Study On Correlation Between Tumor Thickness And Pathological Characteristics Of Gastric Cancer

Objective:To investigate the relationship between the thickness difference and the pathological characteristics of advanced gastric cancer by analyzing the thickness difference of tumor before and after gastric filling.Materials and Methods:68 patients with advanced gastric cancer who underwent CE-CT examination in our hospital from August to November 2019(48 patients with initial diagnosis and 20 patients after neoadjuvant chemotherapy).All patients underwent CT scanning,the plain scan was performed when the stomach cavity was empty state,and then ordered the patient to drink warm water until they were full obviously,and then enhanced scanning was performed.Forwarding original and reconstructed images to AW4.7 workstations,image analysis including measurements of gastric cancer thickness before(plain scan)and after filling(venous)and its difference(DT-GC),CT values for each period(plain scan)(CTNON),arterial CT(CTAP),venous CT(CTPVP),The ΔAP,ΔPVP was calculated(the difference between the CT value and the CTNON value in the corresponding period),evaluation of metastatic lymph node,serosal invasion and other characteristic parameters.Statistical analysis of whether neoadjuvant chemotherapy affected the thickness difference of advanced gastric cancer,and the correlation between the above characteristics and the pathological characteristics of advanced gastric cancer,including T stage,differentiation degree and Lauren classification.Results:1 Correlation analysis:DT-GC is statistically different in 68 patients with advanced gastric cancer(P<0.01).There is no significant difference in DT-GC between sites(cardiac and gastric body),between patients in the initial diagnosis and chemotherapy group(P>0.05).The correlation between DT-GC and pathology is significantly correlated with T stage(T2 and T3/4),differentiation degree(low differentiation and middle differentiation)(P<0.05),But there is no statistical significance between Lauren classification.Moreover,There is a correlation between T staging and serous invasion,differentiation is also correlated with the positive rate of ΔPVP,lymph node metastasis.2 Diagnostic effectiveness evaluation:2.1 Differentiation parameters:the AUC of ΔPVP is 0.739,while the AUC of lymph node positive rate is 0.661.The diagnostic sensitivity of DT-GC and ΔPVP was 88.4%.2.2 T staging parameters:the AUC of the DT-GC is 0.778,and the value of serosal invasion AUC is 0.807.Combined with the above two characteristics,the diagnostic sensitivity is 87.2%.Conclusion:The DT-GC before and after gastric filling is related to the differentiation degree and T stage of gastric cancer.It may be helpful to quantify the degree in stiffness of gastric wall and improve the value of enhanced CT in preoperative evaluation of advanced gastric cancer.