结直肠腺癌组织学分级与CT表现的关系

目的:探讨不同组织学级别结直肠腺癌CT表现的差异.方法:回顾性分析219例经病理确诊的结直肠腺癌患者临床和CT资料,按组织学分化程度分为高级别结直肠腺癌和低级别结直肠腺癌两组,比较两组患者发病年龄、性别、病变部位、病变肠壁长度及厚度、肠壁增厚形式、强化程度、增强后低密度比例、肠周浸润程度、肠周淋巴结肿大、合并肠梗阻、肝脏和腹膜转移的差异.结果:高级别和低级别结直肠腺癌在病变肠壁增厚形式、肠周浸润程度和肠周淋巴结肿大等方面差异有统计学意义(x2 =21.571、6.613和34.859,P＜0.05),在平均发病年龄、性别比例、病变部位、病变肠壁长度及厚度、强化程度、增强后低密度比例、合并肠梗阻肝脏和腹膜转移等方面差异无统计学意义(P＞0.05).结论:不同组织学级别的结直肠腺癌CT表现有显著差异.相对低级别结直肠腺癌,高级别结直肠腺癌病变肠壁更易呈环形增厚、肠周浸润程度更重、肠周淋巴结肿大更多.

The relationship between histological grading and CT manifestations in colorectal adenocarcinoma

Objective:To investigate the relationship between histological grading and CT manifestations of colorectal adenocarcinoma.Methods:The CT findings of 219 patients with colorectal adenocarcinoma confirmed by surgery and pathology were retrospectively analyzed.The patients were divided into high-grade or low-grade colorectal adenocarcinoma group according to the histopathological differentiation of the lesions.The differences of age,gender,location of lesion,length and thickness of the involved intestinal wall,thickening patterns of the intestinal wall,contrast enhancement forms,peri-intestinal invasion,occurrence of intestinal obstruction and regional lymphadenectasis,occurrence of metastasis in other organs were compared between the two groups.Results:There were statistically significant differences of thickening patterns of the intestinal wall,peri-intestinal invasion and occurrence of regional lymphadenectasis between the two groups (x2=21.571,6.613 and 34.859,P＜0.05),while there was no statistically significant difference in age,gender,location of lesion,length and thickness of the involved intestinal wall,the contrast enhancement forms,occurrence of intestinal obstruction,occurrence of metastasis inliver and peritoneum (P＞0.05).Conclusion:There are some differences of CT manifestations of highgrade and low-grade colorectal adenocarcinoma.Compared with low-grade colorectal adenocarcinoma,high-grade colorectal adenocarcinoma is more likely to show annular thickening intestinal wall,bowel infiltration,and regional lymphadenectasis.