螺旋CT在胃癌术前TNM分期中的价值  

Comparative study between MSCT and pathology in preoperative TNM staging of gastric cancer

作　　者：王宝春[1] 周晓秋[1] 汤厚阔[2] 刘云峰[1] 操啸 高大圣 王晶[1] 

机构地区：[1]安徽省合肥市第三人民医院影像中心,合肥230022 [2]安徽省合肥市第三人民医院普外科,合肥230022

出　　处：《安徽医学》2015年第7期828-832,共5页Anhui Medical Journal

摘　　要：目的研究胃癌多层螺旋CT(multi slice spiral,MSCT)的影像特点,探讨其对胃癌TNM分期的术前诊断与术后病理的一致性。方法分别对经手术病理证实的69例胃癌患者进行MSCT平扫及增强扫描,分析其CT影像特点并对其进行术前TNM分期,并与临床术后病理分期进行对比分析,分期的准确性采用Kappa一致性检验。结果 T1期准确率为66.7%(4/6);T2期准确率为72.7%(8/11);T3期准确率为75.0%(36/48);T4期准确率为100%(4/4)。总准确率为75.4%(52/69),总一致性Kappa=0.558,P=0.000;N分期准确率分别为N0期88.2%(15/17),N1期46.9%(15/32),N2期83.3%(10/12),N3期100%(8/8),总N分期准确率为69.56%(48/69),敏感性63.5%,特异性88.2%,一致性Kappa=0.579,P=0.000;M分期中M0期准确率均100%,M1期准确率76.9%(10/13),一致性Kappa=0.844,P=0.000。结论 MSCT在胃癌患者术前TNM分期与术后病理分期有较好的准确性和一致性。Objective To study the imaging characters of the gastric multi-slice spiral CT ( multi-slice spiral, MSCT) , and explore the consistency of preoperative diagnosis and pathologic TNM staging of gastric cancer. Methods Sixty-nine confirmed patients with gastric cancer were scanned by both plain and enhanced MSCT, then the CT imaging features and its preoperative TNM staging were analyzed with Kappa consistency test. Results T1 accuracy rate was 66. 7% (4/6), T2 accuracy rate 72. 7% (8/11), T3 accuracy rate 75. 0% (36/48), and T4 accuracy rate 100% (4/4). The overall accuracy was 75. 4% (52/69) with a good consistency( Kappa=0. 558, P=0. 000);N staging accuracy rates were N0 of 88. 2% (15/17), N1 of 46. 9% (15/32), N2 of 83. 3% (10/12), and N3 of 100% ((8/8). The to-tal accuracy during N staging was 69. 56% ( 48/69 ) , with sensitivity of 63. 5%, specificity of 88. 2%, and a good consistency ( Kappa=0. 579, P=0. 000);in M staging, M0 accuracy rate was 100%, M1 accuracy rate was 76. 9% (10/13), and with a good consistency(Kap-pa=0. 844, P=0. 000). Conclusion MSCT TNM staging and postoperative pathology has better accuracy and consistency in patients with gastric cancer before surgery.

关 键 词：胃癌分期 病理分期 多层螺旋CT 

分 类 号：R735.2[医药卫生—肿瘤]