摘要
目的:探讨螺旋电子计算机断层扫描(CT)薄层扫描对胃部良恶性肿瘤性质的鉴别诊断价值,为胃癌诊治提供科学参考.方法:回顾性分析2021年1月—2022年1月河南科技大学第一附属医院收治的106例胃部肿瘤患者的临床资料,所有患者均接受X线钡餐与CT薄层扫描检查,根据患者胃镜活检或手术病理检查结果,将65例良性肿瘤患者分为良性组,将41例恶性肿瘤患者分为恶性组.比较胃部良恶性肿瘤的影像学特征,主要包括肿块直径、病灶边缘状态、恶性龛影、黏膜侵犯、肌层侵犯等特征.以胃镜活检或手术病理检查为金标准,分析X线钡餐、CT、X线钡餐+CT诊断胃部良恶性肿瘤的效能.结果:恶性组肿块直径≥5 cm、病灶边缘欠清、恶性龛影、黏膜侵犯、肌层侵犯等影像学特征检出率高于良性组,差异有统计学意义(x2=13.974、15.851、19.755、15.306、7.949,P＜0.05).X线钡餐+CT薄层扫描诊断胃部良恶性肿瘤的符合率、灵敏度、特异度、阳性预测值、阴性预测值,均高于X线钡餐、CT薄层扫描单一诊断方式,差异有统计学意义(x2=20.673、13.529、8.159、10.332、11.248,P＜0.05);X线钡餐诊断胃部良恶性肿瘤的AUC为0.685,CT薄层扫描诊断胃部良恶性肿瘤的AUC为0.762,X线钡餐+CT薄层扫描诊断胃部良恶性肿瘤的AUC为0.898.结论:CT薄层扫描能够为胃部肿瘤的良恶性诊断与病情评估提供科学参考依据,操作简单且敏感性好.
Abstract
Objective:To investigate the differential diagnostic value of spiral electron computed tomography(CT)thin-layer scanning on the nature of benign and malignant tumors in the stomach,and to provide scientific reference for the diagnosis and treatment of gastric cancer.Methods:The clinical data of 106 patients with gastric tumors admitted to the hospital from January 2021 to January 2022 were retrospectively analyzed,and all the patients were examined by X-ray barium meal and CT thin-layer scanning.According to the results of patients'gastroscopic biopsy or surgical pathological examination,65 patients with benign tu-mors were divided into benign group,and 41 patients with malignant tumors were divided into malignant group.The imaging fea-tures of benign and malignant tumors in the stomach were compared,mainly including the features of mass diameter,lesion margin status,malignant niche shadow,mucosal invasion,and muscular layer invasion.The efficacy of X-ray barium meal,CT,and X-ray barium meal + CT in diagnosing benign and malignant tumors of the stomach was analyzed using gastroscopic biopsy or surgical pathological examination as the gold standard.Results:The detection rate of imaging features such as mass diameter≥5 cm,poor-ly defined lesion margins,malignant niches,mucosal invasion,and muscular layer invasion was higher in the malignant group than in the benign group,and the difference was statistically significant(x2=13.974,15.851,19.755,15.306,7.949,P＜0.05).The com-pliance rate,sensitivity,specificity,positive predictive value,and negative predictive value of X-ray barium meal + CT thin-layer scan for the diagnosis of benign and malignant tumors in the stomach were higher than those of X-ray barium meal and CT thin-layer scan as a single diagnostic modality,and the difference was statistically significant(x2=20.673,13.529,8.159,10.332,11.248,P＜0.05).The AUC for the diagnosis of benign and malignant tumors in the stomach was 0.685 for barium X-ray meal,0.762 for CT thin-layer scan,and 0.898 for barium X-ray meal + CT thin-layer scan.Conclusion:CT thin-layer scanning can provide a scientific reference for the diagnosis of benign and malignant gastric tumors and the evaluation of their conditions,with simple operation and good sensitivity.
基金项目
河南省医学科技攻关项目(LHGJ202100241)
维普
万方数据