Andåker L, Morales O, Höjer H, Bäckstrand B, Borch K, Larsson J
Department of Surgery, University Hospital, Linköping, Sweden.
Surgery. 1991 Feb;109(2):132-5.
Ninety patients with gastric malignancy underwent computed tomography (CT) before surgery. The CT findings regarding neoplastic invasion of adjacent organs and metastasis or enlarged lymph nodes were compared with the findings at laparotomy (85 cases) or autopsy (5 cases), thus permitting evaluation of the diagnostic accuracy of CT and its usefulness for predicting resectability. When present, neoplastic invasion of adjacent organs was overestimated or underestimated by CT in 21 cases. Invasion of adjacent organs according to CT was false positive in 17 cases and false negative in 11 cases. When liver metastasis or enlarged regional or distant lymph nodes were present, CT overestimated or underestimated their extent in 17 cases, and the diagnosis was false positive in one case and false negative in 33 cases. The positive and negative predictive values of CT concerning resectability of the tumor were 81% and 64%, respectively. Routine preoperative CT in gastric malignancy is concluded to be of limited value and surgical exploration, when feasible, remains the method of choice.
90例胃恶性肿瘤患者在手术前行计算机断层扫描（CT）检查。将CT关于肿瘤侵犯邻近器官及转移或淋巴结肿大的检查结果与剖腹探查（85例）或尸检（5例）结果进行比较，从而评估CT的诊断准确性及其对预测可切除性的作用。当存在肿瘤侵犯邻近器官时，CT高估或低估该情况的有21例。根据CT判断的邻近器官侵犯，假阳性17例，假阴性11例。当存在肝转移或区域或远处淋巴结肿大时，CT高估或低估其范围的有17例，诊断假阳性1例，假阴性33例。CT关于肿瘤可切除性的阳性预测值和阴性预测值分别为81%和64%。得出结论，胃恶性肿瘤常规术前CT的价值有限，可行时手术探查仍是首选方法。
