胃癌淋巴结转移CT诊断指标与病理N分期对照研究  

Comparison study of CT indicators and pathological N staging in lymph node metastasis of gastric cancer

作　　者：唐磊[1] 张晓鹏[1] 孙应实[1] 李洁[1] 汪宁[1] 曹崑[1] 季加孚[2] 李子禹[2] 

机构地区：[1]北京大学临床肿瘤学院北京肿瘤医院暨北京市肿瘤防治研究所医学影像科,100036 [2]北京大学临床肿瘤学院北京肿瘤医院暨北京市肿瘤防治研究所胃肠外科,100036

出　　处：《中华胃肠外科杂志》2008年第6期529-532,共4页Chinese Journal of Gastrointestinal Surgery

基　　金：国家973重点基础研究发展计划资助项目（2006CB705706）;首都医学发展科研基金资助项目（2003-3039）

摘　　要：目的探讨可用于评价胃癌淋巴结转移及术前N分期的影像学指标。方法利用PACS工作站软件对89例胃癌患者的CT淋巴结检出情况进行回顾性分析。记录CT检出淋巴结的大小和数目，并计算每例检出淋巴结的径线和：并将各CT指标与肿瘤的病理N分期进行比较。结果CT检出淋巴结数、最大淋巴结径线及径线和在肿瘤组织不同病理N分期的差异有统计学意义（P〈0．05）；淋巴结转移和非转移两组间上述3个指标的差异也均有统计学意义（P〈0．05）。CT检出淋巴结数在pN1与pN3和pN2与pN1分期间比较，差异有统计学意义（P〈0．01）；淋巴结最大径线在淋巴结转移阳性组各病理分期间比较，差异无统计学意义（P〉0．05）；径线和在pN1与pN2和pN1与pN3分期间比较，差异有统计学意义（P〈0．01）。结论 CT检出淋巴结数目联合淋巴结径线和可为术前肿瘤N分期的评价提供参考。Objective To explore the CT criteria for evaluating lymph node （LN） metastasis and preoperative N-staging of gastric cancer through the comparison of CT signs and surgical pathology. Methods Eighty-nine patients with gastric cancer underwent CT examinations before radical resections. A soft-reading method on PACS workstation was employed to evaluate the detection of LNs. The size and number of LNs were registered, and the accumulated size of LNs was calculated in every case. The pathological N-staging （pN0-3） was considered on the basis of pathological examination of excised specimens according to UICC TNM-staging system （6th edition, 2002）. The relationships between LN metastases and CT findings were analyzed by SPSS using t test and one-way ANOVA analysis. Results The distribution of maximal size, CT detection number and accumulated size were significantly different among different pN stages （P〈0.01）. All these 3 indicators were significantly different between LN metastasis group and non-metastasis group （P〈0.01）. There was no significant difference of maximal size among different pN stages in positive metastasis LNs （P〉0.05）, while significant difference could be found in CT detection number between pNl and pN3（P〈0.01）, pN2 and pN3 （P〈0.01）, and in accumulated size between pNj and pN3（P〈0.01 ）, pN1 and pN2 （P〈0.01）. Conclusions The involvement of LNs in gastric cancer and pN staging are associated with size, number, and accumulated size of CT detection. CT detection number is more valuable in the evaluation of N staging than LNs size. CT detection number combined with accumulated size of LNs can provide meaningful information for preoperative N-staging.

关 键 词：胃肿瘤 淋巴结 体层摄影术 X线计算机 肿瘤分期 

分 类 号：R735.2[医药卫生—肿瘤] R814.2[医药卫生—临床医学]