| Objective:To evaluate the value of the volume measured by multi-slice spiral CT in predicting preoperative N staging of gastric cancer.Methods:From Nov.2011to May.2013, the three-phasic enhanced CT images of193patients of gastric cancer who underwent radical resection were retrospectively collected and analyzed. And all the patients were proven pathologically. Tumor area in the portal phase were reviewed and outlined by two observers independently with a blind method, and the volume of the tumor was calculated and assessed by Kappa test. The patients were divided into4groups according to pathological results. Kruskal-Wallis test was performed to compare tumor volume of gastric cancer, and the correlation between the volume measured by CT and N stage was evaluated by the Spearman analysis. Receiver Operating Characteristic curve analysis was carried out to get the diagnostic value, the cutoff value, their sensitivity and specificity.Results:Intra-observer Kappa value was0.77(P<0.05),0.72(P<0.05), Inter-observer Kappa value was0.69(P<0.05). Significant difference of the volume was found in different groups (H=63.21,.P<0.01). The tumor volume data was positively correlated with different N stages (r=0.568, P<0.05). ROC curve showed that the volume data could help differentiate between stage NO and stage N1-N3(cutoff12.06cm3, sensitivity55%, specificity95%), between stage N0-N1and stage N2-N3(cutoff22.35cm3, sensitivity66%, specificity86%), between stage N0-N2and stage N3(cutoff25.95cm3, sensitivity62%, specificity89%), and the area under ROC curve was0.79,0.80,0.82respectively.Conclusion:The volume of gastric cancer measured by multi-slice spiral CT plays an important part not only in predicting lymph node metastasis staging,but also in optimizing individualized clinical strategy for patients. |
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