Clinical Research Of Combined Application Of Double Contrast-enhanced Ultrasonography And Contrast-enhanced Msct In Preoperative Staging Of Gastric Cancer

Objective:This study compared respectively the consistency of cTNM staging of DCEUS examination and cTNM staging of contrast-enhanced MSCT examination with pTNM staging of postoperative pathology,and found their respective advantages and disadvantages.Furthermore,its purpose was to evaluate the value of its combined application in preoperative cTNM staging of gastric cancer.Methods:Clinical and pathological data of 197 gastric cancer patients admitted to the department of general surgery of our hospital from September 2016 to March 2019 were collected,including gender,age,preoperative cTNM staging of DCEUS examination and contrast-enhanced MSCT examination,and postoperative pathological pTNM.SPSS 19.0 statistical software was used for data statistical analysis.Results:1.The preoperative diagnostic accuracy of DCEUS examination for T staging was : 100% of T1,92.68% of T2,80.00% of T3,and 83.20% of T4,respectively,with an overall diagnostic accuracy of 83.20%.Kappa value was 0.708,excellent consistency.2.The preoperative diagnostic accuracy of DCEUS examination for N staging was : 82.46% of N0,81.25% of N1,65.12% of N2,and 50.77% of N3,respectively,with an overall diagnostic accuracy rate of 68.02%.Kappa value was0.580,good consistency.3.The preoperative diagnostic accuracy of DCEUS examination for M staging was : 98.41% of M0,12.50% of M1,respectively,and with an overall diagnostic accuracy of 96.44%.4.The preoperative diagnostic accuracy of contrast-enhanced MSCT examination for T staging was :22.22% of T1,56.10% of T2,66.67% of T3,and 66.67% of T4,respectively,with an overall diagnostic accuracy of 62.44%.Kappa value was 0.403,with good consistency.5.The preoperative diagnostic accuracy of contrast-enhanced MSCT examination for N staging was: 77.19% of N0,84.38% of N1,88.37% of N2,76.92% of N3,andwith an overall diagnostic accuracy of 80.71%.Kappa value was 0.742,excellent consistency.6.The preoperative diagnostic accuracy of contrast-enhanced MSCT examination for M staging was: 98.94% of M0,87.50% of M1,and with an overall diagnostic accuracy of 98.42%.7.The T staging accuracy of DCEUS examination was higher than that of contrast-enhanced MSCT examination,and there was a statistical difference between the two.The N and M staging accuracy of contrast-enhanced MSCT examination was higher than that of DCEUS examination,and there was a statistical difference between the two.8.The accuracy of the new TduNctMct staging was higher than the TNM staging of DCEUS examination and contrast-enhanced MSCT examination,and there was a statistical difference among the three,p<0.05(p=0.023).Bonfferroni correction was used to compare the differences between two groups,and the results showed statistical difference.Conclusions:1.The preoperative diagnostic accuracy of DCEUS examination for T staging of gastric cancer patients was higher than that of contrast-enhanced MSCT examination,and there was a statistical difference.2.The N and M staging accuracy of preoperative contrast-enhanced MSCT examination in gastric cancer patients was higher than that in DCEUS examination,and there was a statistical difference.3.Using the preoperative DCEUS examination’s T staging of each patient with gastric cancer and the N and M staging of preoperative contrast-enhanced MSCT examination to form a new preoperative TduNctMct staging can improve the accuracy of preoperative TNM staging,which needs to be studied with a large sample size.