多层螺旋CT增强及重建在结肠癌术前TNM分期评估中的价值

The Value of Multislice Spiral CT Enhancement and Reconstruction in Preoperative TNM Staging Evaluation of Colon Cancer

目的评价多层螺旋CT(multislice spiral CT,MSCT)增强及重建在结肠癌术前临床病理分期(tumor-node-metastasis,TNM)评估中的价值。方法回顾性分析2018年1月—2020年12月广东省廉江市人民医院收治的60例结肠癌患者影像学资料,所有患者均进行MSCT检查,以病理结果作为参照的金标准,分析MSCT增强及重建对于评估结肠癌术前TNM分期的价值。结果以病理结果为金标准,MSCT增强诊断结肠癌T_(1)、T_(2)、T_(3)与T_(4)分期与病理结果的符合率分别为75.00%、61.54%、79.31%、40.00%,T分期诊断总符合率为68.33%,Kappa值为0.528;诊断N_(0)、N_(1)与N_(2)分期的符合率分别为92.31%、86.11%与54.55%,N分期诊断总符合率为81.67%;诊断M0、M1分期的符合率为94.00%、80.00%,M分期诊断总符合率为91.67%;MSCT检出转移性淋巴结的准确率为90.00%,敏感度为89.36%、特异度为92.31%,Kappa值为0.735。结论MSCT增强及重建对于结肠癌术前TNM分期评估具有较高的临床应用价值。

Objective To evaluate the value of multislice spiral CT(MSCT)enhancement and reconstruction in tumor-node-metastasis(TNM)evaluation of colon cancer.Methods A retrospective analysis was conducted on the imaging data of 60 colon cancer patients admitted to Lianjiang People's Hospital,Guangdong Province from January 2018 to December 2020.All patients underwent MSCT examination,with pathological results as the reference gold standard.The value of MSCT and reconstruction in evaluating preoperative TNM staging of colon cancer was analyzed.Results Pathological results are the gold standard.The coincidence rates between the T_(1),T_(2),T_(3),and T_(4) staging of colon cancer and the pathological results were 75.00%,61.54%,79.31%and 40.00%,respectively.The total coincidence rate of T staging diagnosis was 68.33%,and the Kappa value was 0.528.The coincidence rates of diagnosing N_(0),N_(1),and N_(2) stages were 92.31%,86.11%,and 54.55%,respectively.The total coincidence rate of N stage diagnosis was 81.67%.The coincidence rates of diagnosing M0 and M1 stages were 94.00%and 80.00%,and the total coincidence rate of M stage diagnosis was 91.67%.The accuracy of MSCT in detecting metastatic lymph nodes was 90.00%,the sensitivity was 89.36%,the specificity was 92.31%,and the Kappa value was 0.735.Conclusion MSCT enhancement and reconstruction have high clinical application value for preoperative TNM staging evaluation of colon cancer.