术前CT评价壁外血管侵犯情况对胃癌患者预后的评估价值

Value of preoperative CT evaluation of extramural vascular invasion in evaluating the prognosis of gastric cancer patients

目的探讨术前CT评价壁外血管侵犯情况对胃癌患者预后的评估价值。方法选择2016年1月-2018年12月于我院接受胃癌根治术的患者作为研究对象,术前进行CT检查并评价患者壁外血管侵犯情况,术后随访患者总生存期(OS)和无病生存期(DFS),采用K-M曲线及Log-rank检验分析壁外血管侵犯情况与患者OS、DFS的关系,采用COX回归模型分析患者OS和DFS的影响因素。结果肿瘤直径≥5 cm、TNMⅢ期胃癌患者术前CT评价壁外血管侵犯的发生率明显高于肿瘤直径<5 cm、TNMⅠ~Ⅱ期胃癌患者(χ^(2)=7.745、7.011,P<0.05);与术前CT评价壁外血管未侵犯的胃癌患者比较,壁外血管侵犯的胃癌患者DFS和OS均明显缩短(χ^(2)=6.245、5.388,P<0.05);壁外血管侵犯、TNM分期是胃癌患者DFS的影响因素,壁外血管侵犯、肿瘤直径、TNM分期是胃癌患者OS的影响因素。结论术前CT评价壁外血管侵犯情况对胃癌患者预后评估有较大的临床价值。

Objective To investigate the value of preoperative CT evaluation of extramural vascular invasion in evaluating the prognosis of gastric cancer patients.Methods The patients who underwent gastrectomy in our hospital from January 2016 to December 2018 were enrolled as subjects,and preoperative CT examination was performed to evaluate extramural vascular invasion.The patients were followed up after surgery to observe overall survival(OS)and disease-free survival(DFS);the K-M curve and the log-rank test were used to analyze the association of extramural vascular invasion with OS and DFS,and the COX regression model was used to investigate the influencing factors for OS and DFS.Results The patients with a tumor diameter of≥5 cm and TNM stageⅢgastric cancer had a significantly higher incidence rate of extramural vascular invasion on preoperative CT evaluation than those with a tumor diameter of<5 cm and TNM stageⅠ-Ⅱgastric cancer(χ^(2)=7.745,7.011,P<0.05).Compared with the gastric cancer patients without extramural vascular invasion on preoperative CT evaluation,the patients with extramural vascular invasion had significantly shorter DFS and OS(χ^(2)=6.245,5.388,P<0.05).Extramural vascular invasion and TNM stage were the influencing factors for DFS,and extramural vascular invasion,tumor diameter,and TNM stage were the influencing factors for OS in gastric cancer patients.Conclusion Preoperative CT evaluation of extramural vascular invasion is of great value in evaluating the prognosis of patients with gastric cancer.