| 王丽丽,孙启飞,张敏.多层螺旋 CT对术前胃癌浸润深度的预测价值[J].安徽医药,2023,27(11):2237-2240. |
| 多层螺旋 CT对术前胃癌浸润深度的预测价值 |
| The predictive value of multi-slice spiral CT in preoperative depth of invasion of gastric cancer |
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| DOI：10.3969/j.issn.1009-6469.2023.11.026 |
| 中文关键词: 胃肿瘤 体层摄影术，螺旋计算机 肿瘤分期 淋巴结转移 |
| 英文关键词: Stomach neoplasms Tomography,spiral computed Tumor staging Lymph node metastasis |
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| 中文摘要: |
| 目的探讨多层螺旋 CT(MSCT)对术前胃癌浸润深度的预测价值。方法选取 2018年 9月至 2021年 12月在宣城市人民医院具有术前 CT检查的行胃癌根治术的胃癌病人 83例，根据术后病理肿瘤 T分期分为 T1~2组和 T3~4组，比较两组间肿瘤生长方式、平扫密度、强化模式、强化程度、长径及宽径、可疑淋巴结转移和术前 CT分期，采用逐步回归法行多因素 logistic回归分析筛选独立危险因素并建立预测模型，使用受试者操作特征( ROC)曲线评估模型在预测术后病理 T3~4期中的作用，并使用 Delong法比较不同模型的曲线下面积( AUC)是否存在差异。结果 T1~2组和 T3~4组 CT图像显示肿瘤呈非溃疡样生长、平扫密度不均匀( 8例比 27例)、不均质强化( 11例比 40例)、静脉期 CT值( 72.8±20.6比 82.2±18.3)、延迟期 CT值( 67.9±16.2比77.7±18.3)、肿瘤长径及宽径、可疑淋巴结转移( 8例比 48例)及 CT分期 T3/4比较，均差异有统计学意义(均 P<0.05)，多因素 logistic回归分析显示非溃疡样生长、可疑淋巴结转移及浆膜面毛糙是预测病理 T3~4期的独立危险因素，基于以上三种征象建立的预测模型 AUC为 0.92，95%CI:(0.84，0.97)显著优于术前 CT肿瘤分期( P<0.001)。结论 MSCT在区分 T1~2和 T3~4期胃癌中具有较高的准确率，联合非溃疡样生长、淋巴结转移及浆膜面毛糙三个征象建立的预测模型较术前 CT肿瘤分期更准确可疑值得临床推广使用。 |
| 英文摘要: |
| Objective To explore the value of multi-slice spiral CT (MSCT) in predicting the preoperative tumor staging of gastric cancer. Methods CT images of 83 patients who underwent gastric cancer surgery in Xuancheng People′s Hospital from September2018 to December 2021 were retrospectively reviewed. According to the postoperative pathological tumor stage, patients were dividedinto two groups according to the postoperative pathological tumor stage: T1-2 group and T3-4 group. The gross appearance, homogeneityof tumor density in plane CT, contrast enhancement pattern, degree of enhancement, the largest length and width of tumor, suspiciouslymph node metastasis and tumor staging on preoperative CT images were compared between those two groups. Multivariate logistic regression analysis was performed to select the independent risk factors to establish a prediction model. ROC curve was used to evaluatethe efficacy of the model in predicting T3-4 and Delong method was used to compare the difference between different AUCs.Results The gross appearance, homogeneity of tumor density in plane CT (8 vs. 27), contrast enhancement pattern (11 vs. 40) , degree of enhancement, the largest length and width of tumor, suspicious lymph node metastasis (8 vs. 48) and tumor staging on preoperative CT images were significantly different between the T1-2 group and T3-4 group (P<0.05). Multivariate logistic regression analysis showed that non-ulcerative appearance, suspicious lymph node metastasis, and serous roughwere independent risk factors for predicting postoperative pathological T3-4 stage. The predictive model based on those three presentations yielded an AUC of 0.92, 95% CI: (0.84, 0.97), significantly better than tumor staging on preoperative CT images alone (P<0.001).Conclusions MSCT has a high accuracy in distinguishing T1-2 and T3-4 in gastric cancer. The prediction model combined with CT presentations of non-ulcer-like appearance, suspicious lymph node metastasis and serous roughwere independent risk factors is more accurate than tumor staging on preoperative CT images alone, which may be helpful for clinical promotion. |
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