增强CT及口服对比剂增强超声对胃癌T分期的预测
Prediction of T stage in gastric carcinoma by enhanced CT and oral contrast-enhanced ultrasonography.
作者信息
Yu Tao, Wang Xinling, Zhao Zilong, Liu Fan, Liu Xiaoting, Zhao Yan, Luo Yahong
机构信息
Department of Medical Image, Dalian Medical University Clinical Oncology College, No. 44 Xiaoheyan Road, Dadong District, Shenyang, 110042, China.
Department of Medical Image, Liaoning Cancer Hospital and Institute, No. 44 Xiaoheyan Road, Dadong District, Shenyang, 110042, China.
出版信息
World J Surg Oncol. 2015 May 19;13:184. doi: 10.1186/s12957-015-0577-7.
BACKGROUND
The aim of this study is to explore the values of enhanced CT and oral contrast-enhanced ultrasonography on preoperative T stage in gastric carcinoma.
METHODS
Forty patients with gastric carcinoma, including 27 males and 13 females, were confirmed by endoscopy, operation, and pathology. The median age of these patients was 49 years old (25 to 73 years). There were 19 cases of well-differentiated adenocarcinoma, 13 cases of poorly differentiated adenocarcinoma, 5 cases of signet ring cell carcinoma, and 4 cases of mucinous adenocarcinoma by pathology. All these patients were examined by both enhanced CT and ultrasound examination simultaneously 1 week before surgery. T staging in all these gastric carcinomas was carried out by enhanced CT or oral contrast-enhanced ultrasonography, respectively, or by both of them. The statistical difference between T stage by imaging and pathological T stage was analyzed.
RESULTS
In this study, there were 5 cases with T1 stage, 9 cases with T2 stage, 20 cases with T3 stage, and 6 cases with T4 stage by pathology; 5 cases with T1 stage, 7 cases with T2 stage, 22 cases with T3 stage, and 6 cases with T4 stage by enhanced CT imaging with an accuracy of 75.00%; 6 cases with T1 stage, 7 cases with T2 stage, 22 cases with T3 stage, and 5 cases with T4 stage by ultrasonography examination, with an accuracy of 77.50%; and 4 cases with T1 stage, 10 cases with T2 stage, 19 cases with T3 stage, and 7 cases with T4 stage by both enhanced CT imaging and ultrasonography examination, with an accuracy of 85.00%. The accuracy of T staging in gastric carcinoma by both enhanced CT and ultrasound was higher than that either by enhanced CT or by ultrasound, respectively (P < 0.05). The anastomosis degree of the gastric carcinoma between enhanced CT and ultrasonography was κ = 0.404.
CONCLUSIONS
Combination diagnosis of enhanced CT and oral contrast-enhanced ultrasonography is helpful to improve the accuracy of T staging of gastric carcinoma before operations.
背景
本研究旨在探讨增强CT及口服对比剂增强超声检查在胃癌术前T分期中的价值。
方法
40例胃癌患者，男性27例，女性13例，经内镜、手术及病理确诊。患者中位年龄49岁（25至73岁）。病理检查有高分化腺癌19例，低分化腺癌13例，印戒细胞癌5例，黏液腺癌4例。所有患者均在手术前1周同时接受增强CT及超声检查。所有胃癌分别通过增强CT或口服对比剂增强超声检查或两者联合进行T分期。分析影像学T分期与病理T分期之间的统计学差异。
结果
本研究中，病理T1期5例，T2期9例，T3期20例，T4期6例；增强CT成像T1期5例，T2期7例，T3期22例，T4期6例，准确率为75.00%；超声检查T1期6例，T2期7例，T3期22例，T4期5例，准确率为77.50%；增强CT成像与超声检查联合T1期4例，T2期10例，T3期19例，T4期7例，准确率为85.00%。增强CT及超声对胃癌T分期的准确率均高于单独使用增强CT或超声（P<0.05）。增强CT与超声对胃癌的吻合度κ=0.404。
结论
增强CT与口服对比剂增强超声联合诊断有助于提高胃癌术前T分期的准确性。
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