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目的评价64排螺旋CT对Ⅳ期胃癌术前分期的准确性。方法收集2007年7月至2008年4月期间我院胃肠外科收治的49例Ⅳ期胃癌患者的临床资料,对其中术前行64排螺旋CT(64MDCT)检查的29例患者进行回顾性分析并按日本胃癌规约对肿瘤进行分期。将CT术前分期结果与临床-手术-病理分期结果进行对照分析。结果本组病例经64MDCT术前分期,其中65.2%(15/23)T分期准确,47.8%(11/23)N分期准确,70.8%(17/24)M分期准确,58.6%TNM分期准确(17/29)。而腹膜转移患者中6/9未能经术前64MDCT检出。结论64MDCT可以对Ⅳ期胃癌进行较准确的分期,其分期准确率降低的主要原因为腹膜转移的漏诊,但64MDCT分期降低并不增加剖腹探查率。
Objective To evaluate the accuracy of 64-slice spiral CT in preoperative staging of stage Ⅳ gastric cancer. Methods The clinical data of 49 patients with stage Ⅳ gastric cancer admitted to our department from July 2007 to April 2008 were collected. Twenty-nine patients underwent 64-slice spiral CT (64MDCT) before surgery were analyzed retrospectively The tumor was staged according to the Japanese stomach cancer protocol. CT preoperative staging and clinical - surgical - pathological staging results were compared. Results The patients were accurately staged by 64MDCT, 65.2% (15/23) T staging was accurate, 47.8% (11/23) N staging was accurate, 70.8% (17/24) M staging was accurate, 58.6% TNM staging was accurate 17/29). 6/9 of patients with peritoneal metastasis failed to be detected by preoperative 64MDCT. Conclusion 64MDCT can accurately stage gastric cancer stage Ⅳ, the staging accuracy rate of the main reason for the missed peritoneal metastasis, but 64MDCT staging does not increase the rate of laparotomy.