發(fā)布時(shí)間：2018-01-16 13:10

  本文關(guān)鍵詞：CT測(cè)量胃癌體積對(duì)N分期評(píng)估的初步研究　出處：《蘭州大學(xué)》2014年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 胃腫瘤 腫瘤分期 體層攝影術(shù) X線計(jì)算機(jī) 診斷 計(jì)算機(jī)輔助

【摘要】：目的：探討多層螺旋CT測(cè)量胃癌體積在胃癌病理N分期預(yù)測(cè)方面的臨床應(yīng)用價(jià)值。 材料與方法：回顧性分析2011年11月至2013年5月在我院經(jīng)病理證實(shí)的胃癌患者(n=193)腹部CT增強(qiáng)資料,且患者均在CT檢查后2周內(nèi)行根治性手術(shù)治療。由2名放射科醫(yī)師采用盲法獨(dú)立測(cè)量門脈期腫瘤病變總體積,采用Kappa檢驗(yàn)比較結(jié)果一致性。將測(cè)量結(jié)果按術(shù)后病理N分期分為N0、N1、N2、N3四組,不同N組腫瘤體積差異比較采用Kruskal-Wallis秩和檢驗(yàn)；對(duì)胃癌體積和其相應(yīng)的N分期用Spearman檢驗(yàn)進(jìn)行相關(guān)性分析。采用ROC曲線分析CT測(cè)量的胃癌體積區(qū)分不同N分期的診斷效能,并初步確定其診斷閾值、敏感度及特異度。 結(jié)果：每名醫(yī)師兩次測(cè)量結(jié)果和2名醫(yī)師各自測(cè)量的腫瘤體積結(jié)果均值之間具有較好的一致性(Kappa值分別為0.77、0.72、0.69,P0.05)。4組N分期對(duì)應(yīng)的腫瘤體積差異具有統(tǒng)計(jì)學(xué)意義(H=63.21，P0.05)。采用多層螺旋CT增強(qiáng)掃描測(cè)量的腫瘤體積與相對(duì)應(yīng)的N分期呈正相關(guān)(r=0.568, P0.05)。ROC曲線分析顯示區(qū)分NO和N1-N3組、N0-N1和N2-N3組、N0-N2和N3組曲線下面積分別為0.79、0.80、0.82,體積閾值12.06cm3、22.35cm3、25.95cm3,敏感度分別為55%、66%、62%,特異度分別為95%、86%、89%。 結(jié)論：多層螺旋CT增強(qiáng)掃描測(cè)量胃癌體積在預(yù)測(cè)N分期評(píng)估中有較好的應(yīng)用價(jià)值,可以給臨床提供更多的信息,有利于指導(dǎo)臨床選擇個(gè)體化的治療方案。
[Abstract]:Objective: to evaluate the clinical value of multislice spiral CT in predicting the pathological N stage of gastric cancer. Materials and methods: from November 2011 to May 2013, we retrospectively analyzed the enhanced CT findings of abdominal CT in patients with gastric cancer confirmed by pathology in our hospital from November 2011 to May 2013. The patients were treated with radical surgery within 2 weeks after CT examination. The total volume of portal phase tumor was measured by two radiologists by blind method. The Kappa test was used to compare the results. The results were divided into four groups according to the pathological N stage after operation: N0 and N1 and N2N3. The difference of tumor volume in different N groups was compared by Kruskal-Wallis rank sum test. The correlation between the volume of gastric cancer and its corresponding N staging was analyzed by Spearman test. The volume of gastric cancer measured by ROC curve was analyzed by CT to distinguish the diagnostic efficacy of different N stages. The diagnostic threshold, sensitivity and specificity were preliminarily determined. Results: there was a good consistency between the results of two measurements and the mean value of tumor volume measured by two physicians. The Kappa value was 0.77 / 0.72 / 0.69, respectively. The difference of tumor volume corresponding to N stage in group P0.054.was statistically significant (P < 0.05). The tumor volume measured by multi-slice spiral CT enhanced scan was positively correlated with the corresponding N stage. The analysis of P0.05- ROC curve showed that the area under the N0-N2 and N3 suites of no and N1-N3 groups were 0.79 and 0.80, respectively. The volume threshold was 12.06 cm ~ 3 ~ 22.35 cm ~ (-3) and 25.95 cm ~ (3), the sensitivity was 55 ~ (65) and the specificity was 95 ~ 86%, respectively. The volume threshold was 12.06 cm ~ (3) and 22.35 cm ~ (3) ~ (25) cm ~ (3). 89. Conclusion: the measurement of gastric cancer volume by multi-slice spiral CT enhanced scanning has a good value in predicting N staging, which can provide more information for clinical practice and be helpful to guide the clinical selection of individualized treatment plan.
【學(xué)位授予單位】：蘭州大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R735.2;R730.44

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 劉煒;李小毅;薛華丹;孫昊;王萱;陳鈺;蘇佰燕;金征宇;鐘定榮;王l，

本文編號(hào)：1433255