增强CT和18F-FDG PET/CT在胃癌术前分期评估中的临床价值比较

目的:对比评估增强计算机断层扫描(contrast enhancement computed tomography,CECT)和~(18)F-FDG正电子发射计算机断层扫描(positron emission tomography/computed tomography,PET/CT)在胃癌术前分期中的临床应用价值。方法:回顾性分析经病理证实的胃癌患者的术前CECT(27例)及~(18)F-FDG PET/CT(39例)图像,于两种影像学手段下,双盲法判定每位患者胃癌的TNM分期,然后分别计算每种影像学方法在胃癌术前分期中的敏感性、特异性、阳性预测值、阴性预测值和准确性。两种影像学方法的差异比较采用Pearson卡方检验。结果:CECT和~(18)F-FDG PET/CT诊断胃癌T分期的敏感性、阳性预测值和准确性分别是100.00%、72.73%、59.26%和100.00%、90.91%、76.92%;CECT和~(18)F-FDG PET/CT诊断胃癌N分期的敏感性、特异性、阳性预测值、阴性预测值和准确性分别是75.00%、71.43%、88.24%、50.00%、74.07%和42.86%、92.00%、75.00%、74.19%、35.90%。结论:CECT和~(18)F-FDG PET/CT均可用于胃癌术前分期的预估,尤其在N分期方面,CECT的敏感性和准确性高于~(18)F-FDG PET/CT。

Comparison of the Clinical Value of CECT and 18F-FDG PET/CT in the Preoperative Staging of Gastric Carcinoma

Objective:To evaluate and compare the diagnostic efficacy of CECT and 18F-FDG PET/CT in the preoperative staging of gastric cancer.Methods:CECT and 18F-FDG PET/CT preoperative images of gastric cancer confirmed by pathology were retrospectively analyzed. Double-blind assessment of TN staging of gastric cancer was performed using 18F-FDG PET/CT and CECT, and compared with the postoperative staging. Sensitivity, specificity, positive and negative predictive values, accuracy of CECT and 18F-FDG PET/CT in TN staging of gastric cancer were calculated. Pearson Chi-square Test was used to evaluate the differences of diagnostic efficacy of CECT and 18F-FDG PET/CT. P<0.05 indicates the difference was statistically significant.Results:Sensitivity, positive predictive values and accuracy of CECT and 18F-FDG PET/CT in T staging of gastric cancer were, respectively, 100.00%, 72.73%, 59.26% and 100.00%, 90.91%, 76.92%. Sensitivity, specificity, positive and negative predictive values, accuracy of CECT and 18F-FDG PET/CT in N staging of gastric cancer were, respectively, 75.00%, 71.43%, 88.24%, 50.00%, 74.07%and 42.86%, 92.00%, 75.00%, 74.19%, 35.90%.Conclusion:CECT and 18F-FDG PET/CT are all a useful tool for the evaluation of preoperative staging of gastric cancer. In addition, CECT is more effective in the assessment ofN staging of gastric cancer.