,which showed good consistency with the results of pathological distant metastasis,suggesting high diagnostic efficiency(P<0.05).Conclusions MSCT scan can effectively determine the lymph node metastasis of gastric cancer,and it is conductive to formulating an accurate surgical regimen and improving the prognosis of patients.