胃癌螺旋CT术前评估及与手术病理分期对照研究

目的:应用螺旋CT行胃癌术前评估,并将CT分期与手术病理分期进行比较。方法:98例胃癌患者术前行腹部螺旋CT检查,并实施手术分期和病理分期。结果:所有患者行手术治疗,其中16例(16%)无法切除,82例(84%)手术切除。CT扫描中胃壁的厚度和浆膜的累及有相关性(P<0.001)。CT和手术预测病理分期的符合率分别为68%和52%。CT过度分期只有17%。结论:螺旋CT是胃癌患者术前检查的一种有效的方法,可预测胃癌病灶的可切除性,从而避免某些不必要的剖腹手术或使手术方案更加合理。CT过度分期的概率较低,其分期的准确率高于手术。

Dynamic CT in the Preoperative Staging of Gastric Cancer:Correlation with Surgical and Pathology Assessment

Objective:To study the dynamic spiral CT in the preoperative staging for patients with gastric cancer and correlated with surgical and pathology assessment.Methods:Dynamic CT of the abdomen was performed in 98 patients with gastric adenocarcinoma before surgery,and the CT features were correlated with pathology findings.Results:Of the total 98 patients,tumor in 16 cases (16%) were non-resectable,and in 82 cases (84%) had tumor resected.Wall thickness assessed in dynamic CT correlated with the risk of serosal involvement (P<0.001).The accuracy of CT and surgery in demonstrating tumor staging were 64% and 52% respectively when correlated with pathology.CT overstaging was 17%. Conclusion:Dynamic CT is a useful modality in predicting the resectability of gastric carcinoma,and unnecessary laparatomy can be prevented.