MSCT用于胃癌淋巴结转移早期诊断的临床价值  

Clinical value of multi-slice spiral CT in the early diagnosis of gastric cancer lymph node metastasis.

作　　者：韩超 陈新晖 赵宝琼 曹辉 王常雨 HAN Chao;CHEN Xin-hui;ZHAO Bao-qiong;CAO Hui;WANG Chang-yu(Department of Radiology,General Hospital of Pingmei Shenma Medical Group,Pingdingshan 467000,Henan,CHINA)

机构地区：[1]平煤神马医疗集团总医院放射科,河南平顶山467000

出　　处：《海南医学》2021年第6期746-749,共4页Hainan Medical Journal

摘　　要：目的探讨多层螺旋CT(MSCT)用于胃癌淋巴结转移早期诊断的临床价值。方法选择2016年1月至2020年1月于平煤神马医疗集团总医院行远端胃癌根治术的80例患者作为研究对象,以患者术后胃标本及淋巴结病理检查结果为金标准,分析MSCT平扫及增强对胃癌淋巴结转移、N分期的判断价值。结果以术后胃癌病理学诊断为金标准,80例胃癌患者中52例(65.00%)有淋巴结转移,其中,术前MSCT增强诊断胃癌淋巴结转移的准确度、敏感度、阳性预测值、阴性预测值为86.25%、88.46%、90.20%、79.31%,明显高于MSCT平扫检查的61.25%、61.54%、74.42%、45.92%,差异均有统计学意义(P<0.05);以术后淋巴结病理诊断为金标准,80例胃癌患者中N0、N1、N2、N3期患者分别为14例、33例、23例、10例,其中MSCT平扫对胃癌N0~N1期及N2~N3期的分期诊断准确度分别为51.06%、72.73%,明显低于MSCT增强的78.72%、96.97%,差异均有统计学意义(P<0.05),其中MSCT增强对N2~N3期的诊断准确率为96.97%,明显高于N0~N1期的72.73%,差异有统计学意义(P<0.05)。结论MSCT增强对胃癌淋巴结转移的准确度较高,对晚期胃癌的适用性更强,可为手术方式的选择提供参考。Objective To explore the clinical value of multi-slice spiral CT(MSCT)in the early diagnosis of gastric cancer lymph node metastasis.Methods Eighty patients who underwent radical resection of distant gastric cancer in General Hospital of Pingmei Shenma Medical Group from January 2016 to January 2020 were enrolled as the research objects.Taking postoperative pathological examination results of gastric specimens and lymph nodes as the golden standard,the determination value of MSCT plain scan and enhanced MSCT for lymph node metastasis and N staging of gastric cancer was analyzed.Results Taking postoperative pathological diagnosis of gastric cancer as the golden standard,there were 52 cases(65.00%)with lymph node metastases in the 80 patients with gastric cancer.The accuracy,sensitivity,positive predictive value,and negative predictive value of enhanced MSCT for diagnosis of lymph node metastasis were 86.25%,88.46%,90.20%,and 79.31%,which were significantly higher than 61.25%,61.54%,74.42%,45.92%of MSCT plain scan(P<0.05).Taking postoperative pathological diagnosis of lymph nodes as the golden standard,there were 14 cases,33 cases,23 cases,and 10 cases with N staging at stage N0,N1,N2,and and N3,respectively.The diagnostic accuracy rates of MSCT plain scan for gastric cancer at stage N0—N1 and N2—N3 were 51.06%and 72.73%,which were significantly lower than 78.72%,96.97%of enhanced MSCT(P<0.05).The diagnostic accuracy rate of gastric cancer at stage N2—N3 was significantly higher than that at stage N0—N1 by enhanced MSCT(96.97%vs 72.73%,P<0.05).Conclusion The diagnostic accuracy of enhanced MSCT is high for lymph node metastasis of gastric cancer,which is more applicable to advanced gastric cancer.It can provide reference for the selection of surgical methods.

关 键 词：胃癌 多层螺旋CT 淋巴结 TNM分期系统 诊断 

分 类 号：R735.2[医药卫生—肿瘤]