Value Analysis Of White Light Endoscopy Combined With Enhanced CT In Differential Diagnosis Of Primary Gastric Lymphoma And Advanced Gastric Cancer

Purpose: To evaluate the value of white light endoscopy combined with enhanced CT and general clinical data in differential diagnosis of primary gastric lymphoma and advanced gastric cancer.Methods: WLE,enhanced CT images and general clinical data of 105 and 210 AGC patients diagnosed with PGL by histopathological examination from June 2012 to June 2012 in The Second Hospital of Lanzhou University were included,and their value in the diagnosis and differential diagnosis of PGL and AGC was compared and analyzed.Result:The diagnosis rate of PGL by WLE alone was only 14.9%,the diagnosis rate of enhanced CT alone was 22.3%,the diagnosis rate after the combination of the two increased to 36.2%,which was statistically significant compared with the diagnosis alone.After univariate and multivariate analysis,the number of lesions under WLE,the lesion shape,the gastric wall thickening,the gastric wall involvement,the degree of enhancement,the density of lesions and whether the serosal surface is smooth are conducive to the differential diagnosis of PGL and AGC,and the AUC of the combined diagnosis of WLE and enhanced CT 0.868 was higher than 0.779 and 0.787 when diagnosed alone.The comparison of general data showed that PGL and AGC had a median age of 55,62 years and a mean course of disease of（8.8±17.78）m,（13.8±15.02）m,respectively.Blood LDH,gastric cancer tumor markers（CEA,CA199 and CA724）,chronic gastrointestinal bleeding and disease risk factors（smoking and pickled food intake,EBV and HBV infected）.Conclusions: Compared with AGC endoscopy,PGL is more likely to show multiple and ulcerative lesions,and the thickening of the gastric wall at the lesion in enhanced CT is more obvious,mild strengthening is mainly the mainstay and the lesion density is uniform,and WLE combined with enhanced CT is conducive to improving the diagnosis and differential diagnosis efficiency of PGL and AGC.At the same tiame,gender,age of onset,chronic gastrointestinal bleeding,risk factors（smoking and pickled food intake,EBV and HBV infected）,LDH and elevated levels of gastric cancer tumor markers are all conducive to the differential diagnosis of PGL and AGC.