多层螺旋CT、超声内镜在胃癌术前分期中的临床意义

发布时间：2018-06-04 05:54

本文选题：胃癌 + TNM分期　；参考：《苏州大学》2013年硕士论文

【摘要】：目的：探讨多层螺旋CT、超声内镜在胃癌术前TNM分期中的临床意义，为胃癌临床治疗方案的选择提供参考依据。材料与方法：选取靖江市中医院普外科2007年5月-2012年5月，经手术治疗的176例胃癌患者作为本研究的研究对象，其术前均未接受过放、化疗及其他特殊治疗。应用多层螺旋CT、超声内镜进行术前的TNM分期，将其与术后病理切片TNM分期进行对比，观察多层螺旋CT、超声内镜在胃癌术前T分期、N分期、M分期的准确率。结果：176例患者中，超声内镜术前T分期诊断结果与术后病理诊断结果T分期比较，准确率从T1至T4分别是：62.50%，75.86%，80.49%，65.85%，总准确率是73.86%；超声内镜术前N分期诊断结果与术后病理诊断结果N分期比较，准确率从N0至N3分别是：79.63%，68.42%，55.56%，50.00%，总准确率是68.18%；超声内镜术前M分期诊断结果与术后病理诊断结果M分期比较，准确率从M0至M1分别是：65.61%，68.42%，总准确率是65.91%。多层螺旋CT术前T分期诊断结果与术后病理诊断结果T分期比较，准确率从T1至T4分别是：54.17%，65.52%，84.15%，75.61%，总准确率是75.00%；多层螺旋CT术前N分期诊断结果与术后病理诊断结果N分期比较，准确率从N0至N3分别是：81.48%，75.00%，72.22%，60.00%，，总准确率是75.00%；多层螺旋CT术前M分期诊断结果与术后病理诊断结果M分期比较，准确率从M0至M1分别是：79.62%，84.21%，总准确率是80.11%。结论：（1）多层螺旋CT、超声内镜对胃癌术前T分期的总准确率分别是75.00%、73.86%，结果相似。多层螺旋CT、超声内镜对T1分期的准确率分别是54.17%、62.5%，差异有统计学意义，因此超声内镜诊断早期胃癌更有优势；（2）多层螺旋CT、超声内镜对胃癌术前N2淋巴结分期的准确率分别是72.22%、55.56%，多层螺旋CT评估N2淋巴结转移有较高准确率，对制定手术清扫范围有指导意义；（3）超声内镜、多层螺旋CT对胃癌术前分期均存在分期不足与分期过度的现象。
[Abstract]:Objective: to investigate the clinical significance of multilayer spiral CTand endoscopic ultrasonography in preoperative TNM staging of gastric cancer and to provide reference for the selection of clinical treatment for gastric cancer. Materials and methods: 176 patients with gastric cancer who were treated surgically from May 2007 to May 2012 in General surgery Department of traditional Chinese Medicine of Jingjiang City were selected as the subjects of this study. None of them received radiotherapy, chemotherapy or other special treatment before operation. The preoperative TNM staging was performed by multislice spiral CT and ultrasonography endoscopy, and compared with the TNM staging of pathological sections after operation. The accuracy of multislice spiral CTS and EUS endoscopy in preoperative T staging and N staging of gastric cancer was observed. Results among 176 patients, T staging before endoscopic ultrasonography was compared with that by pathological diagnosis. The accuracy rates from T1 to T4 were 75.86% and 80.49%, respectively, and the total accuracy was 73.86. The results of N staging before and after endoscopic ultrasonography were compared with those of pathological diagnosis. The accuracy rate from N0 to N3 was 58.42 and 50.00.The total accuracy was 68.18.The accuracy from M0 to M1 was 65.41 and 65.42, respectively, and the total accuracy was 65.91. The total accuracy was 65.91. The accuracy rate of T staging from T1 to T4 was 54.17% and 65.52%, respectively. The total accuracy was 75.61, and the total accuracy was 75.00. The preoperative N staging of multi-slice spiral CT was compared with that of postoperative pathological diagnosis. The accuracy rate from N0 to N3 was 75.00 and 72.22, respectively, and the total accuracy was 75.000.Compared with that of pathological diagnosis after operation, the accuracy of M staging was 75.000.The accuracy from M0 to M1 was 79.62 and 84.21, respectively, and the total accuracy was 80.111. Conclusion the total accuracy of multilayer spiral CTand endoscopic ultrasonography for preoperative T staging of gastric cancer is 75.00 and 73.86, respectively. The results are similar. The accuracy of multilayer spiral CTS and endoscopic ultrasonography in T1 staging was 54.17 and 62.5, respectively. The difference was statistically significant. The accuracy of endoscopic ultrasonography in the staging of N _ 2 lymph nodes before gastric cancer was 72.22 and 55.56, respectively. The accuracy of multi-slice spiral CT in the evaluation of N _ 2 lymph node metastasis was higher. It is of guiding significance to determine the scope of surgical dissection (EUS) and multi-slice spiral CT (MSCT) for the preoperative staging of gastric cancer with insufficient staging and excessive staging.
【学位授予单位】：苏州大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R735.2;R730.44

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