进展期胃肠印戒细胞癌多层螺旋CT表现分析  

Analysis of multi spiral CT manifestations of advanced gastrointestinal signet ring cell carcinoma

作　　者：袁西伟 陈龙宇 邱毅 钟小兵 YUAN Xiwei;CHEN Longyu;QIU Yi;ZHONG Xiaobing(Department of Radiology,the Third Affiliated Hospital of Zunyi Medical University,the First People’s Hospital of Zunyi,Zunyi,Guizhou Province 563002,China;Department of Gastrointestinal Surgery,the Third Affiliated Hospital of Zunyi Medical University,the First People’s Hospital of Zunyi,Zunyi,Guizhou Province 563002,China;Department of Radiology,the People’s Hospital of Honghuagang District,Zunyi,Guizhou Province 563000,China)

机构地区：[1]遵义医科大学第三附属医院,遵义市第一人民医院放射科,贵州遵义563002 [2]遵义医科大学第三附属医院,遵义市第一人民医院胃肠外科,贵州遵义563002 [3]遵义市红花岗区人民医院放射科,贵州遵义563000

出　　处：《实用放射学杂志》2024年第12期1994-1997,共4页Journal of Practical Radiology

摘　　要：目的探讨进展期胃肠印戒细胞癌(SRCC)的多层螺旋CT(MSCT)特征及生物学行为,为临床提供精准术前类型、分期及个性化治疗策略选择。方法回顾性分析经手术或内镜下活检、病理免疫组化确诊的26例(A组)进展期胃肠SRCC临床表现、肿瘤5项标志物及MSCT影像学资料,并以同期随机选择进展期非印戒细胞癌(NSRCC)44例(B组)为对照组,分析2组临床表现、肿瘤5项标志物、MSCT影像学特征表现。结果A、B组男女性别、肿瘤部位、肿瘤厚度(T)及长度(L)、肿瘤5项标志物差异无统计学意义(P>0.05);而年龄、主要症状分组、肿瘤厚长比(TLR)、肿瘤边缘与正常组织交界处夹角(CNA)差异有统计学意义(P<0.05),A、B组年龄[A组≤50岁(12/26、46%),B组>50岁(42/44、95%)]、主要症状分组(χ^(2)=19.085,P<0.05)、肿瘤TLR(Z=-2.044,P<0.05)、CNA(χ^(2)=14.776,P<0.05)差异有统计学意义(P<0.05)。结论SRCC发病年龄低,好发于胃中下部及直肠,TLR小,CNA主要表现为钝角,结直肠SRCC表现为“毛毛虫样”特征。Objective To investigate the multi spiral computed tomography(MSCT)characteristics and biological behaviors of advanced gastrointestinal signet ring cell carcinoma(SRCC),so as to provide accurate preoperative type,stage and personalized choice of treatment strategy in clinical practice.Methods The clinical manifestations,five tumor markers and MSCT imaging data of 26 cases(group A)with advanced gastrointestinal SRCC confirmed by surgical or endoscopic biopsy and pathological immunohistochemistry were analyzed retrospectively,and 44 cases(group B)of advanced non-signet ring cell carcinoma(NSRCC)during the same period were randomly selected as the control group.The clinical manifestations,five tumor markers and MSCT imaging features of groups A and B were analyzed.Results There were no significant differences in gender,tumor location,tumor thickness(T)and length(L),and five tumor markers between groups A and B(P>0.05).There were significant differences in age,main symptoma,tumor thicknessto-length ratio(TLR),angle between cancerous edge and normal tissue(CNA)(P<0.05).However,age of group A and group B[group A≤50 years old(12/26,46%),group B>50 years old(42/44,95%)],main symptom(χ^(2)=19.085,P<0.05),tumor TLR(Z=-2.044,P<0.05)and CNA(χ^(2)=14.776,P<0.05)were significantly different(P<0.05).Conclusion SRCC affects younger patients and is more likely to originate from the middle and lower parts of the stomach and rectum,with lower TLR,obtuse angle of CNA,and“caterpillar-like”characteristics of colorectal SRCC.

关 键 词：胃肠道 印戒细胞癌 计算机体层成像 

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