Clinical Value Of 64-slice Spiral CT Dynamic Enhanced In Gastric Cancer Preoperative Of TNM Staging In Lhasa Region

ObjectiveTo retrospectively analyze the clinical value of 64-slice spiral CT dynamic contrast-enhanced examination in preoperative TNM staging of gastric cancer,and to evaluate its preoperative clinical effect on gastric cancer patients in Lhasa region in comparison with the American Joint Committee on Cancer(AJCC)pathology standard,7th edition,2010.The value of TNM staging provides strong support for preoperative selection of treatment options for gastric cancer.MethodsA total of 54 inpatients with clinically confirmed gastric cancer from March 2016 to May 2017 in Tibet Autonomous Region who underwent multi-slice spiral MDCT and preoperative TNM staging were collected.All patients underwent lesion resection.The treatment was performed in accordance with the patient’s surgical procedure,which was comprehensively considered by the clinician.Routine clearance of metastatic and suspected metastatic lymph nodes and pathological staging were performed.Before the examination,the patients were fasted and water-restricted,and those without contraindications were treated with Oral Anisodamine 20 mg orally before the scan to reduce gastric motility.Before the examination,drink 8001000 ml of water to fill the stomach cavity.According to the CT scan of clinical necessity,the diagnosis of the original data was performed by two radiology diagnosticians of the deputy senior professional title.The two doctors were not informed of the patient’s condition.If there is an objection in the process,agreement is reached after consultation or the agreement is rejected.The evaluation includes the strengthening of gastric cancer and its degree,the location of adjacent lymph nodes and distant metastases,the length and the short diameter of the tumor,and the Borrmann classification.SPSS17.0 statistical software package was used for statistical analysis.Measured data description adopts mean±standard deviation(M±SD),and count data describes adoption rate and composition ratio.The consistency analysis used KAPPA test,when kappa> 0.75 was good consistency,kappa 0.75-0.40 was good consistency,and kappa <0.40 was poor consistency.All analyses were performed using a two-sided test.The test level was α=0.05,P<0.05 was statistically significant.ResultsT1 pathological staging in 1 case,T2 pathological staging in 10 cases,T3 pathological staging in 17 cases,T4 pathological staging in 26 cases,sensitivity of 50%,60%,76.5%,73.1%,with a total sensitivity of 53.7%,KAPPA The coefficient is 0.569,P=0.003.The pathological stage of N was 5 cases in N0 stage,18 cases in N1 stage,10 cases in N2 stage,17 cases in N3 a stage,and 4 cases in N3 b stage.The sensitivities were 60.0%,61.0%,40.0%,23.0%,and 75.0%,respectively.The sensitivity was 46.0% and the KAPPA coefficient was 0.297,P=0.003.There were 42 cases in M0 stage and 12 cases in M1 stage.The sensitivities were 95.0% and 91.0% respectively.The total sensitivity was 96.0%,and the KAPPA coefficient was 0.844.The agreement was good,P=0.003.(4)The sites of the data in this group were almost distributed in the main anatomical sites of the stomach,of which the gastric antrum and gastric curvature were the main ones.There were 34 cases,11 cases(63%,20.4%),and 5 cases of fontanel(9.3%)of the remaining cases were found in 3 cases(5.6%)of the fundus and 1 case of large curvature(1.9%).Of the 54 patients,19 were Borrmann’s type infiltration ulcers,18 nodules,11 localized ulcers,and 5 diffuse infiltrates.The average length of lesions was(6.07±2.74)cm,and the average short diameter was(1.68±1.04)cm.ConclusionT2 sensitivitydata is low in this study,T3,T4 period is higher,T1 period should be considered in combination with other examination methods,and it has higher use value for clinical treatment planning.N phase consistency is low,but there are also relatively high accuracy rates such as N3 b,N1,and N0.The clinical evaluation of N phase has reference significance,and it can also be used as the main inspection method for follow-up after surgery.M-phase CT enhancement examination can well show the metastasis of the tumor,and it can provide a better treatment plan for the clinic.