标题：MSCT用于胃癌淋巴结转移早期诊断的临床价值

      作者：韩超，陈新晖，赵宝琼，曹辉，王常雨    平煤神马医疗集团总医院放射科，河南 平顶山 467000

      卷次： 2021年32卷6期

      【摘要】 目的 探讨多层螺旋CT (MSCT)用于胃癌淋巴结转移早期诊断的临床价值。方法 选择2016年1月至2020年1月于平煤神马医疗集团总医院行远端胃癌根治术的80例患者作为研究对象，以患者术后胃标本及淋巴结病理检查结果为金标准，分析MSCT平扫及增强对胃癌淋巴结转移、N分期的判断价值。结果 以术后胃癌病理学诊断为金标准，80例胃癌患者中52例(65.00%)有淋巴结转移，其中，术前MSCT增强诊断胃癌淋巴结转移的准确度、敏感度、阳性预测值、阴性预测值为86.25%、88.46%、90.20%、79.31%，明显高于MSCT平扫检查的61.25%、61.54%、74.42%、45.92%，差异均有统计学意义(P<0.05)；以术后淋巴结病理诊断为金标准，80例胃癌患者中N0、N1、N2、N3期患者分别为14例、33例、23例、10例，其中MSCT平扫对胃癌N0~N1期及N2~N3期的分期诊断准确度分别为 51.06%、72.73%，明显低于MSCT增强的 78.72%、96.97%，差异均有统计学意义(P<0.05)，其中MSCT增强对N2~N3期的诊断准确率为96.97%，明显高于N0~N1期的72.73%，差异有统计学意义(P<0.05)。结论 MSCT增强对胃癌淋巴结转移的准确度较高，对晚期胃癌的适用性更强，可为手术方式的选择提供参考。
      【关键词】 胃癌；多层螺旋CT；淋巴结；TNM分期系统；诊断
      【中图分类号】 R735.2 【文献标识码】 A 【文章编号】 1003—6350（2021）06—0746—04

Clinical value of multi-slice spiral CT in the early diagnosis of gastric cancer lymph node metastasis.
HAN Chao,CHEN Xin-hui, ZHAO Bao-qiong, CAO Hui, WANG Chang-yu. Department of Radiology, General Hospital of PingmeiShenma Medical Group, Pingdingshan 467000, Henan, CHINA
【Abstract】 Objective To explore the clinical value of multi-slice spiral CT (MSCT) in the early diagnosis ofgastric cancer lymph node metastasis. Methods Eighty patients who underwent radical resection of distant gastric can-cer in General Hospital of Pingmei Shenma Medical Group from January 2016 to January 2020 were enrolled as the re-search objects. Taking postoperative pathological examination results of gastric specimens and lymph nodes as the gold-en standard, the determination value of MSCT plain scan and enhanced MSCT for lymph node metastasis and N stagingof gastric cancer was analyzed. Results Taking postoperative pathological diagnosis of gastric cancer as the goldenstandard, there were 52 cases (65.00%) with lymph node metastases in the 80 patients with gastric cancer. The accuracy,sensitivity, positive predictive value, and negative predictive value of enhanced MSCT for diagnosis of lymph node me-tastasis were 86.25%, 88.46%, 90.20%, and 79.31%, which were significantly higher than 61.25%, 61.54%, 74.42%,