Malaj Altin, Bilaj Fatmir, Shahini Albana, Miraka Marjeta
Consultant, WHO/Europe, Albania.
University Hospital Center "Mother Theresa", Tirana, Albania.
Contemp Oncol (Pozn). 2017;21(2):168-173. doi: 10.5114/wo.2017.68626. Epub 2017 Jun 30.
Gastric adenocarcinoma is among most frequent among cancers in Albania. Early detection and staging is helped by imaging methods, including CT and MRI. This study provides evidence on the CT and MRI accuracy in detecting and pre-operative staging of gastric adenocarcinoma in 62 patients in a diagnostic clinic in Albania. The correct staging of the gastric adenocarcinoma helps decide on the next treatment options.
Sixty-two patients with gastric adenocarcinoma, confirmed with biopsy, underwent both CT and MRI examination at a clinic in Tirana during same week. Images were reviewed to determine the TNM classifications and staging using the current AJCC guidelines. Data on age, sex, cancer location and differentiation were also collected and analyzed. The accuracy, sensitivity, specificity, positive predictive value and negative predictive value was estimated for both CT and MRI.
CT has a higher accuracy than MRI (83% vs. 67%) for T1. Accuracy for T2 was the same (74%). Starting with T3 and upwards, MRI has a slightly more accurate ability to detect and stage the gastric adenocarcinoma (T3: 81 vs. 75; T4: 83 vs. 64). Both the CT and MRI abilities to accurately detect the N classification were the same. Regarding the M classification, the MRI has a slightly more accurate ability to detect metastases (M: 83 vs. 64). Clinicians might benefit from using CT whenever suspect gastric adenocarcinoma patients present first. Decision on surgery requires a MRI to rule out metastases.
胃腺癌是阿尔巴尼亚最常见的癌症之一。包括CT和MRI在内的成像方法有助于早期检测和分期。本研究为阿尔巴尼亚一家诊断诊所的62例胃腺癌患者的CT和MRI检测及术前分期准确性提供了证据。胃腺癌的正确分期有助于确定下一步的治疗方案。
62例经活检确诊为胃腺癌的患者于同一周内在地拉那的一家诊所接受了CT和MRI检查。根据美国癌症联合委员会(AJCC)现行指南对图像进行评估,以确定TNM分类和分期。还收集并分析了患者的年龄、性别、癌症位置和分化程度等数据。分别评估了CT和MRI的准确性、敏感性、特异性、阳性预测值和阴性预测值。
对于T1期,CT的准确性高于MRI(83%对67%)。T2期的准确性相同(74%)。从T3期及以上,MRI检测和分期胃腺癌的能力略高(T3期:81%对75%;T4期:83%对64%)。CT和MRI准确检测N分类的能力相同。关于M分类,MRI检测转移的能力略高(M:83%对64%)。当怀疑为胃腺癌的患者首次就诊时,临床医生使用CT可能会有所帮助。决定是否进行手术需要进行MRI检查以排除转移。