MSCT三期动态增强扫描在胃癌术前分期以及淋巴结转移诊断中的应用价值

目的探究多层螺旋CT（multislice spiral computed tomography，MSCT）三期动态增强扫描在胃癌术前分期以及淋巴结转移诊断中的应用价值。 方法选取2015年1月至2018年1月期间进行手术治疗的胃癌病人60例，记录病人术前MSCT三期动态增强扫描资料和术后病理资料，并以术后病理诊断结果为金标准，分析MSCT三期动态增强扫描对胃癌术前分期以及淋巴结转移诊断的准确性，采用ROC曲线分析MSCT三期动态增强扫描对胃癌术前分期以及淋巴结转移的诊断效能。 结果MSCT三期动态增强扫描对胃癌T₁~T₄分期、淋巴结转移以及M分期诊断结果与术后病理诊断结果均存在一致性（P < 0.01）。MSCT三期动态增强扫描对胃癌术前T分期的总体准确率为80.00%（48/60），其中T₁~T₄分期的准确率分别为75.00%（6/8）、63.64%（7/11）、86.36%（19/22）和84.21%（16/19）；T₁联合T₂、T₂联合T₃以及T₃联合T₄的鉴别准确率分别为68.42%（13/19）、78.79%（26/33）、85.37%（35/41）。MSCT三期动态增强扫描对胃癌淋巴结转移诊断的准确率为85.96%（49/57）。MSCT三期动态增强扫描对胃癌术前M分期的总体准确率为89.83%（53/59），其中M₀与M₁期的准确率分别为92.00%（46/50）、77.78%（7/9）。ROC曲线分析显示:MSCT三期动态增强扫描对胃癌T₁~T₄分期、淋巴结转移以及M分期诊断的曲线下面积分别为0.865、0.788、0.853、0.870、0.850和0.797，均具有一定准确性。 结论MSCT三期动态增强扫描在胃癌术前分期、治疗方案的选择以及预后的判断等方面具有重要价值，值得临床推广使用。

Application value of MSCT tri-phase dynamic enhanced scanning in preoperative staging of gastric cancer and diagnosis of lymphatic metastasis

ObjectiveTo investigate the application value of multislice spiral computed tomography(MSCT)tri-phase dynamic enhanced scanning in the preoperative staging of gastric cancer and diagnosis of lymph node metastasis. MethodsSixty gastric cancer patients scheduled by operation from January 2015 to January 2018 were selected, and the data of preoperative MSCT tri-phase dynamic enhanced scanning and postoperative pathology in all patients were recorded.The postoperative pathological diagnosis was set as the gold standard, the accuracy of MSCT tri-phase dynamic enhanced scanning in the diagnosis of preoperative staging and lymph node metastasis of gastric cancer was analyzed.The diagnostic efficiency of MSCT tri-phase dynamic enhanced scanning in preoperative staging and lymphatic metastasis of gastric cancer was analyzed using ROC curve. ResultsThe results of MSCT tri-phase dynamic enhanced scanning in diagnosing the T₁-T₄ staging, lymph node metastasis and M staging were consistent with the pathological diagnosis of gastric cancer(P < 0.01).The overall accuracy rate of MSCT tri-phase dynamic enhanced scanning in preoperative T staging of gastric cancer was 80.00%(48/60), and the accuracy rates of T₁-T₄ staging were 75.00%(6/8), 63.64%(7/11), 86.36%(19/22)and 84.21%(16/19), respectively.The discriminating accuracy rates of T₁ and T₂, T₂ and T₃, and T₃ and T₄ were 68.42%(13/19)and 78.79%(26/33)and 85.37%(35/41), respectively.The overall accuracy rate of MSCT tri-phase dynamic enhanced scanning in the diagnosis of lymph atic metastasis was 85.96%(49/57).The overall accuracy of MSCT tri-phase dynamic enhanced scanning in preoperative M staging of gastric cancer was 89.83%(53/59), and the accuracy of M₀ and M₁ stages was 92.00%(46/50)and 77.78%(7/9), respectively.The ROC curve analysis showed that the area under the curve of MSCT tri-phase dynamic enhanced scanning in the diagnosis of T₁-T₄ staging, lymphatic metastasis and M staging was 0.865, 0.788, 0.853, 0.870, 0.850 and 0.797, respectively, and which was accurate. ConclusionsMSCT tri-phase dynamic enhanced scanning has important value in preoperative staging, selecting treatment schemes and diagnosing prognosis of gastric cancer, and it is worthy of clinical promotion.