Judgment Value Research Of Multi Slice Spiral Computed Tomography Enhanced Scan For TNM Staging Of Gastric Cancer

Objective:Prospective study the judgement to their Value of 64-slice spiral CT(Multi Slice Spiral Computed Tomography, MSCT) enhanced scans to progressive stage of gastric cancer and guide clinics to assess the surgical risk of gastric cancer and the respectability and make operative planning and prognostic evaluation. Methods:Take a example as following:there were cases in the second ward of General Surgery Department in Affiliated Hospital of Yan’an University from September of 2012 to February of 2014 in which the patients were diagnosed with enhanced gastric cancer by the endoscopy and pathological examination. They underwent 64-slice spiral CT enhanced scans, and underwent gastric cancer radical operation(D2). The gastric specimens and organs and lymph nodes of clinical suspicious involvement resection are formalin-fixed specimens, in which resetting specimens are as radiant drawn certainly on the lesions. After they are stained by HE totally, We can decide the local invasion of gastric cancer and the metastasis of lymph node around the stomach. And we can make judgments about TNM staging of gastric cancer according the determination of gastric under an optical microscope Local invasion of gastric cancer and lymph node metastasis. TNM staging of gastric cancer according to 64-slice spiral CT scan results and compare the pathologic TNM stage. Results:The overall accuracy of MSCT enhancement scanning for T staging of gastric cancer is 82.1%(138/168).The accuracy of T1、T2、T3、T4 staging are 74.1% and 68.2%, 87.1%, 86.0%. The accuracy of N staging is 73.2%(123/168), in which there are 51 cases in stage N0, with the accuracy of 74.5%(38/51), and there are 67 cases in stage N1 with the accuracy of 70.1%(47/67), and there are 50 cases in N2 stage with the accuracy of 76.0%(38/50). M0 accuracy are up to 100%, and M1 accuracy is 85.7%. Conclusion:The MSCT enhanced scan is fairly accurate in assessment the advanced gastric cancer TNM staging, and significantly improve the accuracy of staging of gastric cancer and the prevalence of small lesions, which provides a reliable technical support for evaluation gastric cancer TNM staging. So that the clinicians can select the reasonable treatment and do preoperative assessment for patients, besides, shorten the operative time and improve the quality of surgery and prognosis. The resectability of gastric cancer before operation and evaluation of the scope of radical operation and the operative strategy have great clinical value and significance. However, we must recognize the limitations of MSCT, especially for the early diagnosis. So it’s necessary to combine them with endoscopic ultrasound(EUS), B ultrasound, and gastrointestinal tract and so on, so that the patients have early detection and treatment.