胸部CT在胃癌分期中的应用价值

目的评价胸部CT在胃癌分期中的应用价值。方法回顾性分析2015年6月至2020年1月846例胃癌患者的临床资料。采用胸部、腹部和盆腔CT扫描系统评估转移部位。结果共纳入846例患者,仅有55例(6.5%)发生肺转移,20例(2.4%)发生胸腔或锁骨上淋巴转移,其中8例为肺及胸腔淋巴同时转移。几乎所有肺转移或胸腔淋巴转移均伴有其他部位转移,仅有1例患者出现单一的胸腔淋巴转移(0.12%),未发现孤立性肺转移。当肿瘤累及胃底/贲门时,与远端胃癌相比,肺转移的概率更高,差异有统计学意义(P=0.028)。结论胸部CT在胃癌常规分期中的应用价值较低。但当肿瘤位于胃底/贲门部位时,由于肺转移比例较高,胸部CT具有一定的应用价值。

Objective To evaluate the value of chest CT in staging of gastric cancer(GC).Methods Retrospective analysis of clinical data of 846 GC patients from June 2015 to January 2020.Metastatic sites were evaluated using chest,abdominal,and pelvic CT.Results A total of 846 patients were included,of which only 55(6.5%)had lung metastases,and 20(2.4%)had thoracic or supraclavicular lymph node metastases,of which 8 had simultaneous pulmonary and thoracic lymph node metastases.Almost all lung metastases or thoracic lymph node metastases were accompanied by metastases from other sites.Only 1 patient had single thoracic lymph node metastases(0.12%),and no isolated lung metastases were found.When the tumor involved the gastric fundus/cardia,the probability of lung metastases was higher than that of distal GC,the difference was statistically significant(P=0.028).Conclusion This study indicates that chest CT is of low value in routine staging of GC.However,when the tumor is located in the gastric fundus/cardiac site,chest CT has a certain existence value due to the high proportion of lung metastases.