能谱CT诊断胃癌淋巴结转移的价值及影响因素分析

Diagnostic Value of Spectral CT in Lymph Node Metastasis in Gastric Cancer and Analysis of Influencing Factors

本研究探讨能谱CT诊断胃癌患者发生淋巴结转移的价值及其影响因素。选取87例发生淋巴结转移的胃癌患者作为转移组、90例未发生淋巴结转移的胃癌患者作为对照组,两组患者术前均接受了能谱CT扫描,对比两组的能谱CT相关参数,并绘制受试者操作特征(ROC)曲线分析各项参数诊断胃癌发生淋巴结转移的价值。分析影响能谱CT术前诊断胃癌发生淋巴结转移准确性的相关因素。结显显示,转移组患者淋巴结长短径之比、动脉期IC、静脉期IC、动脉期nIC、静脉期nIC值均显著高于对照组患者(P<0.05);淋巴结长短径之比、动脉期IC、静脉期IC、动脉期nIC、静脉期nIC值诊断胃癌患者发生淋巴结转移的AUC值分别为0.809、0.669、0.734、0.769、0.778;Logistic模型结果显示:病灶周围脂肪毛糙、TNM分期≤Ⅱ期、肿瘤浸润深度未达到黏膜下层是影响能谱CT术前准确诊断胃癌患者是否发生淋巴结转移的影响因素(P<0.05)。能谱CT参数能较为准确地判断胃癌患者手术前是否发生淋巴结转移,对于患者的治疗及预后评估均具有一定的价值。

This study investigated the value of spectral CT in the diagnosis of lymph node metastasis in patients with gastric cancer and its influencing factors.Selected 87 gastric cancer patients with lymph node metastasis as the metastasis group,and 90 gastric cancer patients without lymph node metastasis as the control group.All patients received energy spectral CT scan before,and the related parameters of energy spectral CT were compared between the two groups,and the receiver operating characteristic(ROC)curve was drawn to analyze the value of each parameter in the diagnosis of lymph node metastasis in gastric cancer.The related factors affecting the accuracy of spectral CT in preoperative diagnosis of lymph node metastasis in gastric cancer was analyzed.The results showed that the ratio of the length and diameter of lymph nodes,the IC in the arterial phase,the IC in the venous phase,the nIC in the arterial phase,and the nIC in the venous phase in the metastatic group were significantly higher than those in the non-metastatic group(P<0.05).The AUC values of lymph node length and diameter ratio,arterial phase IC,venous phase IC,arterial phase nIC,and venous phase nIC values for the diagnosis of lymph node metastasis in patients with gastric cancer were 0.809,0.669,0.734,0.769 and 0.778,respectively.Logistic model results showed that:rough fat around the lesion,TNM stage≤stageⅡ,and tumor invasion depth not reaching the submucosa were the influencing factors for the accurate diagnosis of lymph node metastasis in patients with gastric cancer before energy spectrum CT(P<0.05).Spectral CT parameters can more accurately determine whether lymph node metastases occur in gastric cancer patients before surgery,and have certain value for the treatment and prognosis evaluation of patients.