CT判断贲门癌有无脉管癌栓形成的初步探讨

目的初步探讨CT判断贲门癌有无脉管癌栓形成的意义。方法 70例经手术及病理证实的贲门癌病例,按照有无脉管癌栓形成分为VI(+)和VI(-)两组,对比两组间CT检出最大淋巴结大小、淋巴结个数及肿瘤大小的差异,并利用ROC曲线得出不同诊断标准的敏感性、特异性及联合试验。结果 VI(+)组与VI(-)CT检出最大淋巴结平均大小分别为(15.57±4.23)mm和(11.12±3.08)mm,淋巴结个数分别为(15.76±8.49)枚和(9.24±5.12)枚,肿瘤平均大小分别为(6.32±4.29)cm和(4.13±1.90)cm,差异均有统计学意义(P<0.05)。联合应用CT检出淋巴结个数及大小指标,串联试验以10枚淋巴结和最大淋巴结12.5mm为标准时,敏感性和特异性分别为64.9%,84.5%;以10枚淋巴结和最大淋巴结10.5mm为标准时,敏感性和特异性分别为73.0%,72.3%;并联试验以12枚淋巴结和最大淋巴结12.5mm为标准时,敏感性和特异性分别为89.2%,57.6%。结论应用CT检出最大淋巴结大小、淋巴结个数及肿块大小判断贲门癌有无脉管癌栓形成有一定的价值。

Initiatory Research of Judging Vessel Invasion by CT in Esophago-Gastric Junction Carcinoma

Objective To explore the significance of CT in judging vessel invasion in esophago-gastric junction carcinoma. Methods 70 cases of cardia cancer confirmed by surgery and pathology were divided into VI (+) group and VI (-) groups according to with or without vascular invasion. The differences of the largest lymph node size, the number of lymph nodes and tumor size by CT detection of two groups were compared, and the sensitivity, specificity, and joint testing of the different diagnostic criteria by ROC curve were obtained. Results VI (+) group VI (-) of CT detection in the average size of the largest lymph nodes were (15.57 ± 4.23) mm and (11.12 ± 3.08) mm, lymph node number were (15.76 ± 8.49) pieces and (9.24 ± 5.12) pieces, the average tumor size was (6.32 ± 4.29) cm and (4.13 ± 1.90) cm; there were significant differences (P <0.05). Combined with CT detected obtained lymph node number and size of the index, series test when criterions of 10 LNs 12.5 mm, the sensitivity and specificity were 64.9%, 84.5%; when criterions of 10 LNs 10.5 mm, the sensitivity and specificity were 73.0% , 72.3% , when criterions of 12 LNs or 12.5mm LN in Parallel test, the sensitivity and specificity were 89.2% , 57.6% , respectively. Conclusions It has a certain value to obtain the largest lymph node size, lymph node number and tumor size to determine the gastric cardia with or without vascular invasion by CT detection.