Clinical Significance Of Multi-slice Spiral CT And Endoscopic Ultrasonography In The Preoperative Staging Of Gastric Cancer

Objective: To explore the clinical significance of multi-slice spiral CT andendoscopic ultrasonography in the preoperative TNM staging of gastric cancer, so as toprovide references for treatment strategy selection against gastric cancer.Materials and methods：176patients with gastric cancer receiving surgery inthe department of general surgery of Jingjiang hospital of TCM from May,2007to May2012were included in this study. All of the included subjects didn’t receive radiotherapy,chemotherapy or other special treatments. Multi-slice spiral CT and endoscopicultrasonography were applied to preoperative TNM staging, then compared withpostoperative pathologic TNM staging for observation of preoperative T-staging,N-staging, M-staging accuracies of gastric carcinoma with multi-slice spiral CT andendoscopic ultrasonography.Results: Comparison of T staging between endoscopic ultrasonography andpathological diagnosis within the176patients showed that the accuracy rates of T stagingfrom T1to T4were62.50%,75.86%,80.49%and65.85%, respectively, resulting a totalaccuracy rate of73.86%while the accuracy rates of N staging from N0to N3and Mstaging from M0to M1were79.63%,68.42%,55.56%,50.00%and65.61%,68.42%,resulting a total accuracy rate of68.18%,65.91%, respectively.Comparison of T staging between Multi-slice spiral CT and pathological diagnosiswithin the176patients showed that the accuracy rates of T staging from T1to T4were54.17%，65.52%，84.15%and75.61%,respectively, resulting a total accuracy rate of75.00%while the accuracy rates of N staging from N0to N3and Mstaging from M0to M1 were81.48%，75.00%，72.22%,60.00%, and79.62%,84.21%, resulting a totalaccuracy rate of75.00%and80.11%, respectively.Conclusion:（1）The preoperative staging accuracies of gastric carcinoma withmulti-slice spiral CT, endoscopic ultrasonography were75.00%、73.86%, respectively,with similar results. The T1staging accuracies with multi-slice spiral CT, endoscopicultrasonography were54.17%、62.5%.There were significant difference between them,therefore, endoscopic ultrasonography has more advantages in the diagnosis of earlygastric cancer.（2）The preoperative N2lymph node staging accuracies of gastriccarcinoma with multi-slice spiral CT, endoscopic ultrasonography were72.22%、55.56%,respectively. Multi-slice spiral CT has higher accuracy in evaluation of N2lymph nodemetastases, and guiding significance in the development of surgical dissection scope.（3）Both multi-slice spiral CT and endoscopic ultrasonography existed insufficient staging andexcessive staging phenomenon in preoperative staging accuracies of gastric carcinoma...