肿瘤与血管接触三级评价法在胰腺癌术前评价中的价值  

The value of three level evaluation of tumor and vascular contacts in preoperative evaluation of pancreatic cancer

作　　者：张涛[1] 王平 柴志辉[1] 张建党[1] Zhang Tao;Wang Ping;Chai Zhihui;Zhang Jiandang(Nanyang Central Center Hospital,Nanyang,Henan Province,473000)

机构地区：[1]河南省南阳市中心医院,河南南阳473000

出　　处：《中国临床医生杂志》2022年第3期282-285,共4页Chinese Journal For Clinicians

摘　　要：目的探讨多排螺旋CT(multidetector CT,MDCT)肿瘤与血管接触(tumor vessel contact,TVC)三级评价法在胰腺癌术前评价中的应用价值。方法选取2017年1月至2019年3月在河南省南阳市中心医院行手术治疗的胰腺癌患者80例,术前给予MDCT检查,比较TVC三级评价法与手术探查结果的一致性。结果80例患者,手术中共探查408支胰周血管,其中腹腔干81支,肝总动脉87支,肠系膜上动脉82支,肠系膜上静脉76支,门静脉81支;与TVC三级评价法分析一致性κ检验结果分别为0.770、0.731、0.697、0.509和0.688,P<0.05;TVC三级评价法显示侵犯的周围器官主要为十二指肠,诊断胰周血管侵犯可切除的灵敏性、特异性、阳性预测值和阴性预测值分别为100.00%、62.50%、96.07%和100.00%。肿物侵犯周围器官主要为十二指肠;CT诊断肿物可切除的灵敏性、特异性、阳性预测值和阴性预测值分别为78.00%、79.50%、80.00%和77.50%。结论进行TVC三级评价法在可手术胰腺癌患者术前评价中有较好的应用价值,值得临床应用。Objective To explore the value of three-level evaluation of tumor vessel contact(TVC)with multidetector CT(MDCT)in preoperative evaluation of pancreatic cancer.Method From January 2017 to March 2019,80 patients with pancreatic cancer were selected for surgical treatment in our hospital,the MDCT was performed before the operation,and the consistency between TVC three-level evaluation method and surgical exploration results was analyzed.Result In 80 patients,408 peripancreatic vessels were explored,including 81 celiac trunk,87 common hepatic artery,82 superior mesenteric artery,76 superior mesenteric vein and 81 portal vein;The consistencyκvalues of celiac trunk,common hepatic artery,superior mesenteric artery,superior mesenteric vein,portal vein of TVC three-level evaluation analysis and surgical gradingwere 0.770,0.731,0.697,0.509 and 0.688,P<0.05;The sensitivity,specificity,positive predictive value and negative predictive value of TVC three-level evaluation in the diagnosis of resectability of peripancreatic vascular invasion were 100.00%,62.50%,96.07%and 100.00%,respectively.The tumor invaded the surrounding organs,mainly the duodenum.The sensitivity,specificity,positive predictive value and negative predictive value of CT in the diagnosis of tumor resectability were 78.00%,79.50%,80.00%and 77.50%,respectively.Conclusion The TVC three-level evaluation method of MDCT had better application value in preoperative evaluation of operable pancreatic cancer patients,and was worth clinical application.

关 键 词：多排螺旋CT 肿瘤 血管 三级评价法 胰腺癌 术前评价 

分 类 号：R735.9[医药卫生—肿瘤]