多排螺旋计算机断层扫描与分期腹腔镜检查在检测食管胃交界部癌和胃癌腹膜转移中的应用比较
Multidetector Computed Tomography Versus Staging Laparoscopy for the Detection of Peritoneal Metastases in Esophagogastric Junctional and Gastric Cancer.
作者信息
Leeman Matthew F, Patel Dilip, Anderson Judith, OʼNeill J Robert, Paterson-Brown Simon
机构信息
Departments of *General Surgery †Radiology, Royal Infirmary of Edinburgh, Edinburgh, UK.
出版信息
Surg Laparosc Endosc Percutan Tech. 2017 Oct;27(5):369-374. doi: 10.1097/SLE.0000000000000451.
OBJECTIVE
Staging laparoscopy (SL) is the gold standard investigation for detecting peritoneal metastases (PM) in patients with esophagogastric cancer but computed tomography (CT) has undergone significant improvements in recent years. The aim of this study was to investigate whether CT can replace SL in the detection of PM.
MATERIALS AND METHODS
Patients undergoing SL between January 2008 and December 2009 were identified from a prospectively collected database, operation notes were reviewed for the detection of PM. Corresponding CTs were reassessed by 2 experienced gastrointestinal radiologists, blinded to the SL results.
RESULTS
In total, 74 patients undergoing SL were included. Sensitivity and specificity of SL for PM were 94.1% (95% confidence interval, 69.2-99.7) and 100% (90.7-100). Sensitivity and specificity of CT were 58.8% (33.5-80.6) and 89.6% (76.6-96.1), respectively. Area under the curve of receiver operating characteristic curves for SL and CT were 0.971 (SE, 0.033) and 0.742 (SE, 0.78), respectively.
CONCLUSIONS
CT cannot replace SL for the detection of PM in lower esophageal and gastric cancer.
目的
分期腹腔镜检查（SL）是检测食管癌和胃癌患者腹膜转移（PM）的金标准检查方法，但近年来计算机断层扫描（CT）有了显著改进。本研究的目的是调查CT在检测PM方面是否能取代SL。
材料与方法
从一个前瞻性收集的数据库中识别出2008年1月至2009年12月期间接受SL的患者，查阅手术记录以检测PM。由2名经验丰富的胃肠放射科医生对相应的CT进行重新评估，他们对SL结果不知情。
结果
总共纳入了74例接受SL的患者。SL对PM的敏感性和特异性分别为94.1%（95%置信区间，69.2 - 99.7）和100%（90.7 - 100）。CT的敏感性和特异性分别为58.8%（33.5 - 80.6）和89.6%（76.6 - 96.1）。SL和CT的受试者操作特征曲线下面积分别为0.971（标准误，0.033）和0.742（标准误，0.78）。
结论
在检测食管下段和胃癌的PM方面，CT不能取代SL。
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