进展期胃癌术前CT与手术结果的对比研究

目的探讨CT检查对进展期胃癌手术可切除性的术前评估价值。方法回顾性分析对比93例进展期胃癌的CT表现及手术治疗的相关资料。结果胃底贲门癌23例,胃体部癌59例,胃窦部癌11例。肿瘤肿块最大者直径1.5～11cm。93例胃癌均显示胃壁有不同程度的增厚,部分胃壁有软组织肿块形成,黏膜面有溃疡形成,胃腔及贲门狭窄,贲门管壁增厚,食道下段受累以及周围组织器官侵犯等。CT对进展期胃癌的定位、定性诊断与胃镜活检和/或手术病理符合率高,肿瘤检出率可达100%。手术前判断为可切除组的手术切除率达93.3%;不宜手术切除组病例的不能切除率为75.0%。结论胃癌术前CT诊断具有重要临床意义,CT对肿瘤的可切除性评估有较高的参考价值,值得推广应用。

A comparative study of CT diagnosis and operative findings in advanced gastric carcinoma

Abstract:Objective:To explore the value of CT in the preoperative assessment of resectability of advanced gastric carcinoma.
Methods :The relation of CT findings and operative data in 93 cases of advanced gastric carcinoma were retrospectively analyzed.
Results:There were 23 cases of fundus and cardia carcinoma, 59 cases of carcinoma of gastric corpus, and 11 cases of carcinoma of antrum. All cases showed increased thickness of gastric wall in various degrees, some of the cases showed tumor growth in the gastric wall, ulcer of the mucosa, stricture of gastric cavity and cardia, increased thickness of cardiac wall, and invasion of lower esophagus and perigastric organs.The accuracy of location and definitive diagnosis by CT, compared to gastroscopic biopsy and postoperative pathology, was considerable, and the detecting rate of tumor by CT was 100 %.CT had important reference value in preoperative evaluation of tumor resectability.The excision rate in the predicted operable group was 93.3 %; in the predicted unresectable group, the non-excision rate was 75.0%.
Conclusions:Preoperative CT diagnosis of gastric carcinoma has important clinical significance. CT provides a high reference value for assessing the resectability of gastric carcinoma, and it is worthy of widespread use.