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, 李贺, 孙殿钦, 等. 2000–2019年中国胃癌流行病学趋势分析. 中华消化外科杂志, 2021, 20(1): 102-109.
2.	邢超, 于华隆, 姚增武, 等. MSCT在局部晚期胃癌转化治疗后临床T分期及N分期评估中的应用价值. 中国普外基础与临床杂志, 2020, 27(11): 1375-1379.
3.	于华隆, 姚增武, 张翼飞, 等. 多层螺旋CT在晚期胃癌转化治疗后N分期及淋巴结转移判断中的临床应用分析. 中国普外基础与临床杂志, 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.	杨恒, 李建平. 胃癌淋巴结转移术前多层螺旋CT增强扫描与术后病理诊断一致性研究. 中国CT和MRI杂志, 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.	赵建溪, 任刚, 蔡嵘, 等. 多排螺旋CT诊断早期胃癌淋巴结转移的准确性研究. 诊断学理论与实践, 2016, 15(2): 174-179.
9.	王珊, 王超智. 多层螺旋CT增强扫描在胃癌淋巴结转移诊断的临床价值. 中国CT和MRI杂志, 2016, 14(7): 97-99.
10.	付英杰, 顾程, 李欣, 等. 多层螺旋CT扫描多平面重组技术在胃癌术前T、N分期中的应用. 山东医药, 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.	许舒航, 冯玲玲, 陈永明, 等. 多层螺旋CT对胃癌各淋巴结分区淋巴结转移诊断敏感性研究. 中华胃肠外科杂志, 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.	金元贞, 仝开军, 舒荣宝, 等. 胃癌区域淋巴结转移的CT征象分析. 中国CT和MRI杂志, 2020, 18(5): 14-17.
16.	马国武, 王焕勇, 彭如臣. 螺旋CT增强扫描对进展期胃癌的淋巴结转移的应用价值研究. 中国CT和MRI杂志, 2017, 15(7): 104-106, 116.
17.	陶华, 申晋疆. 64排螺旋CT对胃癌淋巴结转移的诊断价值及诊断准确率的影响. 肿瘤影像学, 2020, 29(3): 314-318.
18.	王霄霄, 单秀红, 潘冬刚, 等. MSCT对胃癌转移淋巴结的诊断价值. 实用放射学杂志, 2017, 33(5): 695-699.
19.	柴亚如, 高剑波, 邢静静, 等. 能谱CT多参数成像预测胃癌淋巴结转移的应用价值. 中华消化外科杂志, 2021, 20(2): 240-245.
20.	胡国权, 郝建成, 范元军等. 256层CT动态增强及后处理技术在胃癌术前TN分期的临床应用. 皖南医学院学报, 2017, 36(4): 378-381.
21.	石景森. 普外科肿瘤学. 北京: 人民卫生出版社, 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, 李贺, 孙殿钦, 等. 2000–2019年中国胃癌流行病学趋势分析. 中华消化外科杂志, 2021, 20(1): 102-109.
2. 邢超, 于华隆, 姚增武, 等. MSCT在局部晚期胃癌转化治疗后临床T分期及N分期评估中的应用价值. 中国普外基础与临床杂志, 2020, 27(11): 1375-1379.
3. 于华隆, 姚增武, 张翼飞, 等. 多层螺旋CT在晚期胃癌转化治疗后N分期及淋巴结转移判断中的临床应用分析. 中国普外基础与临床杂志, 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. 杨恒, 李建平. 胃癌淋巴结转移术前多层螺旋CT增强扫描与术后病理诊断一致性研究. 中国CT和MRI杂志, 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. 赵建溪, 任刚, 蔡嵘, 等. 多排螺旋CT诊断早期胃癌淋巴结转移的准确性研究. 诊断学理论与实践, 2016, 15(2): 174-179.
9. 王珊, 王超智. 多层螺旋CT增强扫描在胃癌淋巴结转移诊断的临床价值. 中国CT和MRI杂志, 2016, 14(7): 97-99.
10. 付英杰, 顾程, 李欣, 等. 多层螺旋CT扫描多平面重组技术在胃癌术前T、N分期中的应用. 山东医药, 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. 许舒航, 冯玲玲, 陈永明, 等. 多层螺旋CT对胃癌各淋巴结分区淋巴结转移诊断敏感性研究. 中华胃肠外科杂志, 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. 金元贞, 仝开军, 舒荣宝, 等. 胃癌区域淋巴结转移的CT征象分析. 中国CT和MRI杂志, 2020, 18(5): 14-17.
16. 马国武, 王焕勇, 彭如臣. 螺旋CT增强扫描对进展期胃癌的淋巴结转移的应用价值研究. 中国CT和MRI杂志, 2017, 15(7): 104-106, 116.
17. 陶华, 申晋疆. 64排螺旋CT对胃癌淋巴结转移的诊断价值及诊断准确率的影响. 肿瘤影像学, 2020, 29(3): 314-318.
18. 王霄霄, 单秀红, 潘冬刚, 等. MSCT对胃癌转移淋巴结的诊断价值. 实用放射学杂志, 2017, 33(5): 695-699.
19. 柴亚如, 高剑波, 邢静静, 等. 能谱CT多参数成像预测胃癌淋巴结转移的应用价值. 中华消化外科杂志, 2021, 20(2): 240-245.
20. 胡国权, 郝建成, 范元军等. 256层CT动态增强及后处理技术在胃癌术前TN分期的临床应用. 皖南医学院学报, 2017, 36(4): 378-381.
21. 石景森. 普外科肿瘤学. 北京: 人民卫生出版社, 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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