Feasibility of differentiating T3 from T4a gastric cancer in different Lauren classification by determining serosa invasion：Diagnostic performance of high enhanced serosa sign  

作　　者：Rui-Jia Sun Lei Tang Ying Chen Xiao-Ting Li Yu Sun Zi-Yu Li Ying-Shi Sun 

机构地区：[1]Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing) Department of Radiology, Beijing 100142, China [2]Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing) Departrnent of Pathology, Beijing 100142, China [3]Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing) Center of Gastrointestinal Surgery, Peking University Cancer Hospital & Institute, Beijing 100142, China

出　　处：《Chinese Journal of Cancer Research》2018年第2期263-271,共9页中国癌症研究（英文版）

基　　金：funding by National Natural Science Foundation of China (No. 81471640, 81371715)

摘　　要：Objective： To study the value of high enhanced serosa sign on contrast-enhanced computed tomography（CT）in differentiating T3 from T4a gastric cancer in different Lauren classification.Methods： This study included 276 consecutive patients with surgically confirmed p T3 or p T4a gastric cancers.The pre-operative CT images were reviewed by two radiologists blinded. The demonstration of the high enhanced serosa on CT between T3 and T4a was compared with chi-square test. The diagnostic performance of this sign on CT in the differentiation of T4a from T3 in different Lauren classification was calculated.Results： The accuracy, sensitivity, specificity, positive predictive value（PPV） and negative predictive value（NPV） for the judgement of serosa invasion using the high enhanced serosa sign on CT was 74.6%, 63.7%, 83.6%,76.0% and 73.8% by one radiologist and 76.4%, 66.1%, 84.9%, 78.1% and 75.4% by the other radiologist.Compared to the intestinal-type, the sensitivity of the judgement of serosa invasion using the high enhanced serosa sign on CT in diffuse-type was significant higher（80% in both readers）, while the specificity trended to be lower（65.9% and 80.5%, respectively）. There is no significant difference in the accuracy of diagnosis between intestinaltype and diffuse-type of gastric cancers（the P-values of two radiologists were 0.968, 0.591, respectively）. The combination of the high enhanced serosa sign with conventional CT signs is significant different in diagnosis of T3 and T4a（P〈0.001）. The diagnostic accuracy was increased in both radiologists after the combination. The two readers achieved substantial agreement, with Kappa coefficient of 0.63, P〈0.001.Conclusions： The high enhanced serosa sign on CT is associated with serosa involvement. The sensitivity of the judgement of serosa invasion using this sign on CT in diffuse-type was significant higher than that in intestinal-type.Objective： To study the value of high enhanced serosa sign on contrast-enhanced computed tomography（CT）in differentiating T3 from T4a gastric cancer in different Lauren classification.Methods： This study included 276 consecutive patients with surgically confirmed p T3 or p T4a gastric cancers.The pre-operative CT images were reviewed by two radiologists blinded. The demonstration of the high enhanced serosa on CT between T3 and T4a was compared with chi-square test. The diagnostic performance of this sign on CT in the differentiation of T4a from T3 in different Lauren classification was calculated.Results： The accuracy, sensitivity, specificity, positive predictive value（PPV） and negative predictive value（NPV） for the judgement of serosa invasion using the high enhanced serosa sign on CT was 74.6%, 63.7%, 83.6%,76.0% and 73.8% by one radiologist and 76.4%, 66.1%, 84.9%, 78.1% and 75.4% by the other radiologist.Compared to the intestinal-type, the sensitivity of the judgement of serosa invasion using the high enhanced serosa sign on CT in diffuse-type was significant higher（80% in both readers）, while the specificity trended to be lower（65.9% and 80.5%, respectively）. There is no significant difference in the accuracy of diagnosis between intestinaltype and diffuse-type of gastric cancers（the P-values of two radiologists were 0.968, 0.591, respectively）. The combination of the high enhanced serosa sign with conventional CT signs is significant different in diagnosis of T3 and T4a（P〈0.001）. The diagnostic accuracy was increased in both radiologists after the combination. The two readers achieved substantial agreement, with Kappa coefficient of 0.63, P〈0.001.Conclusions： The high enhanced serosa sign on CT is associated with serosa involvement. The sensitivity of the judgement of serosa invasion using this sign on CT in diffuse-type was significant higher than that in intestinal-type.

关 键 词：Computed tomography gastric cancer STAGING serosa invasion imaging 

分 类 号：R735.2[医药卫生—肿瘤]