| Objective: To discuss the accuracy and application value of ultrasonic gastroscopy and multi-slice spiral CT in the diagnosis of preoperative clinical T and N stages of gastric cancer,and to provide a reference for clinical selection of examination methods.Methods: Retrospectively analyze the clinical and pathological data of 100 patients with gastric cancer who underwent ultrasonic gastroscopy and multi-layer spiral CT examination in Qinghai University Affiliated Hospital from December 2019 to December 2020,and determine the preoperative T and N stages of gastric cancer patients,and the pathology department issued a pathological stage report after surgery,and the observation indicators include:(1)T stage and N stage interpreted by ultrasound gastroscopy and multi-layer spiral CT before surgery;(2)T stage and N stage of postoperative pathology;and "gold standard" with postoperative pathological results.The accuracy,sensitivity,specificity and positive predictive values of ultrasonic gastroscopy and multilayer spiral CT on T and N stages were calculated,and the kappa values were used to test the consistency of ultrasonic gastroscopy and multilayer spiral CT with postoperative pathological results,respectively.Compare the two inspection methods to determine which means are more advantageous.Results: In this study,100 patients were collected,and the accuracy of ultrasound endoscopy in diagnosing the depth of gastric cancer invasion was 78%,the kappa value was 0.707(P<0.05),the sensitivity was 91%,and the specificity was 84%,the positive predictive value(Tis-2)was 88%,and the positive predictive value(T3-4)was 88%.Among them,Tis accuracy rate is 100%,T1 accuracy rate is 89.5%,T2 accuracy rate is 84.8%,T3 accuracy rate is 77.3%,T4 accuracy rate is 56.5%.The accuracy of multilayer spiral CT on the depth of gastric cancer infiltration was 49%,the kappa value was 0.327(P<0.05),the sensitivity was 69%,and the specificity was 82%,the positive predictive value(Tis-2)was 83%,and the positive predictive value(T3-4)was 69%.Among them,Tis accuracy rate is 33.3%,T1 accuracy is 47.4%,T2 accuracy rate is45.5%,T3 accuracy rate is 54.4%,T4 accuracy rate is 52.2%.Endoscopy was 57%accurate for the number of lymph node metastases in the diagnostic area,kappa value was 0.419(P<0.05),sensitivity was 77%,specificity was82%,positive predictive value(N0-1)was 87%,and positive predictive value(N2-3)was 70%.Among them,the accuracy rate of N0 is 53.2%,the accuracy rate of N1 is57.1%,the accuracy rate of N2 is 63.2%,and the accuracy rate of N3 is 60.0%.The accuracy of multilayer spiral CT for the number of lymph node metastases in the diagnostic area was 77%,the kappa value was 0.679(P<0.05),the sensitivity was 92%,the specificity was 85%,the positive predictive value(N0-1)was 90%,and the positive predictive value(N2-3)was 87%.Among them,the accuracy rate of N0 is 72.3%,the accuracy rate of N1 is 78.6%,the accuracy rate of N2 is 94.7%,and the accuracy rate of N3 is 70.0%.Conclusion: 1.Ultrasound endoscopy and multi-layer spiral CT can be used as an important means for the detection and preoperative accurate staging and evaluation of gastric cancer,and contain higher accuracy rates in both T stage and N stage;2.The accuracy of ultrasound endoscopy in diagnosing the degree of tumor invasion is better than that of multilayer spiral CT,and the accuracy of multilayer spiral CT in diagnosing perireal lymph nodes is better than that of ultrasound endoscopy,and it has more advantages in diagnosing distant metastases.Therefore,the combination of the two can maximize the accuracy of preoperative staging of gastric cancer and have guiding significance for the preoperative staging of gastric cancer.3.Ultrasound endoscopy can be used as an auxiliary diagnostic tool for ct clinical T staging of gastric cancer. |
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