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目的:探讨早期胃癌原发病灶的计算机断层扫描(computed tomography,CT)特征及临床病理特征.方法:回顾性分析104例经病理证实为早期胃癌患者的胃壁黏膜厚度及其增强各期△CT值的变化,并行单因素分析黏膜内癌(T1a)和黏膜下癌(T1b)患者的临床病理特征.结果:黏膜内癌(T1a)和黏膜下癌(T1b)两组患者在p N分期和p TNM分期上存在统计学意义上的差异(P=0.0080;P=0.0175),而在诸如年龄、性别、肿瘤位置、肿瘤最大径、胃切除类型、切除淋巴结数量、大体分型、肿瘤分化、淋巴管浸润、静脉浸润、神经浸润等临床病理特征上,两组患者没有显著性差异(P>0.05).104例早期胃癌均显示胃壁有不同程度的增厚.胃癌病变处黏膜厚度(4.37m m±0.91 m m)较正常组黏膜厚度(2.62 m m±0.44 mm)明显增厚(t=14.65,P<0.0001).增强后动脉期原发病灶处胃壁黏膜线样强化,△CT平均值为26 Hu,静脉期病灶呈持续性强化,强化CT值比动脉期高27 Hu,平衡期所有病例病变强化程度略有下降.早期胃癌与正常对照组间动脉期、门脉期及平衡期△CT值比较差异均有统计学意义(t=3.44,P=0.0008;t=11.55,P<0.0001;t=7.67,P<0.0001).结论:螺旋CT增强扫描对早期胃癌诊断具有重要的临床价值.黏膜内癌(T1a)和黏膜下癌(T1b)患者在p N分期和p TNM分期上存在明显差异.
Objective: To investigate the characteristics and clinicopathological features of computed tomography (CT) of primary gastric cancer in early stage.Methods: A retrospective analysis was performed on the gastric mucosal thickness in 104 cases with pathologically confirmed early gastric cancer and its clinical significance (T1a) and submucosal carcinoma (T1b) in patients with submucosal carcinoma (T1a) and submucosal carcinoma (T1b) were analyzed by single factor analysis.Results: There was a statistically significant difference in TNM staging (P = 0.0080; P = 0.0175) but not in age, gender, tumor location, maximum tumor diameter, type of gastrectomy, number of resected lymph nodes, gross type, tumor differentiation, There was no significant difference between the two groups (P> 0.05) .104 cases of early gastric cancer showed thickening of the gastric wall to varying degrees. The gastric mucosal thickness (4.37mm ± 0.91 mm) was significantly thicker than that of normal mucosa (2.62 mm ± 0.44 mm) (t = 14.65, P <0.0001) .In the enhanced arterial phase, Venous stage lesions were continuously enhanced, The CT value was 27 Hu higher than that of the arterial phase, and the degree of lesion enhancement was slightly decreased in all cases in the balance period.Compared with the △ CT value of arterial phase, portal phase and balance phase in early gastric cancer and normal control group, there was significant difference (t = 3.44, P = 0.0008; t = 11.55, P <0.0001; t = 7.67, P <0.0001) .Conclusion The enhanced spiral CT has important clinical value in the diagnosis of early gastric cancer. T1b) patients in the p N staging and p TNM staging significant differences.