本文選題：胃癌 + TNM分期��； 參考：《蘇州大學》2013年碩士論文

【摘要】：目的：探討多層螺旋CT、超聲內鏡在胃癌術前TNM分期中的臨床意義，為胃癌臨床治療方案的選擇提供參考依據。 材料與方法：選取靖江市中醫(yī)院普外科2007年5月-2012年5月，經手術治療的176例胃癌患者作為本研究的研究對象，其術前均未接受過放、化療及其他特殊治療。應用多層螺旋CT、超聲內鏡進行術前的TNM分期，將其與術后病理切片TNM分期進行對比，觀察多層螺旋CT、超聲內鏡在胃癌術前T分期、N分期、M分期的準確率。 結果：176例患者中，超聲內鏡術前T分期診斷結果與術后病理診斷結果T分期比較，準確率從T1至T4分別是：62.50%，75.86%，80.49%，65.85%，總準確率是73.86%；超聲內鏡術前N分期診斷結果與術后病理診斷結果N分期比較，準確率從N0至N3分別是：79.63%，68.42%，55.56%，50.00%，總準確率是68.18%；超聲內鏡術前M分期診斷結果與術后病理診斷結果M分期比較，準確率從M0至M1分別是：65.61%，68.42%，總準確率是65.91%。 多層螺旋CT術前T分期診斷結果與術后病理診斷結果T分期比較，準確率從T1至T4分別是：54.17%，65.52%，84.15%，75.61%，總準確率是75.00%；多層螺旋CT術前N分期診斷結果與術后病理診斷結果N分期比較，準確率從N0至N3分別是：81.48%，75.00%，72.22%，60.00%，，總準確率是75.00%；多層螺旋CT術前M分期診斷結果與術后病理診斷結果M分期比較，準確率從M0至M1分別是：79.62%，84.21%，總準確率是80.11%。 結論：（1）多層螺旋CT、超聲內鏡對胃癌術前T分期的總準確率分別是75.00%、73.86%，結果相似。多層螺旋CT、超聲內鏡對T1分期的準確率分別是54.17%、62.5%，差異有統(tǒng)計學意義，因此超聲內鏡診斷早期胃癌更有優(yōu)勢；（2）多層螺旋CT、超聲內鏡對胃癌術前N2淋巴結分期的準確率分別是72.22%、55.56%，多層螺旋CT評估N2淋巴結轉移有較高準確率，對制定手術清掃范圍有指導意義；（3）超聲內鏡、多層螺旋CT對胃癌術前分期均存在分期不足與分期過度的現象。
[Abstract]:Objective: to investigate the clinical significance of multilayer spiral CTand endoscopic ultrasonography in preoperative TNM staging of gastric cancer and to provide reference for the selection of clinical treatment for gastric cancer. Materials and methods: 176 patients with gastric cancer who were treated surgically from May 2007 to May 2012 in General surgery Department of traditional Chinese Medicine of Jingjiang City were selected as the subjects of this study. None of them received radiotherapy, chemotherapy or other special treatment before operation. The preoperative TNM staging was performed by multislice spiral CT and ultrasonography endoscopy, and compared with the TNM staging of pathological sections after operation. The accuracy of multislice spiral CTS and EUS endoscopy in preoperative T staging and N staging of gastric cancer was observed. Results among 176 patients, T staging before endoscopic ultrasonography was compared with that by pathological diagnosis. The accuracy rates from T1 to T4 were 75.86% and 80.49%, respectively, and the total accuracy was 73.86. The results of N staging before and after endoscopic ultrasonography were compared with those of pathological diagnosis. The accuracy rate from N0 to N3 was 58.42 and 50.00.The total accuracy was 68.18.The accuracy from M0 to M1 was 65.41 and 65.42, respectively, and the total accuracy was 65.91. The total accuracy was 65.91. The accuracy rate of T staging from T1 to T4 was 54.17% and 65.52%, respectively. The total accuracy was 75.61, and the total accuracy was 75.00. The preoperative N staging of multi-slice spiral CT was compared with that of postoperative pathological diagnosis. The accuracy rate from N0 to N3 was 75.00 and 72.22, respectively, and the total accuracy was 75.000.Compared with that of pathological diagnosis after operation, the accuracy of M staging was 75.000.The accuracy from M0 to M1 was 79.62 and 84.21, respectively, and the total accuracy was 80.111. Conclusion the total accuracy of multilayer spiral CTand endoscopic ultrasonography for preoperative T staging of gastric cancer is 75.00 and 73.86, respectively. The results are similar. The accuracy of multilayer spiral CTS and endoscopic ultrasonography in T1 staging was 54.17 and 62.5, respectively. The difference was statistically significant. The accuracy of endoscopic ultrasonography in the staging of N _ 2 lymph nodes before gastric cancer was 72.22 and 55.56, respectively. The accuracy of multi-slice spiral CT in the evaluation of N _ 2 lymph node metastasis was higher. It is of guiding significance to determine the scope of surgical dissection (EUS) and multi-slice spiral CT (MSCT) for the preoperative staging of gastric cancer with insufficient staging and excessive staging.
【學位授予單位】：蘇州大學
【學位級別】：碩士
【學位授予年份】：2013
【分類號】：R735.2;R730.44

【參考文獻】

相關期刊論文 前10條

1 黃娟;陳衛(wèi)霞;王小鵬;姚晉;;多排螺旋CT對胃癌T分期的診斷價值[J];四川大學學報(醫(yī)學版);2009年06期

2 胡曉燕;吳湖炳;王全師;周文蘭;李洪生;王麗娟;;~(18)F-FDG PET/CT顯像對胃癌術前分期的臨床價值[J];中國臨床醫(yī)學影像雜志;2010年12期

3 房殿春;彭貴勇;;早期胃癌的內鏡診治進展[J];中國消化內鏡;2007年04期

4 賈業(yè)貴;鄧長生;;超聲內鏡對胃癌外科手術及內鏡下黏膜可切除性的評價[J];世界華人消化雜志;2009年16期

5 嚴超,朱正綱,燕敏,諸琦,陳軍,劉炳亞,尹浩然,林言箴;內鏡超聲檢查對胃癌術前評估淋巴結狀況的價值[J];診斷學理論與實踐;2002年03期

6 吳暉;何裕隆;蔡世榮;吳文輝;王昭;宋武;張常華;詹文華;;胃癌腹膜種植臨床病理特征及手術對預后的影響[J];中國實用外科雜志;2007年11期

7 潘源;薛強;梁寒;張汝鵬;崔青皓;劉寧;;320例胃癌根治術后預后因素的回顧性分析[J];中國腫瘤臨床;2008年13期

8 陳志新;張波;;胃癌綜合治療現狀及展望[J];中國普外基礎與臨床雜志;2008年01期

9 徐國良;高曉燕;單宏波;羅廣裕;黎建軍;張蓉;李茵;林世永;;超聲內鏡檢查在胃癌術前分期中的臨床應用價值[J];中山大學學報(醫(yī)學科學版);2009年05期

10 朱正綱,嚴超,陳克敏,諸琦,燕敏,陳軍,劉炳亞,尹浩然,林言箴;內鏡超聲檢查與多層螺旋CT對胃癌術前分期的對比研究[J];中華胃腸外科雜志;2002年02期

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