[Application of three-dimensional ultrasonography to assess the abdominal lymph node metastasis of gastric carcinoma].

OBJECTIVE

To investigate the clinical value of three-dimensional ultrasonography (3D-US) in the diagnosis of abdominal lymph node metastasis of gastric carcinoma.

METHODS

A total of 95 patients with gastric cancer diagnosed by gastroscopy and confirmed by pathology after operation were examined by 3D-US preoperatively.The characteristics of gastric carcinoma was assessed using QLAB software. The tumor volume, lesion diameter and invasion depth of gastric cancer were measured.

RESULTS

All of the 95 subjects were divided into two groups according to their lymph nodes status postoperatively: group N+ , 71 patients with lymph node metastasis; and group N0, 24 patients without lymph node metastasis.The quantitative 3D-US analysis and pathological results of these two groups were compared with each other. The tumor volume of group N+ was significantly higher than that of the group N0 [(26.02±6.87)cm(3) vs. (13.11±2.79)cm(3), P<0.05], the invasion depth was significantly deeper in the group N+ than in the group N0 [(1.57±0.29)cm VS (1.10±0.29)cm, P<0.05]. However, there was no significant difference of the lesion diameters between these two groups. Multivariate analysis showed that tumor volume and depth of invasion are independently correlated with lymph node metastasis. A cut-off value=16.8 cm(3) of the tumor volume for assessing the lymph node metastasis had a sensitivity of 90.1% and specificity of 95.8%, respectively, obtained by the area under the ROC curve.

CONCLUSION

The tumor volume of gastric cancer can be obtained by 3D-ultrasonography, and the tumor volume can be considered as a new potential index to evaluate the abdominal lymph node metastasis of gastric cancer before surgery.