Ren Xiu-Chun, Liang Pan
Department of Ultrasonography, The First Affiliated Hospital, Zhengzhou University, Zhengzhou, China.
Department of Radiology, The First Affiliated Hospital, Zhengzhou University, Zhengzhou, China.
Medicine (Baltimore). 2024 Dec 13;103(50):e40816. doi: 10.1097/MD.0000000000040816.
The purpose of the article is to determine whether differentiation and enhanced CT features can preoperatively predict microvascular/nerve invasion in locally advanced gastric cancer. Retrospective analysis of the CT and pathological data of 325 patients with locally advanced gastric cancer confirmed by pathology in our hospital from July 2011 to August 2023. The patient's age, gender, tumor location, T stage, N stage, TNM stage, differentiation, Lauren classification, as well as tumor thickness, tumor longest diameter, plain CT value, arterial CT value, venous CT value, arterial phase enhancement rate, and venous phase enhancement rate were assessed. This study included a total of 325 patients with locally advanced gastric cancer and 189 patients (58.15%) with microvascular/nerve invasion. The results of the univariate analysis showed that gender, location, T stage, N stage, TNM stage, differentiation, Lauren classification, tumor thickness, and longest diameter of the tumor were associated with microvascular/nerve invasion (P < .05). Multivariate analysis suggested that TNM stage and differentiation were independent risk factors for microvascular/nerve invasion. The receiver operating characteristic analysis showed that the diagnostic efficacy of the combined parameter of TNM stage and differentiation was better than that of the single parameter, in which area under the curve, sensitivity, and specificity were 0.819 (95%CI: 0.770-0.867), 66.7%, and 83.8%, respectively. Differentiation and enhanced CT are helpful in predicting whether microvascular/nerve invasion occurs in locally advanced gastric cancer before operation, especially the combined parameters of TNM stage and differentiation.
本文的目的是确定分化程度和增强CT特征能否在术前预测局部进展期胃癌的微血管/神经侵犯。回顾性分析2011年7月至2023年8月在我院经病理确诊的325例局部进展期胃癌患者的CT及病理资料。评估患者的年龄、性别、肿瘤位置、T分期、N分期、TNM分期、分化程度、Lauren分型，以及肿瘤厚度、肿瘤最长径、平扫CT值、动脉期CT值、静脉期CT值、动脉期强化率和静脉期强化率。本研究共纳入325例局部进展期胃癌患者，其中189例（58.15%）发生微血管/神经侵犯。单因素分析结果显示，性别、位置、T分期、N分期、TNM分期、分化程度、Lauren分型、肿瘤厚度和肿瘤最长径与微血管/神经侵犯有关（P < .05）。多因素分析提示TNM分期和分化程度是微血管/神经侵犯的独立危险因素。受试者工作特征分析显示，TNM分期和分化程度联合参数的诊断效能优于单一参数，其曲线下面积、灵敏度和特异度分别为0.819（95%CI：0.770-0.867）、66.7%和83.8%。分化程度和增强CT有助于术前预测局部进展期胃癌是否发生微血管/神经侵犯，尤其是TNM分期和分化程度的联合参数。
