摘要
目的:探讨早期胃癌原发病灶的计算机断层扫描(computed tomography,CT)特征及临床病理特征.方法:回顾性分析104例经病理证实为早期胃癌患者的胃壁黏膜厚度及其增强各期△CT值的变化,并行单因素分析黏膜内癌(T1a)和黏膜下癌(T1b)患者的临床病理特征.结果:黏膜内癌(T1a)和黏膜下癌(T1b)两组患者在p N分期和p TNM分期上存在统计学意义上的差异(P=0.0080;P=0.0175),而在诸如年龄、性别、肿瘤位置、肿瘤最大径、胃切除类型、切除淋巴结数量、大体分型、肿瘤分化、淋巴管浸润、静脉浸润、神经浸润等临床病理特征上,两组患者没有显著性差异(P>0.05).104例早期胃癌均显示胃壁有不同程度的增厚.胃癌病变处黏膜厚度(4.37m m±0.91 m m)较正常组黏膜厚度(2.62 m m±0.44 mm)明显增厚(t=14.65,P<0.0001).增强后动脉期原发病灶处胃壁黏膜线样强化,△CT平均值为26 Hu,静脉期病灶呈持续性强化,强化CT值比动脉期高27 Hu,平衡期所有病例病变强化程度略有下降.早期胃癌与正常对照组间动脉期、门脉期及平衡期△CT值比较差异均有统计学意义(t=3.44,P=0.0008;t=11.55,P<0.0001;t=7.67,P<0.0001).结论:螺旋CT增强扫描对早期胃癌诊断具有重要的临床价值.黏膜内癌(T1a)和黏膜下癌(T1b)患者在p N分期和p TNM分期上存在明显差异.
AIM： To assess the value of contrast enhanced multiphasic spiral computed tomography （MDCT） in the detection of early gastric cancer and the clinicopathologic features of early gastric cancer. METHODS： One hundred and four patients who underwent MDCT examination and were pathologically confirmed with early gastric cancer were included in the study. The thickness of the mucosa of the gastric wall, its changes in enhanced CT values in three enhancement phases, and clinicopathologic features of early gastric cancer were analyzed. RESULTS： There were statistically significant differences in pN and pTNM stages between Tla and Tlb patients （P = 0.0080; P = 0.0175）, although no significant differences were found in sex, age, tumor location, tumor size, gastric operation type, number of retrieved lymph nodes, morphological classification, histological type, lymphatic invasion, venous invasion or nervous invasion （P 〉 0.05）. All the patients showed thickening of the stomach wall to different degrees. The thickness of the gastric mucosa （4.37 mm ± 0.91 mm） in early gastric cancer patients was greater than that （2.62 mm ± 0.44 mm） in the control group （t = 14.65, P 〈 0.0001）.The gastric mucosa in primary lesions in the arterial phase showed line like enhancement in the arterial phase （average ACT value = 26 Hu）,and persistent enhancement in the venous phase （CT value was 27 Hu higher than that in arterial the phase）. All cases showed a slightly lower degree of lesion enhancement in the equilibrium phase. There were statistically significant differences in the changes of CT values between early gastric cancer patients and normal controls in the arterial, portal venous and equilibrium phases （t = 3.44, P = 0.0008; t = 11.55, P 〈 0.0001; t = 7.67, P 〈 0.0001）. CONCLUSION： MDCT can provide useful information to improve the diagnosis of early gastric cancer. There are significant differences in pN and pTNM stages between Tla and Tlb patients.
出处
《世界华人消化杂志》
CAS
2015年第1期110-115,共6页
World Chinese Journal of Digestology
基金
上海交通大学医学院科研基金资助项目
No.09XJ21013
上海市卫生局科研基金资助项目
Nos.2010029
2010057
上海市科学技术委员会科研基金资助项目
No.124119a0300
上海市教育委员会科研基金资助项目
No.12Y2034
江苏省科技计划基金资助项目
No.BL2014064~~
关键词
早期胃癌
计算机断层扫描
临床病理特征
Early gastric cancer
Computed tomography
Clinicopathologic features
