CT测量胃癌体积对N分期评估的初步研究  

Preliminary study of gastric carcinoma volume measurement using computed tomography for N staging evaluation

作　　者：姜楠[1] 郭顺林[1] 王刚[1] 辛仲宏[1] 翟亚楠[1] 周忠春[1] 殷亮[1] 杨梅[1] 袁浩[2] 冯颖[3] 

机构地区：[1]兰州大学第一医院放射科,甘肃兰州730000 [2]兰州大学第一医院消化科,甘肃兰州730000 [3]兰州大学第一医院病理科,甘肃兰州730000

出　　处：《实用放射学杂志》2015年第1期87-90,共4页Journal of Practical Radiology

摘　　要：目的：探讨多层螺旋 CT 测量胃癌体积在 N 分期预测方面的价值。方法收集经病理证实的胃癌患者（n=193）CT 资料,测量门脉期肿瘤体积,比较该结果和相应 N 分期的相关性并用 ROC 曲线分析其区分不同 N 分期的诊断效能。结果肿瘤体积测量结果具有较好的一致性（Kappa 值分别为0.77、0.72、0.69,P〈0.05）,且与相应的 N 分期呈正相关（r =0.568,P 〈0.05）。区分 N0和 N1～N3组、N0～N1和 N2～N3组、N0～N2和 N3组曲线下面积分别为0.79、0.80、0.82,体积阈值12.06 cm3、22.35 cm3、25.95 cm3,敏感度55%、66%、62%,特异度95%、86%、89%。结论CT 测量胃癌体积对 N 分期评估有一定应用价值,有利于指导临床选择个体化的治疗方案。Objective To evaluate the value of volume measured by multi-slice spiral CT in preoperative N staging of gastric canc-er.Methods CT data of 1 93 cases of gastric cancer proven pathologically were collected and analyzed.Volume of the tumor was cal-culated in the portal phase,and the correlation between the results and N staging was evaluated.ROC curve was used to get diagnos-tic value to differentiate N stages.Results Intra-observer Kappa value was 0.77 （P 〈0.05 ）,0.72 （P 〈0.05 ）,Inter-observer Kappa value was 0.69 （P 〈0.05）.The tumor volume data was positively correlated with different N stages （r=0.568,P 〈0.05）. ROC curve showed that the volume could help differentiate between stage N0 and stage N1 - N3 （cutoff 12.06 cm3 ,sensitivity 55%,specificity 95%）,stage N0-N1 and stage N2-N3 （cutoff 22.35 cm3 ,sensitivity 66%,specificity 86%）,stage N0-N2 and stage N3 （cutoff 25.95 cm3 ,sensitivity 62%,specificity 89%）respectively.Conclusion The volume of gastric cancer measured by CT plays an important part in predicting lymph node metastasis staging and optimizing individualized clinical strategy for patients.

关 键 词：胃癌 计算机体层成像 分期 计算机辅助 

分 类 号：R735.2[医药卫生—肿瘤] R814.42[医药卫生—临床医学]