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目的对比分析溃疡型胃癌患者术前多层螺旋CT(MSCT)检查与胃镜检查,评价MSCT对溃疡型胃癌诊断及术前评估的价值,为临床制定手术方案提供依据。方法选取2013年1月至2015年4月经手术病理证实为溃疡型胃癌患者150例,术前均行胃MSCT检查和胃镜检查,将MSCT术前T分期结果与术后外科病理检查结果进行比较。结果 T2期26例占17.3%,T3期33例占22.0%,T4a期40例占26.7%,T4b期51例占34.0%。术后病理检查T2期24例占16.0%,T3期30例占20.0%,T4a期46例占30.7%,T4b期50例占33.3%。溃疡型胃癌术前MSCT检查与外科术后病理检查T分期的符合率为80.3%,其T2占20例,T3占24例,T4a占32例,T4b占44例。MSCT检查T分期与术后组织病理检查T分期检测结果的一致性良好(Kappa=0.76,P<0.01)。结论溃疡型胃癌患者术前胃MSCT检查能较好的对胃癌做出诊断并能较准确评价胃癌周围浸润情况,对术前指导手术方案制定有主要价值。
Objective To compare and analyze the value of MSCT and gastroscopy in the diagnosis of gastric ulcer before operation and evaluate the value of MSCT in the diagnosis and preoperative evaluation of gastric cancer. Methods From January 2013 to April 2015, 150 patients with ulcerative gastric cancer were confirmed by pathology. Gastric MSCT and gastroscopy were performed before operation. The results of preoperative T-staging and postoperative pathological examination were compared. Results 26 cases of T2 stage accounted for 17.3%, 33 cases of T3 stage accounted for 22.0%, T4a stage of 40 cases accounted for 26.7%, T4b stage of 51 cases accounted for 34.0%. The postoperative pathological examination of 24 cases of T2 accounted for 16.0%, 30 cases of T3 accounted for 20.0%, 46 cases of T4a accounted for 30.7%, 50 cases of T4b 33.3%. The coincidence rate of preoperative MSCT and postoperative pathological T staging in gastric ulcer was 80.3%. T2 was 20 cases, T3 was 24 cases, T4a was 32 cases and T4b was 44 cases. MSCT examination of T staging and postoperative histopathological T staging consistency test results (Kappa = 0.76, P <0.01). Conclusion The preoperative gastric MSCT examination of gastric ulcer patients can be a better diagnosis of gastric cancer and can more accurately evaluate the surrounding gastric cancer infiltration, preoperative guidance for the development of surgical programs have a major value.