Department of Radiology, The First Affiliated Hospital of Xiamen University, Xiamen, China
Department of Ultrasound, The First Affiliated Hospital of Xiamen University, Xiamen, China
Diagn Interv Radiol. 2023 Mar 29;29(2):228-233. doi: 10.4274/dir.2021.21286. Epub 2022 Dec 28.
To investigate the value of tumor morphologic features of pT1-2 gastric cancer (GC) on contrast-enhanced computed tomography (CT) in assessing lymph node metastasis (LNM) with reference to histopathological results.
Eighty-six patients seen from October 2017 to April 2019 with pT1-2 GC proven by histopathology were included. Tumor volume and CT densities were measured in the plain scan and the portal-venous phase (PVP), and the percent enhancement was calculated. The correlations between tumor morphologic features and the N stages were analyzed. The diagnostic capability of tumor volume and enhancement features in predicting the LN status of pT1-2 GCs was further investigated using receiver operating characteristic (ROC) analysis.
Tumor volume, CT density in the PVP, and tumor percent enhancement in the PVP correlated significantly with the N stage (rho: 0.307, 0.558, and 0.586, respectively). Tumor volumes were significantly lower in the LNM- group than in the LNM+ group (14.4 mm vs. 22.6 mm, P = 0.004). The differences between the LNM- and LNM+ groups in the CT density in the PVP and the percent enhancement in the PVP were also statistically significant (68.00 HU vs. 87.50 HU, < 0.001; and 103.06% vs. 179.19%, < 0.001, respectively). The area under the ROC curves for identifying the LNM+ group was 0.69 for tumor volume and 0.88 for percent enhancement in the PVP, respectively. The percent enhancement in the PVP of 145.2% and tumor volume of 17.4 mL achieved good diagnostic performance in determining LNM+ (sensitivity: 71.4%, 82.1%; specificity: 91.4%, 58.6%; and accuracy: 84.9%, 66.3%, respectively).
Tumor volume and percent enhancement in the PVP of pT1-2 GC could improve the diagnostic accuracy of LNM and would be helpful in image surveillance of these patients.
探讨 CT 增强扫描中 pT1-2 期胃癌（GC）的肿瘤形态学特征对病理结果评估淋巴结转移（LNM）的价值。
回顾性分析 2017 年 10 月至 2019 年 4 月期间经病理证实为 pT1-2 GC 的 86 例患者的资料。在平扫和门静脉期（PVP）测量肿瘤体积和 CT 密度，并计算增强百分比。分析肿瘤形态学特征与 N 分期的相关性。进一步采用受试者工作特征（ROC）曲线分析肿瘤体积和增强特征预测 pT1-2 GC 淋巴结状态的诊断能力。
肿瘤体积、PVP 期 CT 密度和 PVP 期肿瘤增强百分比与 N 分期显著相关（rho：0.307、0.558 和 0.586）。与 LNM+组相比，LNM-组肿瘤体积明显较小（14.4mm 比 22.6mm，P=0.004）。LNM-组和 LNM+组在 PVP 期 CT 密度和 PVP 期肿瘤增强百分比上的差异也具有统计学意义（68.00HU 比 87.50HU，<0.001；103.06%比 179.19%，<0.001）。肿瘤体积和 PVP 期肿瘤增强百分比识别 LNM+组的 ROC 曲线下面积分别为 0.69 和 0.88。PVP 期肿瘤增强百分比为 145.2%，肿瘤体积为 17.4mL 时，在确定 LNM+方面具有较好的诊断性能（敏感性：71.4%，82.1%；特异性：91.4%，58.6%；准确性：84.9%，66.3%）。
pT1-2 期 GC 的肿瘤体积和 PVP 期肿瘤增强百分比可以提高 LNM 的诊断准确性，有助于对这些患者进行影像学监测。
