Diagnostic value of multi-slice spiral CT on metastatic lymph node and N stage of resectable gastric cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

HU Guoquan ¹ ,  HAO Jiancheng ¹ , FAN Yuanjun ¹ , PENG Rong ¹ , HUAI Jianguo ² , WEN Qian ³

1. Department of Imaging, The First People’s Hospital of Wuhu City, Wuhu, Anhui 241060, P. R. China;
2. Department of Pathology, The First People’s Hospital of Wuhu City, Wuhu, Anhui 241060, P. R. China;
3. Center of Imaging, Yijishan Hospital of South Anhui Medical College, Wuhu, Anhui 241004, P. R. China;

Corresponding?author：

HAO Jiancheng, Email: haojiancheng168@163.com

Keywords：

gastric cancer; multi-slice spiral CT; lymph node; metastasis; N stage

DOI：

10.7507/1007-9424.202108097

Video：

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Objective To investigate the vaules of multi-slice spiral CT (MSCT) in diagnosing metastatic lymph nodes and judging N stage of resectable gastric cancer. Methods Fifty-nine patients with gastric cancer performed preoperative MSCT plain scan and triple enhanced scans from February 2019 to March 2021 in the First People’s Hospital of Wuhu City were collected. The results of postoperative pathology were taken as the gold standard, the short diameter, long diameter, short to long diameter ratio, CT values of triple enhanced scans and lymphatic hilar blur were compared between the metastatic lymph nodes and the non-metastatic lymph nodes. Results The preoperative MSCT showed that there were 50 cases of metastatic lymph nodes and 9 cases of non-metastatic lymph nodes in 59 patients with gastric cancer. A total of 1 467 lymph nodes were harvested, including 562 metastatic lymph nodes and 905 non-metastatic lymph nodes. The short diameter, long diameter, short to long diameter ratio, and the CT values of plain scan, arterial phase, portal vein phase, and delayed phase of metastatic lymph nodes were higher than those of non-metastatic lymph nodes (P<0.05), and the incidence of lymphatic hilar blur was also higher than that of non-metastatic lymph nodes (P<0.05). Referring to the results of postoperative pathological examination, the accuracies of MSCT in judging of N0, N1, N2, N3a, and N3b stages were 88.9% (8/9), 83.3% (5/6), 85.7% (12/14), 92.3% (12/13), 88.2% (15/17), respectively, and the total accuracy was 88.1% (52/59), the specificity was 96.6% (57/59), and the sensitivity was 91.2% (52/57). Conclusion According to this study results, preoperative MSCT has higher specificity, sensitivity, and accuracy in diagnosing metastatic lymph nodes and judging N stage of resectable gastric cancer.

Citation： HU Guoquan, HAO Jiancheng, FAN Yuanjun, PENG Rong, HUAI Jianguo, WEN Qian. Diagnostic value of multi-slice spiral CT on metastatic lymph node and N stage of resectable gastric cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2022, 29(4): 527-531. doi: 10.7507/1007-9424.202108097 Copy

1.	曹毛毛, 李賀, 孫殿欽, 等. 2000–2019年中國胃癌流行病學趨勢分析. 中華消化外科雜志, 2021, 20(1): 102-109.
2.	邢超, 于華隆, 姚增武, 等. MSCT在局部晚期胃癌轉化治療后臨床T分期及N分期評估中的應用價值. 中國普外基礎與臨床雜志, 2020, 27(11): 1375-1379.
3.	于華隆, 姚增武, 張翼飛, 等. 多層螺旋CT在晚期胃癌轉化治療后N分期及淋巴結轉移判斷中的臨床應用分析. 中國普外基礎與臨床雜志, 2020, 27(2): 158-162.
4.	Gutierrez OB, Choi A, Draganov P, et al. Mo1163 a multicenter study evaluating risk factors of lymph node metastasis in early gastric cancer in the United States. Gastrointest Endosc, 2017, 85(5): AB444. doi: 10.1016/j.gie.2017.03.1034.
5.	楊恒, 李建平. 胃癌淋巴結轉移術前多層螺旋CT增強掃描與術后病理診斷一致性研究. 中國CT和MRI雜志, 2019, 17(9): 113-115.
6.	Lu J, Zhao YJ, Zhou Y, et al. Modified staging system for gastric neuroendocrine carcinoma based on American Joint Committee on Cancer and European Neuroendocrine Tumor Society systems. Br J Surg, 2020, 107(3): 248-257.
7.	Ikoma N, Estrella JS, Blum M, et al. Central lymph node metastasis in gastric cancer is predictive of survival after preoperative therapy. J Gastrointest Surg, 2018, 22(8): 1325-1333.
8.	趙建溪, 任剛, 蔡嶸, 等. 多排螺旋CT診斷早期胃癌淋巴結轉移的準確性研究. 診斷學理論與實踐, 2016, 15(2): 174-179.
9.	王珊, 王超智. 多層螺旋CT增強掃描在胃癌淋巴結轉移診斷的臨床價值. 中國CT和MRI雜志, 2016, 14(7): 97-99.
10.	付英杰, 顧程, 李欣, 等. 多層螺旋CT掃描多平面重組技術在胃癌術前T、N分期中的應用. 山東醫藥, 2020, 60(15): 92-94.
11.	Jiang M, Wang X, Shan X, et al. Value of multi-slice spiral computed tomography in the diagnosis of metastatic lymph nodes and N-stage of gastric cancer. J Int Med Res, 2019, 47(1): 281-292.
12.	Zhou JW, Yan YY, Zhang WY, et al. Diagnosis with spiral CT imaging before gastric carcinoma surgery. J Biol Regul Homeost Agents, 2018, 32(3): 725-730.
13.	許舒航, 馮玲玲, 陳永明, 等. 多層螺旋CT對胃癌各淋巴結分區淋巴結轉移診斷敏感性研究. 中華胃腸外科雜志, 2019, 22(10): 984-989.
14.	D’Elia F, Zingarelli A, Palli D, et al. Hydro-dynamic CT preoperative staging of gastric cancer: correlation with pathological findings. A prospective study of 107 cases. Eur Radiol, 2000, 10(12): 1877-1885.
15.	金元貞, 仝開軍, 舒榮寶, 等. 胃癌區域淋巴結轉移的CT征象分析. 中國CT和MRI雜志, 2020, 18(5): 14-17.
16.	馬國武, 王煥勇, 彭如臣. 螺旋CT增強掃描對進展期胃癌的淋巴結轉移的應用價值研究. 中國CT和MRI雜志, 2017, 15(7): 104-106, 116.
17.	陶華, 申晉疆. 64排螺旋CT對胃癌淋巴結轉移的診斷價值及診斷準確率的影響. 腫瘤影像學, 2020, 29(3): 314-318.
18.	王霄霄, 單秀紅, 潘冬剛, 等. MSCT對胃癌轉移淋巴結的診斷價值. 實用放射學雜志, 2017, 33(5): 695-699.
19.	柴亞如, 高劍波, 邢靜靜, 等. 能譜CT多參數成像預測胃癌淋巴結轉移的應用價值. 中華消化外科雜志, 2021, 20(2): 240-245.
20.	胡國權, 郝建成, 范元軍等. 256層CT動態增強及后處理技術在胃癌術前TN分期的臨床應用. 皖南醫學院學報, 2017, 36(4): 378-381.
21.	石景森. 普外科腫瘤學. 北京: 人民衛生出版社, 2005: 223-238.
22.	Liu Y, Liu G, Hou B, et al. Ultrasound intervention combined with multi-slice spiral CT has excellent diagnostic value in lymph node metastasis of gastric cancer. Am J Transl Res, 2021, 13(10): 11764-11770.

1. 曹毛毛, 李賀, 孫殿欽, 等. 2000–2019年中國胃癌流行病學趨勢分析. 中華消化外科雜志, 2021, 20(1): 102-109.
2. 邢超, 于華隆, 姚增武, 等. MSCT在局部晚期胃癌轉化治療后臨床T分期及N分期評估中的應用價值. 中國普外基礎與臨床雜志, 2020, 27(11): 1375-1379.
3. 于華隆, 姚增武, 張翼飛, 等. 多層螺旋CT在晚期胃癌轉化治療后N分期及淋巴結轉移判斷中的臨床應用分析. 中國普外基礎與臨床雜志, 2020, 27(2): 158-162.
4. Gutierrez OB, Choi A, Draganov P, et al. Mo1163 a multicenter study evaluating risk factors of lymph node metastasis in early gastric cancer in the United States. Gastrointest Endosc, 2017, 85(5): AB444. doi: 10.1016/j.gie.2017.03.1034.
5. 楊恒, 李建平. 胃癌淋巴結轉移術前多層螺旋CT增強掃描與術后病理診斷一致性研究. 中國CT和MRI雜志, 2019, 17(9): 113-115.
6. Lu J, Zhao YJ, Zhou Y, et al. Modified staging system for gastric neuroendocrine carcinoma based on American Joint Committee on Cancer and European Neuroendocrine Tumor Society systems. Br J Surg, 2020, 107(3): 248-257.
7. Ikoma N, Estrella JS, Blum M, et al. Central lymph node metastasis in gastric cancer is predictive of survival after preoperative therapy. J Gastrointest Surg, 2018, 22(8): 1325-1333.
8. 趙建溪, 任剛, 蔡嶸, 等. 多排螺旋CT診斷早期胃癌淋巴結轉移的準確性研究. 診斷學理論與實踐, 2016, 15(2): 174-179.
9. 王珊, 王超智. 多層螺旋CT增強掃描在胃癌淋巴結轉移診斷的臨床價值. 中國CT和MRI雜志, 2016, 14(7): 97-99.
10. 付英杰, 顧程, 李欣, 等. 多層螺旋CT掃描多平面重組技術在胃癌術前T、N分期中的應用. 山東醫藥, 2020, 60(15): 92-94.
11. Jiang M, Wang X, Shan X, et al. Value of multi-slice spiral computed tomography in the diagnosis of metastatic lymph nodes and N-stage of gastric cancer. J Int Med Res, 2019, 47(1): 281-292.
12. Zhou JW, Yan YY, Zhang WY, et al. Diagnosis with spiral CT imaging before gastric carcinoma surgery. J Biol Regul Homeost Agents, 2018, 32(3): 725-730.
13. 許舒航, 馮玲玲, 陳永明, 等. 多層螺旋CT對胃癌各淋巴結分區淋巴結轉移診斷敏感性研究. 中華胃腸外科雜志, 2019, 22(10): 984-989.
14. D’Elia F, Zingarelli A, Palli D, et al. Hydro-dynamic CT preoperative staging of gastric cancer: correlation with pathological findings. A prospective study of 107 cases. Eur Radiol, 2000, 10(12): 1877-1885.
15. 金元貞, 仝開軍, 舒榮寶, 等. 胃癌區域淋巴結轉移的CT征象分析. 中國CT和MRI雜志, 2020, 18(5): 14-17.
16. 馬國武, 王煥勇, 彭如臣. 螺旋CT增強掃描對進展期胃癌的淋巴結轉移的應用價值研究. 中國CT和MRI雜志, 2017, 15(7): 104-106, 116.
17. 陶華, 申晉疆. 64排螺旋CT對胃癌淋巴結轉移的診斷價值及診斷準確率的影響. 腫瘤影像學, 2020, 29(3): 314-318.
18. 王霄霄, 單秀紅, 潘冬剛, 等. MSCT對胃癌轉移淋巴結的診斷價值. 實用放射學雜志, 2017, 33(5): 695-699.
19. 柴亞如, 高劍波, 邢靜靜, 等. 能譜CT多參數成像預測胃癌淋巴結轉移的應用價值. 中華消化外科雜志, 2021, 20(2): 240-245.
20. 胡國權, 郝建成, 范元軍等. 256層CT動態增強及后處理技術在胃癌術前TN分期的臨床應用. 皖南醫學院學報, 2017, 36(4): 378-381.
21. 石景森. 普外科腫瘤學. 北京: 人民衛生出版社, 2005: 223-238.
22. Liu Y, Liu G, Hou B, et al. Ultrasound intervention combined with multi-slice spiral CT has excellent diagnostic value in lymph node metastasis of gastric cancer. Am J Transl Res, 2021, 13(10): 11764-11770.

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Diagnostic value of multi-slice spiral CT on metastatic lymph node and N stage of resectable gastric cancer

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