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目的探讨T_2期胃癌临床病理特征及多层螺旋CT(MSCT)在T_2期胃癌术前TNM分期中的价值。方法单因素分析93例T_2期胃癌患者的临床病理特征,并行MSCT术前TNM分期,与术后病理检查结果进行对照。结果浅肌层癌(T_2a)和深肌层癌(T_2b)两组患者在临床病理特征上差异无统计学意义(P>0.05)。MSCT对T_2期胃癌T分期准确率为91.40%(85/93);N分期准确率为66.67%(62/93),其中对pN0、pN1、pN2和pN3期判断的准确率分别为68.18%(30/44)、65.00%(26/40)、60.00%(3/5)和75.00%(3/4);TNM分期的准确率为67.74%(63/93),其中Ⅰ、Ⅱ、Ⅲ和Ⅳ期分期准确率分别为68.18%(30/44)、64.10%(25/39)、60.00%(3/5)和100%(5/5)。结论 T_2a和T_2b患者在临床病理特征上没有显著差异。MSCT动态增强扫描对T_2期胃癌术前TNM分期具有重要的临床价值。
Objective To investigate the clinicopathological features of T 2 gastric cancer and the value of multislice spiral CT (MSCT) in preoperative TNM staging of T 2 gastric cancer. Methods The clinical and pathological characteristics of 93 patients with T 2 gastric cancer were analyzed by univariate analysis. The TNM stage before MSCT was compared with the postoperative pathological findings. Results There was no significant difference in the clinicopathological features between superficial muscular carcinoma (T_2a) and deep myometrial carcinoma (T_2b) (P> 0.05). The accuracy of MS staging was 91.40% (85/93) for T 2 gastric cancer and 66.67% (62/93) for N staging. The diagnostic accuracy of pN0, pN1, pN2 and pN3 was 68.18% The accuracy of TNM staging was 67.74% (63/93), among which, Ⅰ, Ⅱ, Ⅲ and 65% (26/40), 60.00% (3/5) and 75.00% The accuracy of stage Ⅳ was 68.18% (30/44), 64.10% (25/39), 60.00% (3/5) and 100% (5/5) respectively. Conclusion There is no significant difference in the clinicopathological characteristics of T 2 a and T 2 b patients. MSCT dynamic contrast-enhanced scan has important clinical value in preoperative TNM staging of T 2 gastric cancer.