Predictive values of multidetector-row computed tomography combined with serum tumor biomarkers in preoperative lymph node metastasis of gastric cancer
Predictive values of multidetector-row computed tomography combined with serum tumor biomarkers in preoperative lymph node metastasis of gastric cancer
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DOI：
10.21147/j.issn.1000-9604.2019.03.07
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发表时间：
2019-06-01
影响因子：
5.1
通讯作者：
Liang, Han
中科院分区：
文献类型：
--
作者：
Bai, Huihui;Deng, Jingyu;Liang, Han
目的：多层螺旋CT(MDCT)和血清肿瘤标志物是评价胃癌(GC)术前淋巴结转移和临床分期的常用方法。方法：对445例胃癌根治术患者的临床病理资料进行回顾性分析，评价MDCT和血清肿瘤标志物对胃癌淋巴结转移分期的诊断价值。结果：经多因素Logistic回归分析，影响胃癌淋巴结转移的独立相关因素为肿瘤大小、肿瘤侵犯深度、血管侵犯、血管栓子和软组织侵犯。与手术后病理结果比较，多层螺旋CT检测淋巴结短径的最佳临界值为6.0 mm，预测淋巴结转移的准确率为75.7%。此外，淋巴结短径临界值结合血清肿瘤标志物[包括糖类抗原(CA)-724和CA-199]可提高术前预测淋巴结转移的敏感性(最高达89.3%)。结论：联合应用MDCT和血清肿瘤标志物可提高胃癌患者术前淋巴结转移的敏感性和准确性。
Objective: Multidetector-row computed tomography (MDCT) and serum tumor biomarkers are commonly used to evaluate the preoperative lymph node metastasis and the clinical staging of gastric cancer (GC). This study intends to evaluate the clinical predictive value of MDCT and serum tumor biomarkers in lymph node metastasis of GC.Methods: The clinicopathologic data of 445 GC patients who underwent radical gastrectomy were retrospectively analyzed to evaluate the diagnostic value of MDCT and serum tumor biomarkers in lymph node metastatic staging of GC before surgery.Results: With the multinomial logistic regression analysis, the independent relative factors of lymph node metastasis of GC were identified as tumor size, depth of tumor invasion, vessel invasion, vascular embolus, and soft tissue invasion. The optimal critical value of the short diameter of lymph nodes detected by MDCT scanning for evaluation of preoperative lymph node metastasis was 6.0 mm, with 75.7% as predictive accuracy of lymph node metastasis compared to the postoperative pathological results of GC patients. In addition, the critical value of the short diameter of lymph nodes combined with serum tumor biomarkers [ including carbohydrate antigen (CA)-724 and CA-199] could show an enhancement of predictive sensitivity of lymph node metastasis (up to 89.3%) before surgery.Conclusions: MDCT combined with serum tumor biomarkers should be adopted to improve preoperative sensitivity and accuracy of lymph node metastasis for GC patients.