CT测量胃癌体积对N分期评估的初步研究

发布时间：2018-01-16 13:10

本文关键词：CT测量胃癌体积对N分期评估的初步研究　出处：《兰州大学》2014年硕士论文　论文类型：学位论文

【摘要】：目的：探讨多层螺旋CT测量胃癌体积在胃癌病理N分期预测方面的临床应用价值。材料与方法：回顾性分析2011年11月至2013年5月在我院经病理证实的胃癌患者(n=193)腹部CT增强资料,且患者均在CT检查后2周内行根治性手术治疗。由2名放射科医师采用盲法独立测量门脉期肿瘤病变总体积,采用Kappa检验比较结果一致性。将测量结果按术后病理N分期分为N0、N1、N2、N3四组,不同N组肿瘤体积差异比较采用Kruskal-Wallis秩和检验；对胃癌体积和其相应的N分期用Spearman检验进行相关性分析。采用ROC曲线分析CT测量的胃癌体积区分不同N分期的诊断效能,并初步确定其诊断阈值、敏感度及特异度。结果：每名医师两次测量结果和2名医师各自测量的肿瘤体积结果均值之间具有较好的一致性(Kappa值分别为0.77、0.72、0.69,P0.05)。4组N分期对应的肿瘤体积差异具有统计学意义(H=63.21，P0.05)。采用多层螺旋CT增强扫描测量的肿瘤体积与相对应的N分期呈正相关(r=0.568, P0.05)。ROC曲线分析显示区分NO和N1-N3组、N0-N1和N2-N3组、N0-N2和N3组曲线下面积分别为0.79、0.80、0.82,体积阈值12.06cm3、22.35cm3、25.95cm3,敏感度分别为55%、66%、62%,特异度分别为95%、86%、89%。结论：多层螺旋CT增强扫描测量胃癌体积在预测N分期评估中有较好的应用价值,可以给临床提供更多的信息,有利于指导临床选择个体化的治疗方案。
[Abstract]:Objective: to evaluate the clinical value of multislice spiral CT in predicting the pathological N stage of gastric cancer. Materials and methods: from November 2011 to May 2013, we retrospectively analyzed the enhanced CT findings of abdominal CT in patients with gastric cancer confirmed by pathology in our hospital from November 2011 to May 2013. The patients were treated with radical surgery within 2 weeks after CT examination. The total volume of portal phase tumor was measured by two radiologists by blind method. The Kappa test was used to compare the results. The results were divided into four groups according to the pathological N stage after operation: N0 and N1 and N2N3. The difference of tumor volume in different N groups was compared by Kruskal-Wallis rank sum test. The correlation between the volume of gastric cancer and its corresponding N staging was analyzed by Spearman test. The volume of gastric cancer measured by ROC curve was analyzed by CT to distinguish the diagnostic efficacy of different N stages. The diagnostic threshold, sensitivity and specificity were preliminarily determined. Results: there was a good consistency between the results of two measurements and the mean value of tumor volume measured by two physicians. The Kappa value was 0.77 / 0.72 / 0.69, respectively. The difference of tumor volume corresponding to N stage in group P0.054.was statistically significant (P < 0.05). The tumor volume measured by multi-slice spiral CT enhanced scan was positively correlated with the corresponding N stage. The analysis of P0.05- ROC curve showed that the area under the N0-N2 and N3 suites of no and N1-N3 groups were 0.79 and 0.80, respectively. The volume threshold was 12.06 cm ~ 3 ~ 22.35 cm ~ (-3) and 25.95 cm ~ (3), the sensitivity was 55 ~ (65) and the specificity was 95 ~ 86%, respectively. The volume threshold was 12.06 cm ~ (3) and 22.35 cm ~ (3) ~ (25) cm ~ (3). 89. Conclusion: the measurement of gastric cancer volume by multi-slice spiral CT enhanced scanning has a good value in predicting N staging, which can provide more information for clinical practice and be helpful to guide the clinical selection of individualized treatment plan.
【学位授予单位】：兰州大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R735.2;R730.44

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