| Background:Gastric cancer is one of the most frequent digestive caner. The tumor, node, metastasis (TNM) system has been become the principal method for assessing the extent of disease, determining prognosis in gastric cancer patients and affecting the therapy strategies.Objective:To assess the clinical significance of endoscopic ultrasongraphy(EUS) and CT-virtual in the diagnosis and preoperative stage of gastric cancer.Method:Twenty-four gastric cancer patients had been scanned on CT-Virtual companied with endoscopic ultrasongrphy ,which the operative findings and pathological diagnosis were correlated with that of spiral CT and endoscopic ultrasongrphy findings.Result:The sensitivities of EUS in T,N and M stage were 87.5%(21/24);79.2%(19/24) and 57.1%(4/7), respectively; the sensitivities and specificities of EUS in T1-T4 stage metastasis were:100%(1/1),100%(1/1);66.7%(2/3),100%(2/2);92.9%(13/14),86.7%(13/15);83.3%(5/6) and 83.3%(5/6),respectively; the sensitivities and specificities of lymph nodle (N0,N1,N2) metastasis were 88.9%(8/9),88.9%(8/9);80%(8/10),72.7%(8/11);60%(3/5) and 75%(3/4);respectively.The sensitivities of CT-virtual in T,N and M stage were 79.2%(19/24);70.8%(17/24)and 100%(7/7)。But it can not distinguish gastric cancer between T1 and T2 stages, the sensitivities and specificities of CT scanning on the metastasis of T1-T2 stage were: 0%(0/0)and 0%(0/0), respectively;the sensitivities and specificities of CT scanning on the metastasis of T3-T4 stage were:92.9%(13/14), 76.4%(13/17);100%(6/6), 85.7%(6/7);the sensitivities and specificities of lymph node (N0,N1,N2) metastasis were:77.8%(7/9),70%(7/10);60%(6/10), 66.7%(6/9);80%(4/5) and 80%(4/5), respectively;the the sensitivities and specificities of CT in determining the distant metastases was :100%(7/7) and 100%(7/7) ,respectively。Conclusion: EUS shows the prominent advantage in preoperative evaluation of the staging of gastric cancer especially on the diagnosis of the depth of tumor invasion and local lymph node metastasis ,CT-virtual is an efficient complement for gastric cancer.1.EUS compared with CT-virtual, shows the prominent advantage in preoperative evaluation of the staging of gastric cancer especially on the diagnosis of the depth of tumor invasion ,especially on early gastric cancer.Thus, EUS should be prioritily choosed to diagnose the superficial process under endoscope.2.There are no obvious difference between using EUS and CT- virtual to detect the N stages of gastric cancer. But CT-virtual is an efficient complement in diagnosis of gastric cancer.3.CT-virtual is far better than EUS for the diagnosis of M stages.It can accurately stage the preoperative cancer,which is very important for choosing operation indication to avoid the unnecessary operative treatment.4.The combination of CT-Virtual technique and Endoscopic ultrasonography is benefit to evaluate the preoperative examination of gastric cancer , which is beneficial to choose operative limitation and the prognosis judgement.Therefore,the clinical value of EUS in the preoperative T staging for patients with gastric cancer was relatively satiefying . However,in order to determining the TNM stage more accurately,EUS must be combined with other imaging examinations,such as spiral CT-virtual. |
