Habermann Christian R, Weiss Florian, Riecken Rasmus, Honarpisheh Human, Bohnacker Sabine, Staedtler Carsten, Dieckmann Christoph, Schoder Volker, Adam Gerhard
Department of Diagnostic and Interventional Radiology, University Hospital Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany.
Radiology. 2004 Feb;230(2):465-71. doi: 10.1148/radiol.2302020828.
To compare the performance of helical computed tomography (CT) and endoscopic ultrasonography (US) in the preoperative staging of gastric cancer.
Fifty-one consecutive patients with a primary malignant gastric tumor (stage T2-T4) were preoperatively evaluated with both helical CT and endoscopic US within 3 days. Each tumor was staged according to the TNM classification system with both modalities. All patients subsequently underwent surgery. Results of CT and endoscopic US were compared with histologic staging of tumor invasion depth and regional lymph node metastasis. For comparison of CT and endoscopic US data, the marginal homogeneity test was used, and a P value of less than.05 was determined to indicate statistical significance.
In comparison with histologic results, CT achieved correct T staging in 39 patients (76%) and correct N staging in 35 patients (70%). The corresponding results for endoscopic US achieved correct T staging in 44 patients (86%) and correct N staging in 45 patients (90%). There was no significant difference between T staging (P =.55) and N staging (P >.99). Because of challenging detection of wall layers, correct T staging was difficult for CT and endoscopic US in the differentiation of T2 and T3 lesions.
Compared with endoscopic US, helical CT focused on the stomach provides valuable results regarding T and N staging in patients with gastric cancer.
比较螺旋计算机断层扫描（CT）和内镜超声检查（US）在胃癌术前分期中的表现。
连续51例原发性胃恶性肿瘤（T2 - T4期）患者在3天内接受了螺旋CT和内镜超声检查的术前评估。通过这两种检查方式，根据TNM分类系统对每个肿瘤进行分期。所有患者随后均接受了手术。将CT和内镜超声检查的结果与肿瘤浸润深度和区域淋巴结转移的组织学分期进行比较。为比较CT和内镜超声检查的数据，采用了边际齐性检验，P值小于0.05被确定为具有统计学意义。
与组织学结果相比，CT对39例患者（76%）实现了正确的T分期，对35例患者（70%）实现了正确的N分期。内镜超声检查的相应结果是对44例患者（86%）实现了正确的T分期，对45例患者（90%）实现了正确的N分期。T分期（P = 0.55）和N分期（P > 0.99）之间没有显著差异。由于难以检测到胃壁各层，在区分T2和T3病变时，CT和内镜超声检查都难以实现正确的T分期。
与内镜超声检查相比，针对胃部的螺旋CT在胃癌患者的T和N分期方面提供了有价值的结果。
