Comparative Study On The Diagnostic Value Of Endoscopic Ultrasonography And Multislice Spira Enhanced CT In The Preoperative TN Staging Of Primary Gastric Adenocarcinoma

Objective:A retrospective study was conducted to compare endoscopic ultrasonography and enhanced CT in the preoperative TNstaging of primary gastric cancer and to evaluate its clinical application value.Methods:Among 681 patients treated in our hospital from February 2015 to December 2020,377 patients with primary gastric cancer who had not received preoperative chemoradiotherapy or immunotargeted therapy and had been pathologically confirmed after surgery with complete clinical data were screened out and retrospectively analyzed.EUS and enhanced CT examination were performed before surgery and compared with postoperative pathological staging.Results:Among In 377 patients included in the study,the diagnostic value of EUS for T staging was as follows:1.The accuracy of EUS in the diagnosis of T1+T2 was 61.5%and that of T3+T4 was49.5%,the difference was statistically significant(χ~2=4.614,p<0.05).2.The accuracy of EUS in the diagnosis of upper gastric carcinoma was 37.0%,and that of lower gastric carcinoma was 31.0%,the difference was statistically significant(χ~2=27.382,p<0.05).3.The accuracy of EUS in the diagnosis of diffuse gastric cancer was 30.4%,and the accuracy of EUS in the diagnosis of intestinal gastric cancer was 32.4%,the difference was statistically significant(χ~2=1.507,p>0.05).Value of enhanced CT in T staging diagnosis:1.The accuracy of enhanced CT in the diagnosis of T1+T2 was 48.5%,and that of T3+T4 was 67.8%,the difference was statistically significant(χ~2=10.376,p<0.05).2.The accuracy of enhanced CT in the diagnosis of upper gastric carcinoma was 30.1%,and the accuracy of enhanced CT in the diagnosis of lower gastric carcinoma was 36.8%,the difference was statistically significant(χ~2=22.011,p<0.05).3.The accuracy of enhanced CT in the diagnosis of diffuse gastric cancer was 38.0%,and the accuracy of enhanced CT in the diagnosis of intestinal gastric cancer was 39.3%,the difference was not statistically significant(χ~2=1.307,p>0.05).Diagnostic value of EUS in N staging:The accuracy of EUS diagnosis was 87.7%without lymph node metastasis and11.0%with lymph node metastasis,the difference was statistically significant(χ~2=16.4,p<0.05).Value of enhanced CT in N stage diagnosis:The accuracy of enhanced CT in the diagnosis of lymph node metastasis was 83.4%and 23.1%,respectively(χ~2=23.1,p<0.05).Conclusion:1.EUS is more accurate in diagnosing low T1 and T2 stages than enhanced CT,while enhanced CT is more accurate in diagnosing T3 and T4 stages.2.EUS is more accurate in diagnosing upper gastric carcinoma than lower gastric carcinoma,and enhanced CT is more accurate in diagnosing lower gastric carcinoma than upper gastric carcinoma.3.Among different Lauren types,the two tests showed no significant difference in the diagnostic accuracy of intestinal type and diffuse type.4.Both tests have high diagnostic accuracy in cases without lymph node metastasis,while EUS is more accurate in diagnosis.The accuracy of enhanced CT in diagnosis of lymph node metastasis is high.