螺旋CT和彩色多普勒血流显像检查对胰腺癌可切除性的评估价值  

Value of helical computed tomography and color doppler flowing imaging in assessing the resectability of pancreatic cancer

作　　者：李敬东[1] 张小明[1] 戴毅[1] 彭勇[1] 李波[2] 曾勇[2] 严律南[2] 

机构地区：[1]川北医学院附属医院肝胆外科,南充637000 [2]四川大学华西医院肝脏外科,成都610041

出　　处：《中华消化外科杂志》2009年第3期217-219,共3页Chinese Journal of Digestive Surgery

基　　金：国家自然科学基金（30370436）

摘　　要：目的探讨术前螺旋CT（HCT）与彩色多普勒血流显像（CDPI）判断胰腺癌能否行根治性切除的价值。方法回顾性分析1995年1月至2002年12月川北医学院附属医院收治的114例胰腺癌患者的临床资料。以手术和病理检查结果为标准评估术前HCT和CDPI检查对胰腺癌能否行根治性切除的判断价值。采用χ^2检验和Fisher确切概率法分析检测结果。结果114例胰腺癌患者中，109例行HCT检查，97例行CDPI检查，其中96例行HCT和CDPI联合检查。HCT检查发现肿瘤部位与根治性切除率的关系：胰头癌为45．3％（39／86），胰体尾癌为26．3％（5／19），全胰腺癌为0（0／9），胰头癌根治性切除率高于胰体尾癌（χ^2=8．965，P〈0．05）；肿瘤浸润率和转移率均随肿瘤增大而增加，而切除率降低（z=6．15，5．35，7．18，P〈0．01）。两种检查方法对胰腺癌可切除性的判断：HCT检查灵敏度为77．8％，特异度为82．2％；CDPI检查的灵敏度为73．3％，特异度为80．6％；联合HCT和CDPI检查的灵敏度为90．6％，特异度为92．4％。HCT、CDPI及联合HCT和CDPI检查的Kappa一致性检验值分别为0．58、0．52和0．82。结论HCT与CDPI联合检查能弥补彼此的不足，较准确地判断胰腺癌可切除性。Objective To determine the value of helical computed tomography （HCT） and color doppler flowing imaging （CDPI） in evaluating the resectability of pancreatic cancer. Methods The clinical data of 114 patients with pancreatic cancer who had been admitted to the Affiliated Hospital of North Sichuan Medical College from January 1995 to December 2002 were retrospectively analyzed. The values of HCT and CDPI in assessing the resectability of pancreatic cancer were determined according to the results of operation and pathological examination. All the data were analyzed by chi-square test and Fisher exact probability. Results Of all patients, 109 were examined by HCT, 97 by CDPI and 96 by HCT ＋ CDPI. For patients examined by HCT, the resection rates of pancreatic head cancer, pancreatic body and tail cancer and total pancreatic cancer were 45.3% （39/86） , 26.3% （5/19） and 0 （0/9）, respectively. The resection rate of pancreatic head cancer was higher than that of pancreatic body and tail cancer （ χ^2 = 8. 965, P 〈 0.05）. With the increase of tumor size, the invasion rate and metastasis rate were increased and the resection rate was decreased （ z = 6.15, 5.35, 7.18, P 〈 0.01 ）. The sensitivity rate and specificity rate were 77.8% and 82.2% of HCT, 73.3% and 80.6% of CDPI, 90.6% and 92.4% of HCT ＋ CDPI in assessing the resectability of pancreatic cancer. The values of Kappa identity test of HCT, CDPI and HCT ＋ CDPI were 0.58, 0.52 and 0.82, respectively. Conclusions Combined application of HCT and CDPI can further improve the accuracy in assessing the resectability of pancreatic cancer.

关 键 词：胰腺肿瘤 螺旋CT 彩色多普勒血流显像 切除 

分 类 号：R735.9[医药卫生—肿瘤]