飞利浦64排增强CT扫描在胃癌术前分期中的应用

目的:分析飞利浦64排增强CT扫描在胃癌术前分期中的应用价值。方法:选取我院2016年1月至2018年1月收治的450例经胃镜检查证实的胃癌患者纳入研究，术前采取飞利浦64排增强CT扫描方式评估TNM分期，以术后病理检查结果作为“金标准”，分析飞利浦64排增强CT扫描在胃癌术前分期中的准确性。结果:飞利浦64排增强扫描T1期灵敏度为64.00%，特异度99.06%，准确性97.11%，Kappa值0.70；T2期灵敏度为70.65%，特异度94.97%，准确性90.00%，Kappa值0.68；T3期灵敏度为83.93%，特异度81.42%，准确性82.67%，Kappa值0.65；T4期灵敏度为70.64%，特异度88.27%，准确性84.00%，Kappa值0.57；飞利浦64排增强扫描N0期灵敏度为80.25%，特异度85.85%，准确性82.89%，Kappa值0.66；N1期灵敏度为77.16%，特异度92.36%，准确性86.89%，Kappa值0.71；N2期灵敏度为84.00%，特异度90.00%，准确性89.33%，Kappa值0.58；飞利浦64排增强扫描M分期检查灵敏度为96.62%，特异度93.85%，准确性96.22%，Kappa值0.86。结论:依据飞利浦64排增强CT扫描结果进行胃癌术前TNM分期，与术后病理检查一致，其中M分期检查准确性最高，与术后病理一致性极好，可为患者治疗方案的合理选择提供重要参考。

Application of Philips 64-row enhanced CT scan in preoperative staging of gastric cancer

Objective:To analyze the application value of Philips 64-row enhanced CT scan in preoperative staging of gastric cancer.Methods:450 cases of patients with gastric cancer confirmed by gastroscopy from January 2016 to January 2018 were enrolled in the study.The 64-row enhanced CT scan was used to evaluate the TNM staging before operation.The postoperative pathological findings were used as gold standard to analyze the accuracy of Philips 64-row enhanced CT scan in preoperative staging of gastric cancer.Results:The sensitivity,specificity,accuracy and Kappa value of Philips 64-row enhanced scan were 64.00%,99.06%,97.11% and 0.70 in T1 stage,and were 70.65%,94.97%,90.00% and 0.68 in T2 stage,and were 83.93%,81.42%,82.67% and 0.65 in T3 stage,and were 70.64%,88.27%,84.00% and 0.57 in T4 stage.The sensitivity,specificity,accuracy and Kappa value of Philips 64-row enhanced scan were 80.25%,85.85%,82.89% and 0.66 in N0 stage,and were 77.16%,92.36%,86.89% and 0.71 in N1 stage,and were 84.00%,90.00%,89.33% and 0.58 in N2 stage.The sensitivity,specificity,accuracy and Kappa value of Philips 64-row enhanced scan were 96.62%,93.85%,96.22% and 0.86 in M staging.Conclusion:According to Philips 64-row enhanced CT scan results,preoperative TNM staging of gastric cancer is consistent with postoperative pathological examination.M staging has the highest accuracy and is excellent consistency with postoperative pathology,which can provide important reference for the rational selection of treatment regimens.