ISSN 1004-4140
CN 11-3017/P
朱政锜, 段书峰, 龚海鹏. 胃癌壁外血管侵犯MDCT表现对淋巴结转移的诊断价值[J]. CT理论与应用研究（中英文）, 2024, 33(2): 207-212. DOI: 10.15953/j.ctta.2023.005.
引用本文: 朱政锜, 段书峰, 龚海鹏. 胃癌壁外血管侵犯MDCT表现对淋巴结转移的诊断价值[J]. CT理论与应用研究（中英文）, 2024, 33(2): 207-212. DOI: 10.15953/j.ctta.2023.005.
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ZHU Z Q, DUAN S F, GONG H P. Diagnostic Value of CT-detected Extramural Vessel Invasion in Lymph Node Metastasis of Gastric Cancer[J]. CT Theory and Applications, 2024, 33(2): 207-212. DOI: 10.15953/j.ctta.2023.005. (in Chinese).
Citation: ZHU Z Q, DUAN S F, GONG H P. Diagnostic Value of CT-detected Extramural Vessel Invasion in Lymph Node Metastasis of Gastric Cancer[J]. CT Theory and Applications, 2024, 33(2): 207-212. DOI: 10.15953/j.ctta.2023.005. (in Chinese).
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胃癌壁外血管侵犯MDCT表现对淋巴结转移的诊断价值

Diagnostic Value of CT-detected Extramural Vessel Invasion in Lymph Node Metastasis of Gastric Cancer

    摘要
  • 摘要: 目的：探讨胃癌壁外血管侵犯MDCT表现对淋巴结转移的诊断价值。方法：回顾性收集2020年1月至2022年6月经手术病理证实的105例胃癌患者；所有患者CT扫描后2周内行根治性胃癌切除术与D2淋巴结清扫术；门脉期MDCT图像上采用5分量表对胃癌EMVI情况进行评估；根据病理淋巴结转移情况将患者分为淋巴结转移组与非淋巴结转移组。比较两组间临床病理特征差异，多因素Logistic回归分析胃癌淋巴结转移的影响因素，受试者操作特征（ROC）曲线用于评估ctEMVI对淋巴结转移的诊断价值，比较ctEMVI和淋巴结短径对淋巴结转移的诊断价值。结果：淋巴结转移组中，脉管侵犯占60.9％（39例），肿瘤大小（＞5 cm）占64.1％（41例），ctEMVI阳性占79.7％（51例），CT转移性淋巴结阳性占56.2％（36例）；非淋巴结转移组中，脉管侵犯，肿瘤大小（＞5 cm），ctEMVI阳性及CT转移性淋巴结阳性分别占21.9％（9例），24.4％（10例），21.9％（9例）和19.5％（8例），两组间的差异均有统计学意义；多因素logistic回归分析显示ctEMVI是淋巴结转移的独立影响因素；ROC曲线显示ctEMVI诊断淋巴结转移的AUC为0.854。ctEMVI诊断淋巴结转移的敏感性，准确性优于淋巴结短径。结论：ctEMVI是淋巴结转移的独立影响因素，ctEMVI在诊断淋巴结转移方面具有重要价值。

     

    Abstract: Objective: To investigate the diagnostic value of extramural vessel invasion (EMVI) in multidetector row computed tomography (MDCT) of lymph node metastasis of gastric cancer. Methods: A total of 105 patients with pathologically confirmed gastric cancer treated at our hospital between January 2020 and June 2022 were retrospectively collected. All patients underwent radical gastrectomy and D2 lymph node dissection within 2 weeks after the CT scan. The EMVI status of gastric cancer was evaluated on portal-phase MDCT images using a 5-point scale. According to the pathological status of lymph node metastasis, the patients were divided into lymph node and non-lymph node metastasis groups, and their clinicopathologic features were compared. We then performed a multivariate logistic regression analysis of lymph node metastasis in gastric cancer. A receiver operating characteristic (ROC) curve was used to evaluate the diagnostic value of CT-detected EMVI (ctEMVI) in lymph node metastasis, and the diagnostic values of ctEMVI and lymph node short diameter in lymph node metastasis were compared. Results: In the lymph node metastasis group, lymphovascular invasion, tumor size (>5 cm), ctEMVI positivity, and CT metastatic lymph node positivity accounted for 60.9% (n=39), 64.1% (n=41), 79.7% (n=51), and 56.2% (n=36) of cases, respectively. In the non-metastatic group, lymphovascular invasion, tumor size (>5 cm), ctEMVI positivity, and CT metastatic lymph node positivity accounted for 21.9% (n=9), 24.4% (n=10), 21.9% (n=9), and 19.5% (n=8), respectively. The intergroup difference was statistically significant. The multivariate logistic regression analysis showed that ctEMVI was an independent factor of lymph node metastasis. The ROC curve showed that the area under the curve of ctEMVI for diagnosing lymph node metastasis was 0.854. The sensitivity and accuracy of ctEMVI were superior to those of lymph node short diameter in the diagnosis of lymph node metastasis. Conclusion: This study found that ctEMVI was an independent factor and of great value in the diagnosis of lymph node metastasis.

     

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