多排螺旋CT在检测早期胃癌淋巴结转移中的临床价值评估

目的评估多排螺旋CT在检测早期胃癌术前淋巴结转移中的临床价值。方法使用多排螺旋CT评估77例早期胃癌患者的淋巴结转移情况,其中24例患者采用的多排螺旋CT层厚为2.5～5.0 mm,53例患者采用的层厚为7.5～10.0 mm。结果多排螺旋CT检测淋巴结转移的准确率为74.0%,而手术评估的准确率为54.5%。采用2.5～5.0 mm层厚的多排螺旋CT对淋巴结转移诊断的敏感度、特异度、阳性预测值和阴性预测值分别为75.0%、65.0%、30.0%和92.9%;采用7.5～10.0 mm层厚的多排螺旋CT对淋巴结转移诊断的敏感度、特异度、阳性预测值和阴性预测值分别为62.5%、82.2%、38.5%和92.5%;而相应手术的评估值分别为45.5%、63.6%、17.2%和87.2%。结论MDCT对淋巴结转移诊断的准确率较高,对早期胃癌淋巴结转移的检测有一定的临床价值。

Clinical value of multidetector computed tomography in detecting lymph node metastasis of early gastric cancer

OBJECTIVE: To evaluate multidetector computed tomography (MDCT) as a pre-operative staging tool for detecting lymph node metastasis in patients with early gastric cancer (EGC). METHODS: In 77 consecutive patients with EGC, lymph node metastasis was assessed pre-operatively with MDCT at a slice thickness of 2.5 - 5.0 mm (n=24) or 7.5 - 10.0 mm (n =53). RESULTS: Overall accuracy of detecting NO to N3 lymph node was 74.0% for MDCT and 54.5% for operative assessment. The sensitivity, specificity, positive predictive value and negative predictive value in detecting lymph node metastasis was 75. 0%, 65.0%, 30.0% and 92.9% with 2.5 - 5.0 mm MDCT image, which was 62.5%, 82.2%, 38.5% and 92.5% by 7.5 - 10.0 mm MDCT image, whereas it was only 45.5%, 63.6%, 17.2% and 87.2% by operative assessment. CONCLUSION: Pre-operative assessment by multidetector CT may have a high accuracy in detecting lymph node metastasis for patients with early gastric cancer.