论文部分内容阅读
目的归纳对早期凹陷型胃癌(DEGC)组织型(HT)及浸润深度(ID)诊断有意义的X线征象,制作诊断流程图。资料与方法纳入术前行X线钡餐检查、术后病理证实的凹陷型胃癌(DGC)21例(早期胃癌17例,浅表凹陷型进展期胃癌4例)。查阅文献,归纳对DEGC的HT及ID诊断有意义的X线征像及其定义,制作简易诊断标准。观察21例X线像病灶形态特征、部位、大小等,分析与HT及ID诊断的关系,总结规律,制作诊断流程图。分别用简易标准与流程图对21例DGC进行HT及ID诊断,与病理对照计算一致率及各征象敏感性。结果HT诊断时,简易标准使用病灶凹陷边界及凹陷面作为诊断指标,流程图中加入病变部位(是否位于胃底腺区域内)为新指标。ID诊断时,简易标准使用病变是否具有厚度或硬度作为诊断指标,流程图中加入病灶大小及凹陷周围隆起影的宽度为新指标。HT及ID诊断,简易标准与病理对照一致率分别为92.86%和90.48%,流程图诊断分别为95.23%和80.95%。结论对于DEGC的HT及ID诊断而言,X线诊断流程图有较高的诊断价值,可用于临床工作的参考诊断,但仍需改进。
Objective To summarize the X-ray findings of histological (HT) and invasive depth (ID) diagnoses of early-stage depression gastric cancer (DEGC) and to make a diagnostic flow chart. Materials and Methods 21 cases of DGC (17 cases of early gastric cancer and 4 cases of superficial depressed advanced gastric cancer) were enrolled in preoperative X-ray barium meal examination. Review the literature, summarize the significance of the X-ray signs and their definitions of HT and ID diagnosis of DEGC, and make a simple diagnostic criteria. 21 cases of X-ray lesions were observed morphological features, location, size, etc., and HT and ID diagnosis of the relationship between the summary of the law, the production of diagnostic flow chart. Twenty-one cases of DGC were diagnosed by HT and ID with simple criteria and flow chart respectively, and the consistency and the sensitivity of each sign were calculated. Results In the diagnosis of HT, the simple criteria used the lesion border and the concave surface as the diagnostic indexes. It is a new indicator that the lesion site (whether located in the fundic gland region) is added into the flow chart. ID diagnosis, the simple criteria to use the thickness of the lesion or hardness as a diagnostic indicator, the flow chart to join the lesion size and the width of the shadow around the bulge of a new indicator. HT and ID diagnosis, simple standard and pathology control consistent rates were 92.86% and 90.48%, the flow chart diagnosis was 95.23% and 80.95%. Conclusion For the diagnosis of HT and IDC of DEGC, the diagnostic flowchart of X-ray diagnosis has high diagnostic value and can be used for reference diagnosis in clinical work. However, it still needs improvement.