The Influence Of Drinking And Not Drinking Water Before 64-slice Spiral CT On The Accuracy Of Preoperative TN Staging Of Gastric Cancer

BackgroundGastric cancer(GC)is one of the most common malignant tumors in China.Surgery is the cornerstone in the management of GC based on multidisciplinary team according to the latest clinical guideline.Decision-making largely depends on precise clinical stage determined by imaging evaluation.As the improvement of technology,the widespread use of multidetector row CT(MDCT)is observed in diagnosis,clinical stage and follow-up of GC.For GC patients,MDCT with water filling method results in clear presentation in terms of location,size,growth pattern,organs involved and status of lymph nodes.It has been rarely reported that water filling method has an effect on the accuracy of MDCT for evaluating clinical stage of GC.ObjectiveThe purpose of this study is to investigate the diagnostic value of 64-slice spiral CT with water-filling method in preoperative TN staging of GC and the effect of on the accuracy of clinical staging.A more precise clinical stage will provide more information for dicision-making.MethodA total of 120 GC patients(water drinking group:60 cases;no water drinkingGroup:60 cases)with preoperative contrast-enhanced CT and postoperative pathological results undergoing radical gastrectomy in our hospital from January 2014 to March 2017 were retrospectively studied.ResultsThe accuracy of CT diagnosis of TN staging in drinking water group was relatively high,which was highly consistent with postoperative pathological findings.In the water drinking group,there was high consistency between CT diagnosis of T staging and pathological data(Kappa=0.714).In the no water-drinking group,there was medium consistency between CT diagnosis of T staging and pathological data(Kappa=0.506).The overall accuracies in two groups had significant difference(P=0.039).In the water drinking group,there was high consistency between CT diagnosis of N staging and pathological data(Kappa=0.640).In the no water drinking group,there was medium consistency between CT diagnosis of N staging and pathological data(Kappa=0.510).The overall accuracies in two groups had no significant difference(P=0.426).ConclusionThere is a satisfactory clinical value of application with 64-row spiral CT in the clinical staging of GC,and drinking water before the CT scanning could increase the accuracy of the preoperative T staging,which contributes to optimizing the therapeutic regimes for GC.