• 吉林大學(xué)中日聯(lián)誼醫(yī)院胃腸外科（長(zhǎng)春 130033）;

目的  介紹胃癌術(shù)前分期診斷常用檢查方法的研究進(jìn)展。
方法  收集近年來(lái)國(guó)內(nèi)、外胃癌術(shù)前分期診斷常用檢查方法的相關(guān)文獻(xiàn)并進(jìn)行分析。
結(jié)果  經(jīng)腹超聲、超聲內(nèi)鏡、CT、MRI、PET及腹腔鏡檢查為胃癌術(shù)前分期診斷提供了客觀依據(jù)，提高了胃癌術(shù)前分期診斷的準(zhǔn)確性。
結(jié)論  各種檢查技術(shù)的不斷提高，有助于臨床醫(yī)生更好地判定胃癌術(shù)前分期，也有助于根據(jù)不同的分期實(shí)施不同的術(shù)式。

引用本文： 張海燕,孫立波. 胃癌術(shù)前分期診斷的研究進(jìn)展. 中國(guó)普外基礎(chǔ)與臨床雜志, 2010, 17(1): 34-36. doi: 復(fù)制

1. Parkin DM, Bray F, Ferlay J, et al. Global cancer statistics, 2002 [J]. CA Cancer J Clin, 2005; 55(2): 74108.
2. De Vita F, Giuliani F, Galizia G, et al. Neoadjuvant and adjuvant chemotherapy of gastric cancer [J]. Ann Oncol, 2007; 18(Suppl 6): 2023.
3. Liao SR, Dai Y, Huo L, et al. Transabdominal ultrasonography in preoperative staging of gastric cancer [J]. World J Gastroenterol, 2004; 10(23): 33993404.
4. Ozmen MM, Zulfikaroglu B, Kucuk NO, et al. Lymphoscintigraphy in detection of the regional lymph node involvement in gastric cancer [J]. Ann R Coll Surg Engl, 2006; 88(7): 632638.
5. Lee DH, Ko YT, Park SJ, et al. Comparison of hydroUS and spiral CT in the staging of gastric cancer [J]. Clin Imaging, 2001; 25(3): 181186.
6. Ingram M, Arregui ME. Endoscopic ultrasonography [J]. Surg Clin North Am, 2004; 84(4): 10351059.
7. 孫明軍, 王軼淳, 劉曉東. 超聲內(nèi)鏡對(duì)胃癌術(shù)前分期的意義 [J]. 中華消化雜志, 2006; 26(2): 133134.
8. 彭貴勇, 房殿春, 李向紅. 內(nèi)鏡超聲在上消化道黏膜下腫瘤診斷和治療中的價(jià)值 [J]. 中華消化內(nèi)鏡雜志, 2004; 21(2): 138.
9. Bentrem D, Gerdes H, Tang L, et al. Clinical correlation of endoscopic ultrasonography with pathologic stage and outcome in patients undergoing curative resection for gastric cancer [J]. Ann Surg Oncol, 2007; 14(6): 18531859.
10. Potrc S, Skalicky M, Ivanecz A. Does endoscopic ultrasound staging already allow individual treatment regimens in gastric cancer? [J]. Wien Klin Wochenschr, 2006;118(Suppl 2): 4851.
11. Polkowski M, Palucki J, Wronska E, et al. Endosonography versus helical computed tomography for locoregional staging of gastric cancer [J]. Endoscopy, 2004; 36(7): 617623.
12. Habermann CR, Weiss F, Riecken R, et al. Preoperative staging of gastric adenocarcinoma: comparison of helical CT and endoscopic US [J]. Radiology, 2004; 230(2): 465471.
13. Puli SR, Batapati J, Reddy K, et al. How good is endoscopic ultrasound for TNM staging of gastric cancers? A metaanalysis and systematic review [J]. World J Gastroenterol, 2008; 14(25): 40114019.
14. Tsendsuren T， Jun SM， Mian XH. Usefulness of endoscopic ultrasonography in preoperative TNM staging of gastric cancer [J]. World J Gastroenterol, 2006; 12(1): 4347.
15. Lee YT, Ng EK, Hung LCT, et al. Accuracy of endoscopic ultrasonography in diagnosing ascites and predicting peritoneal metastases in gastric cancer patients [J]. Gut, 2005; 54(11)： 15411545.
16. 黃子星, 陳心足, 宋彬, 等. 64 排螺旋CT 對(duì)Ⅳ期胃癌術(shù)前分期的價(jià)值 [J]. 中國(guó)普外基礎(chǔ)與臨床雜志, 2008; 15(8): 623627.
17. Lim JS, Yun MJ, Kim MJ, et al. CT and PET in stomach cancer: preoperative staging and monitoring of response to therapy [J]. Radiographics, 2006; 26(1): 143156.
18. Bhandari S, Shim CS, Kim JH, et al. Usefulness of threedimensional, multidetector row CT in the evaluation of gastric cancer: a comparison with conventional endoscopy, EUS and histopathology [J]. Gastrointest Endosc, 2004; 59(6): 619626.
19. Habermann CR, Weiss F, Riecken R, et al. Preoperative staging of gastric adenocarcinoma: comparison of helical CT and endoscopic US [J]. Radiology, 2004; 230(2): 465471.
20. Kim YN, Choi D, Kim SH, et al. Gastric cancer staging at isotropic MDCT including coronal and sagittal MPR images: endoscopically diagnosed early vs. advanced gastric cancer [J]. Abdom Imaging, 2009; 34(1): 2634.
21. Chen BB, Liang PC, Liu KL, et al. Preoperative diagnosis of gastric tumors by three dimensional multidetector row CT and double contrast barium meal study: correlation with surgical and histologic results [J]. J Formos Med Assoc, 2007; 106(11): 943952.
22. Chen CY, Hsu JS, Wu DC, et al. Gastric cancer: preoperative local staging with 3D multidetector row CT-correlation with surgical and histopathologic results [J]. Radiology, 2007; 242(2): 472482.
23. Yang DM, Kim HC, Jin W, et al. 64 multidetectorrow computed tomography for preoperative evaluation of gastric cancer: histological correlation [J]. J Comput Assist Tomogr, 2007; 31(1): 98103.
24. BaSsalamah A, Prokop M, Uffmann M, et al. Dedicated multidetector CT of the stomach: spectrum of diseases [J]. Radiographics, 2003; 23(3): 625644.
25. Davies J, Chalmers AG, SueLing HM, et al. Spiral computed tomography and operative staging of gastric carcinoma: a comparison with histopathological staging [J]. Gut, 1997; 41(3): 314319.
26. Lim JS, Kim MJ, Yun MJ, et al. Comparison of CT and 18FFDG pet for detecting peritoneal metastasis on the preoperative evaluation for gastric carcinoma [J]. Korean J Radiol, 2006; 7(4): 249256.
27. Kang BC, Kim JH, Kim KW, et al. Value of the dynamic and delayed MR sequence with GdDTPA in the Tstaging of stomach cancer: correlation with the histopathology [J]. Abdom Imaging, 2000; 25(1): 1424.
28. Tatsumi Y, Tanigawa N, Nishimura H, et al. Preoperative diagnosis of lymph node metastases in gastric cancer by magnetic resonance imaging with ferumoxtran10 [J]. Gastric Cancer, 2006; 9(2): 120128.
29. Tokuhara T, Tanigawa N, Matsuki M, et al. Evaluation of lymph node metastases in gastric cancer using magnetic resonance imaging with ultrasmall superparamagnetic iron oxide (USPIO): diagnostic performance in postcontrast images using new diagnostic criteria [J]. Gastric Cancer, 2008; 11(4): 194200.
30. Rohren EM, Turkington TG, Coleman RE. Clinical applications of PET in oncology [J]. Radiology, 2004; 231(2): 305332.
31. Yun M, Lim JS, Noh SH， et al. Lymph node staging of gastric cancer using 18FFDG PET: a comparison study with CT [J]. J Nucl Med, 2005; 46(10): 15821588.
32. Chen J, Cheong JH, Yun MJ, et al. Improvement in preoperative staging of gastric adenocarcinoma with positron emission tomography [J]. Cancer， 2005; 103(11): 23832390.
33. Muntean V, Mihailov A, Iancu C, et al. Staging laparoscopy in gastric cancer. Accuracy and impact on therapy [J]. J Gastrointestin Liver Dis, 2009; 18(2): 189195.
34. Song KY, Kim JJ, Kim SN, et al. Staging laparoscopy for advanced gastric cancer: is it also useful for the group which has an aggressive surgical strategy? [J]. World J Surg, 2007; 31(6): 12281233.
35. 沈志勇, 劉驊, 曹暉. 胃癌基因診斷和治療的研究進(jìn)展 [J]. 中國(guó)普外基礎(chǔ)與臨床雜志, 2009; 16(6): 500502.
36. Lehnert T, Rudek B, Kienle P, et al. Impact of diagnostic laparoscopy on the management of gastric cancer: prospective study of 120 consecutive patients with primary gastric adenocarcinoma [J]. Br J Surg, 2002; 89(4): 471475.
  1. 1. Parkin DM, Bray F, Ferlay J, et al. Global cancer statistics, 2002 [J]. CA Cancer J Clin, 2005; 55(2): 74108.
  2. 2. De Vita F, Giuliani F, Galizia G, et al. Neoadjuvant and adjuvant chemotherapy of gastric cancer [J]. Ann Oncol, 2007; 18(Suppl 6): 2023.
  3. 3. Liao SR, Dai Y, Huo L, et al. Transabdominal ultrasonography in preoperative staging of gastric cancer [J]. World J Gastroenterol, 2004; 10(23): 33993404.
  4. 4. Ozmen MM, Zulfikaroglu B, Kucuk NO, et al. Lymphoscintigraphy in detection of the regional lymph node involvement in gastric cancer [J]. Ann R Coll Surg Engl, 2006; 88(7): 632638.
  5. 5. Lee DH, Ko YT, Park SJ, et al. Comparison of hydroUS and spiral CT in the staging of gastric cancer [J]. Clin Imaging, 2001; 25(3): 181186.
  6. 6. Ingram M, Arregui ME. Endoscopic ultrasonography [J]. Surg Clin North Am, 2004; 84(4): 10351059.
  7. 7. 孫明軍, 王軼淳, 劉曉東. 超聲內(nèi)鏡對(duì)胃癌術(shù)前分期的意義 [J]. 中華消化雜志, 2006; 26(2): 133134.
  8. 8. 彭貴勇, 房殿春, 李向紅. 內(nèi)鏡超聲在上消化道黏膜下腫瘤診斷和治療中的價(jià)值 [J]. 中華消化內(nèi)鏡雜志, 2004; 21(2): 138.
  9. 9. Bentrem D, Gerdes H, Tang L, et al. Clinical correlation of endoscopic ultrasonography with pathologic stage and outcome in patients undergoing curative resection for gastric cancer [J]. Ann Surg Oncol, 2007; 14(6): 18531859.
  10. 10. Potrc S, Skalicky M, Ivanecz A. Does endoscopic ultrasound staging already allow individual treatment regimens in gastric cancer? [J]. Wien Klin Wochenschr, 2006;118(Suppl 2): 4851.
  11. 11. Polkowski M, Palucki J, Wronska E, et al. Endosonography versus helical computed tomography for locoregional staging of gastric cancer [J]. Endoscopy, 2004; 36(7): 617623.
  12. 12. Habermann CR, Weiss F, Riecken R, et al. Preoperative staging of gastric adenocarcinoma: comparison of helical CT and endoscopic US [J]. Radiology, 2004; 230(2): 465471.
  13. 13. Puli SR, Batapati J, Reddy K, et al. How good is endoscopic ultrasound for TNM staging of gastric cancers? A metaanalysis and systematic review [J]. World J Gastroenterol, 2008; 14(25): 40114019.
  14. 14. Tsendsuren T， Jun SM， Mian XH. Usefulness of endoscopic ultrasonography in preoperative TNM staging of gastric cancer [J]. World J Gastroenterol, 2006; 12(1): 4347.
  15. 15. Lee YT, Ng EK, Hung LCT, et al. Accuracy of endoscopic ultrasonography in diagnosing ascites and predicting peritoneal metastases in gastric cancer patients [J]. Gut, 2005; 54(11)： 15411545.
  16. 16. 黃子星, 陳心足, 宋彬, 等. 64 排螺旋CT 對(duì)Ⅳ期胃癌術(shù)前分期的價(jià)值 [J]. 中國(guó)普外基礎(chǔ)與臨床雜志, 2008; 15(8): 623627.
  17. 17. Lim JS, Yun MJ, Kim MJ, et al. CT and PET in stomach cancer: preoperative staging and monitoring of response to therapy [J]. Radiographics, 2006; 26(1): 143156.
  18. 18. Bhandari S, Shim CS, Kim JH, et al. Usefulness of threedimensional, multidetector row CT in the evaluation of gastric cancer: a comparison with conventional endoscopy, EUS and histopathology [J]. Gastrointest Endosc, 2004; 59(6): 619626.
  19. 19. Habermann CR, Weiss F, Riecken R, et al. Preoperative staging of gastric adenocarcinoma: comparison of helical CT and endoscopic US [J]. Radiology, 2004; 230(2): 465471.
  20. 20. Kim YN, Choi D, Kim SH, et al. Gastric cancer staging at isotropic MDCT including coronal and sagittal MPR images: endoscopically diagnosed early vs. advanced gastric cancer [J]. Abdom Imaging, 2009; 34(1): 2634.
  21. 21. Chen BB, Liang PC, Liu KL, et al. Preoperative diagnosis of gastric tumors by three dimensional multidetector row CT and double contrast barium meal study: correlation with surgical and histologic results [J]. J Formos Med Assoc, 2007; 106(11): 943952.
  22. 22. Chen CY, Hsu JS, Wu DC, et al. Gastric cancer: preoperative local staging with 3D multidetector row CT-correlation with surgical and histopathologic results [J]. Radiology, 2007; 242(2): 472482.
  23. 23. Yang DM, Kim HC, Jin W, et al. 64 multidetectorrow computed tomography for preoperative evaluation of gastric cancer: histological correlation [J]. J Comput Assist Tomogr, 2007; 31(1): 98103.
  24. 24. BaSsalamah A, Prokop M, Uffmann M, et al. Dedicated multidetector CT of the stomach: spectrum of diseases [J]. Radiographics, 2003; 23(3): 625644.
  25. 25. Davies J, Chalmers AG, SueLing HM, et al. Spiral computed tomography and operative staging of gastric carcinoma: a comparison with histopathological staging [J]. Gut, 1997; 41(3): 314319.
  26. 26. Lim JS, Kim MJ, Yun MJ, et al. Comparison of CT and 18FFDG pet for detecting peritoneal metastasis on the preoperative evaluation for gastric carcinoma [J]. Korean J Radiol, 2006; 7(4): 249256.
  27. 27. Kang BC, Kim JH, Kim KW, et al. Value of the dynamic and delayed MR sequence with GdDTPA in the Tstaging of stomach cancer: correlation with the histopathology [J]. Abdom Imaging, 2000; 25(1): 1424.
  28. 28. Tatsumi Y, Tanigawa N, Nishimura H, et al. Preoperative diagnosis of lymph node metastases in gastric cancer by magnetic resonance imaging with ferumoxtran10 [J]. Gastric Cancer, 2006; 9(2): 120128.
  29. 29. Tokuhara T, Tanigawa N, Matsuki M, et al. Evaluation of lymph node metastases in gastric cancer using magnetic resonance imaging with ultrasmall superparamagnetic iron oxide (USPIO): diagnostic performance in postcontrast images using new diagnostic criteria [J]. Gastric Cancer, 2008; 11(4): 194200.
  30. 30. Rohren EM, Turkington TG, Coleman RE. Clinical applications of PET in oncology [J]. Radiology, 2004; 231(2): 305332.
  31. 31. Yun M, Lim JS, Noh SH， et al. Lymph node staging of gastric cancer using 18FFDG PET: a comparison study with CT [J]. J Nucl Med, 2005; 46(10): 15821588.
  32. 32. Chen J, Cheong JH, Yun MJ, et al. Improvement in preoperative staging of gastric adenocarcinoma with positron emission tomography [J]. Cancer， 2005; 103(11): 23832390.
  33. 33. Muntean V, Mihailov A, Iancu C, et al. Staging laparoscopy in gastric cancer. Accuracy and impact on therapy [J]. J Gastrointestin Liver Dis, 2009; 18(2): 189195.
  34. 34. Song KY, Kim JJ, Kim SN, et al. Staging laparoscopy for advanced gastric cancer: is it also useful for the group which has an aggressive surgical strategy? [J]. World J Surg, 2007; 31(6): 12281233.
  35. 35. 沈志勇, 劉驊, 曹暉. 胃癌基因診斷和治療的研究進(jìn)展 [J]. 中國(guó)普外基礎(chǔ)與臨床雜志, 2009; 16(6): 500502.
  36. 36. Lehnert T, Rudek B, Kienle P, et al. Impact of diagnostic laparoscopy on the management of gastric cancer: prospective study of 120 consecutive patients with primary gastric adenocarcinoma [J]. Br J Surg, 2002; 89(4): 471475.