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目的 :探究CT对原发性胃癌患者壁外血管侵犯影像诊断的可行性。方法 :选取2013年11月~2015年11月于我院接受治疗的100例原发性胃癌患者,按照随机数表法分为A、B两组,A组为利用CT检查判断是否患有壁外血管侵犯的患者,B组为采用医生常规判断法判断是否患有壁外血管侵犯的患者。记录A组所有患者的各项CT参数如T分期(T1、T2、T3、T4)、N分期(N1、N2、N3、N0)、M分期(M1、M0)、肿瘤大小、肿瘤生长方式等数据。所有患者在手术中判定患者是否存在壁外血管侵犯现象并记录,分别计算两组中诊断正确的壁外血管侵犯的比例并记录。将A、B组判断结果相比,计算两者敏感性、特异性、阳性预测值与阴性预测值。结果 :A组患者中Ⅰ组有T11例,T20例,T30例,T415例,N13例,N24例,N33例,N06例,M110例,M06例;Ⅱ组有T14例,T26例,T35例,T419例,N17例,N215例,N35例,N07例,M124例,M010例。A组患者中Ⅰ组肿瘤小于5cm1例(6.25%),肿瘤大于5cm15例(93.75%),远端结节型10例(62.5%),近端结节型加弥漫型6例(37.5%);Ⅱ组肿瘤小于5cm16例(47.06%),肿瘤大于5cm18例(52.94%),远端结节型23例(67.65%),近端结节型加弥漫型11例(32.35%)。A组诊断正确的壁外血管侵犯15例(93.8%);B组诊断正确的壁外血管侵犯19例(67.9%)。A组敏感性1.00,特异性0.97,阳性预测值0.94,阴性预测值1.00;B组敏感性0.59,特异性0.50,阳性预测值0.68,阴性预测值0.41。结论 :CT影像能够较为准确的判断原发性胃癌患者是否有壁外血管侵犯的现象出现,且各项CT参数能够较准确的反应壁外血管侵犯的状况。
Objective: To investigate the feasibility of CT in the diagnosis of vascular invasion in patients with primary gastric cancer. Methods: A total of 100 patients with primary gastric cancer treated in our hospital from November 2013 to November 2015 were divided into two groups according to the random number table (A and B). The patients in group A were examined by CT to determine whether they had wall External vascular invasion of patients, B group is the use of conventional judgment of doctors to determine whether suffering from extravascular invasion of patients. All the CT parameters such as T stage (T1, T2, T3, T4), N stage (N1, N2, N3, N0), M stage (M1, M0), tumor size, data. All patients in the operation to determine whether the existence of patients with extravascular vascular invasion and record, were calculated in both groups were diagnosed correctly the proportion of extravasal vascular invasion and record. Comparing the judgment result of group A and group B, the sensitivity, specificity, positive predictive value and negative predictive value were calculated. Results: In group A, there were T11 cases, T20 cases, T30 cases, T415 cases, N13 cases, N24 cases, N33 cases, N06 cases, M110 cases and M06 cases. There were T14 cases, T26 cases and T35 cases in group Ⅱ , T419 cases, N17 cases, N215 cases, N35 cases, N07 cases, M124 cases, M010 cases. In group A, there were 1 case (6.25%) with less than 5cm in tumor Ⅰ, 15 cases (93.75%) with more than 5cm in tumor, 10 cases (62.5%) with distal nodules and 6 cases (37.5% . In group Ⅱ, tumor size was less than 5 cm in 16 cases (47.06%), tumor larger than 5 cm in 18 cases (52.94%), distal nodular type in 23 cases (67.65%) and proximal nodular type in diffuse type in 11 cases (32.35%). In group A, 15 cases (93.8%) were correctly diagnosed as extravascular vessels invasion and 19 cases (67.9%) were diagnosed correctly in group B as extravascular vessels. Group A had a sensitivity of 1.00, a specificity of 0.97, a positive predictive value of 0.94, and a negative predictive value of 1.00. Group B had a sensitivity of 0.59, a specificity of 0.50, a positive predictive value of 0.68, and a negative predictive value of 0.41. CONCLUSION: CT images can be more accurate to determine whether there is extravasal vascular invasion in patients with primary gastric cancer, and CT parameters can more accurately reflect the situation of vascular invasion outside the wall.