黃子星 1 , 陳心足 2 , 宋彬 1 , 伍兵 1 , 胡建昆 2 , 張波 2 , 周成 2
  • 1. 四川大學(xué)華西醫(yī)院放射科（成都 610041）;;
  • 2. 四川大學(xué)華西醫(yī)院胃腸外科（成都 610041）;

目的 　評(píng)價(jià)64排螺旋CT對(duì)Ⅳ期胃癌術(shù)前分期的準(zhǔn)確性。
方法 　收集2007年7月至2008年4月期間我院胃腸外科收治的49例Ⅳ期胃癌患者的臨床資料，對(duì)其中術(shù)前行64排螺旋CT（64 MDCT）檢查的29例患者進(jìn)行回顧性分析并按日本胃癌規(guī)約對(duì)腫瘤進(jìn)行分期。 將CT術(shù)前分期結(jié)果與臨床-手術(shù)-病理分期結(jié)果進(jìn)行對(duì)照分析。
結(jié)果 　本組病例經(jīng)64 MDCT術(shù)前分期，其中65.2%（15/23）T分期準(zhǔn)確，47.8%（11/23）N分期準(zhǔn)確，70.8%（17/24）M分期準(zhǔn)確，58.6%TNM分期準(zhǔn)確（17/29）。 而腹膜轉(zhuǎn)移患者中6/9未能經(jīng)術(shù)前64 MDCT檢出。
結(jié)論 　64 MDCT可以對(duì)Ⅳ期胃癌進(jìn)行較準(zhǔn)確的分期，其分期準(zhǔn)確率降低的主要原因?yàn)楦鼓まD(zhuǎn)移的漏診，但64 MDCT分期降低并不增加剖腹探查率。

引用本文： 黃子星,陳心足,宋彬,伍兵,胡建昆,張波,周成. 64排螺旋CT對(duì)Ⅳ期胃癌術(shù)前分期的價(jià)值. 中國(guó)普外基礎(chǔ)與臨床雜志, 2008, 15(8): 623-627. doi: 復(fù)制

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4. 　Rivera F, Vega-Villegas ME, Lopez-Brea MF. Chemotherapy of advanced gastric cancer [Ｊ]. Cancer Treat Rev, 2007; 33(4)∶315.
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6. 　韓方海， 詹文華， 張肇達(dá)， 等. 影響胃癌患者術(shù)后生存因素的Cox回歸分析 [Ｊ]. 中國(guó)普外基礎(chǔ)與臨床雜志， 2006； 13(1)∶29.
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9. 　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.
10. 　Chen CY, Wu DC, Kang WY, et al. Staging of gastric cancer with 16-channel MDCT [Ｊ]. Abdom Imaging, 2006; 31(5)∶514.
11. 　Kim JH, Eun HW, Goo DE, et al. Imaging of various gastric lesions with 2D MPR and CT gastrography performed with multidetector CT [Ｊ]. Radiographics, 2006; 26(4)∶1101.
12. 　Hur J, Park MS, Lee JH, et al. Diagnostic accuracy of multidetector row computed tomography in T and N staging of gastric cancer with histopathologic correlation [Ｊ]. J Comput Assist Tomogr, 2006; 30(3)∶372.
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14. 　Shimizu K, Ito K, Matsunaga N, et al. Diagnosis of gastric cancer with MDCT using the water-filling method and multiplanar reconstruction: CT-histologic correlation [Ｊ]. AJR Am J Roentgenol, 2005; 185(5)∶1152.
15. 　Kim AY, Kim HJ, Ha HK. Gastric cancer by multidetector row CT: preoperative staging [Ｊ]. Abdom Imaging, 2005; 30(4)∶465.
16. 　Yang DM, Kim HC, Jin W, et al. 64 multidetector-row computed tomography for preoperative evaluation of gastric cancer: histological correlation [Ｊ]. J Comput Assist Tomogr, 2007; 31(1)∶98.
17. 　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 [Ｊ]. Eur Radiol, 2000; 10(12)∶1877.
  1. 1. 　孫秀娣， 牧人， 周有尚， 等. 中國(guó)胃癌死亡率20年變化情況分析及其發(fā)展趨勢(shì)預(yù)測(cè) [Ｊ]. 中華腫瘤雜志， 2004； 26(1)∶4.
  2. 2. 　Hu JK, Li CM, Chen XZ, et al. The effectiveness of intravenous 5-fluorouracil-containing chemotherapy after curative resection for gastric carcinoma: A systematic review of published randomized controlled trials [Ｊ]. J Chemother, 2007; 19(4)∶359.
  3. 3. 　朱正綱. 胃癌外科治療相關(guān)問題的基本認(rèn)識(shí) [Ｊ]. 中國(guó)普外基礎(chǔ)與臨床雜志， 2008； 15(1)∶1.
  4. 4. 　Rivera F, Vega-Villegas ME, Lopez-Brea MF. Chemotherapy of advanced gastric cancer [Ｊ]. Cancer Treat Rev, 2007; 33(4)∶315.
  5. 5. 　Chen XZ, Jiang K, Hu JK, et al. Cost-effectiveness analysis of chemotherapy for advanced gastric cancer in China [Ｊ]. World J Gastroenterol, 2008; 14(17)∶2715.
  6. 6. 　韓方海， 詹文華， 張肇達(dá)， 等. 影響胃癌患者術(shù)后生存因素的Cox回歸分析 [Ｊ]. 中國(guó)普外基礎(chǔ)與臨床雜志， 2006； 13(1)∶29.
  7. 7. 　Japanese Gastric Cancer Association. Japanese Classification of Gastric Carcinoma—2nd English Edition [Ｊ]. Gastric Cancer, 1998; 1(1)∶10.
  8. 8. 　Takao M, Fukuda T, Iwanaga S, et al. Gastric cancer: evaluation of triphasic spiral CT and radiologic-pathologic correlation [Ｊ]. J Comput Assist Tomogr, 1998; 22(2)∶288.
  9. 9. 　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.
  10. 10. 　Chen CY, Wu DC, Kang WY, et al. Staging of gastric cancer with 16-channel MDCT [Ｊ]. Abdom Imaging, 2006; 31(5)∶514.
  11. 11. 　Kim JH, Eun HW, Goo DE, et al. Imaging of various gastric lesions with 2D MPR and CT gastrography performed with multidetector CT [Ｊ]. Radiographics, 2006; 26(4)∶1101.
  12. 12. 　Hur J, Park MS, Lee JH, et al. Diagnostic accuracy of multidetector row computed tomography in T and N staging of gastric cancer with histopathologic correlation [Ｊ]. J Comput Assist Tomogr, 2006; 30(3)∶372.
  13. 13. 　Kumano S, Murakami T, Kim T, et al. T staging of gastric cancer: role of multi-detector row CT [Ｊ]. Radiology, 2005; 237(3)∶961.
  14. 14. 　Shimizu K, Ito K, Matsunaga N, et al. Diagnosis of gastric cancer with MDCT using the water-filling method and multiplanar reconstruction: CT-histologic correlation [Ｊ]. AJR Am J Roentgenol, 2005; 185(5)∶1152.
  15. 15. 　Kim AY, Kim HJ, Ha HK. Gastric cancer by multidetector row CT: preoperative staging [Ｊ]. Abdom Imaging, 2005; 30(4)∶465.
  16. 16. 　Yang DM, Kim HC, Jin W, et al. 64 multidetector-row computed tomography for preoperative evaluation of gastric cancer: histological correlation [Ｊ]. J Comput Assist Tomogr, 2007; 31(1)∶98.
  17. 17. 　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 [Ｊ]. Eur Radiol, 2000; 10(12)∶1877.