CAJ | 학술논문

目的探讨多层螺旋CT辅助术中判断胃癌浆膜侵犯的价值.方法回顾性分析2009年8月至2011年6月间中国医科大学附属第一医院收治的206例胃癌患者的临床资料.将术前CT和术中判断胃癌浆膜侵犯情况与术后病理对照,以比较术前CT与术中判断胃癌浆膜侵犯的诊断价值.结果术前CT和术中判断胃癌浆膜侵犯的敏感性分别为88.5％和98.9％,特异性分别为81.5％和61.3％,CT判断浆膜侵犯的准确率高于术中判断,但差异未达到统计学意义(84.5％比77.2％,P=0.060).术中判断胃癌浆膜面为正常型、反应型、结节型、腱状型和多彩弥漫型者浆膜侵犯率分别为0(0/29)、2.5％(1/40)、40.5％(15/37)、59.2％(29/49)和82.4％(42/51).对于浆膜呈腱状型表现者,术中判断胃癌浆膜侵犯的准确率为61.2％,明显低于术前CT的87.8％ (P=0.002).结论术前CT检查能够辅助术中判断胃癌浆膜有无侵犯,对浆膜呈腱状型的胃癌,手术医生应重视术前CT诊断.
목적 탐토다층라선CT보조술중판단위암장막침범적개치.방법 회고성분석2009년8월지2011년6월간중국의과대학부속제일의원수치적206례위암환자적림상자료.장술전CT화술중판단위암장막침범정황여술후병리대조,이비교술전CT여술중판단위암장막침범적진단개치.결과 술전CT화술중판단위암장막침범적민감성분별위88.5％화98.9％,특이성분별위81.5％화61.3％,CT판단장막침범적준학솔고우술중판단,단차이미체도통계학의의(84.5％비77.2％,P=0.060).술중판단위암장막면위정상형、반응형、결절형、건상형화다채미만형자장막침범솔분별위0(0/29)、2.5％(1/40)、40.5％(15/37)、59.2％(29/49)화82.4％(42/51).대우장막정건상형표현자,술중판단위암장막침범적준학솔위61.2％,명현저우술전CT적87.8％ (P=0.002).결론 술전CT검사능구보조술중판단위암장막유무침범,대장막정건상형적위암,수술의생응중시술전CT진단.
Objective To explore the value of multidetector CT on aiding intraoperative judgement of serosal invasion of gastric cancer.Methods Clinical data of 206 cases of gastric cancer undergoing radical surgery in the First Hosptial of China Medical University from August 2009 to June 2011 were analyzed retrospectively.Preoperative CT findings and intraoperative judgement of serosal invasion in gastric cancer were compared with pathological results in order to investigate their values.Results The sensitivity and specificity of preoperative CT findings and intraoperative judgement of serosal invasion were 88.5％,81.5％ and 98.9％,61.3％,respectively.The accuracy of preoperative CT in diagnosing serosal invasion was higher than that of intraoperative judgement,while the difference was not statistically significant (84.5％ vs.77.2％,P=0.060).The rates of serosal invasion of normal type,reactive type,nodular type,tendonoid type and color-diffused type were 0 (0/29),2.5％ (1/40),40.5％ (15/37),59.2％ (29/49),and 82.4％(42/51) respectively.The accuracy of preoperative CT in diagnosing serosal invasion of gastric cancer with tendonoid type was higher than that of intraoperative judgement,and the difference was statistically significant (61.2％ vs.87.8％,P=0.002).Conclusions Multidetector CT plays an important role in aiding intraoperation judgement of serosal invasion of gastric cancer.For gastric cancer with tendonoid and color-diffused macroscopic serosal appearance,surgeons should pay attention to the value of preoperative CT findings.