The application value of multi-slice spiral CT in the evaluation of clinical T stage and N stage after transformation treatment of local advanced gastric cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

XING Chao , YU Hualong ,  YAO Zengwu ,  JIANG Lixin

Department of Gastrointestinal Surgery, The Affiliated Yantai Yuhuangding Hospital, Qingdao University, Yantai, Shandong 264000, P. R. China;

Corresponding?author：

YAO Zengwu, Email: yzw1986yzw@126.com; JIANG Lixin, Email: jianglixin1969@hotmail.com

Keywords：

gastric cancer; transformation therapy; tomography /X-ray computed; TNM staging; pathology

DOI：

10.7507/1007-9424.202003106

Video：

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Objective To explore the value of multi-slice spiral CT (MSCT) in ycT stage and ycN stage evaluation of patients with locally advanced gastric cancer (cT4bN0-3M0) who underwent surgery after transformation therapy.Methods Clinical data of 32 patients with locally advanced gastric cancer (cT4bN0-3M0) in Affiliated Yantai Yuhuangding Hospital of Qingdao University form January 2017 to April 2019 were retrospective analyzed. All the patients underwent surgery after SOX regimen transformation therapy. Preoperative MSCT plain and enhanced scan were used to evaluate clinical T stage (ycT) and clinical N stage (ycN). The accuracy of MSCT scanning was evaluated by comparing with the gold standard for postoperative pathological ypT stage and ypN stage.Results The accuracy of preoperative MSCT examination on ycT stage after transformation therapy was 78.1% (25/32), and that of ycN was 56.3% (18/32).Conclusion The accuracy of MSCT in preoperative ycT stage and ycN stage after successful transformation therapy for locally advanced gastric cancer (cT4bN0-3M0) is relatively high.

Citation： XING Chao, YU Hualong, YAO Zengwu, JIANG Lixin. The application value of multi-slice spiral CT in the evaluation of clinical T stage and N stage after transformation treatment of local advanced gastric cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2020, 27(11): 1375-1379. doi: 10.7507/1007-9424.202003106 Copy

1.	胡祥. Ⅳ期胃癌的外科治療. 中華消化外科雜志, 2017, 16(3): 223-226.
2.	Amin MB, Edge S, Greene F, et al. AJCC Cancer Staging Manual. 8th ed. New York: Springer, 2017: 93-99.
3.	李濤, 陳凜. SOX方案新輔助化療應用于進展期胃癌的有效性和安全性研究. 中華胃腸外科雜志, 2011, 14(2): 104-106.
4.	唐磊. 從UICC/AJCC第8版TNM分期看胃癌影像學T分期的發展方向. 中華胃腸外科雜志, 2017, 20(7): 735-739.
5.	中國臨床腫瘤學會指南工作委員會. 中國臨床腫瘤學會(CSCO)原發性胃癌診療指南(2017. V1). 北京: 人民衛生出版社, 2017: 20-24.
6.	王之龍, 唐磊, 李子禹, 等. 多排螺旋CT檢查對食管胃結合部腺癌新輔助化療后臨床分期評估的應用價值. 中華消化外科雜志, 2018, 17(8): 861-868.
7.	周斌, 陳環球. Ⅳ期胃癌轉化治療的實踐. 中國腫瘤外科雜志, 2016, 8(4): 217-222.
8.	Amin MB, Greene FL, Edge SB, et al. The Eighth Edition AJCC Cancer Staging Manual: continuing to build a bridge from a population-based to a more “personalized” approach to cancer staging. CA Cancer J Clin, 2017, 67(2): 93-99.
9.	朱正綱. 胃癌術前分期的現狀及其對術前精準分期的思考. 中華胃腸外科雜志, 2016, 19(2): 126-131.
10.	Hwang SW, Lee DH, Lee SH, et al. Preoperative staging of gastric cancer by endoscopic ultrasonography and multidetectorrow computed tomography. J Gastroenterol Hepatol, 2010, 25(3): 512-518.
11.	周柱玉, 鄭紅, 張海兵, 等. 口服超聲造影與增強CT對胃癌術前 T分期的對比分析. 臨床超聲醫學雜志, 2016, 18(6): 380-383.
12.	李婷, 來彥博, 郭玉林, 等. 3.0T MRI與64層螺旋CT在進展期胃癌術前T分期的診斷價值比較. 實用放射學雜志, 2015, 31(1): 91-94.
13.	張軍, 李哲, 于繼群, 等. MSCT對原發性胃癌患者T 分期的對比分析. 中華普外科手術學雜志(電子版), 2017, 11(6): 468-471.
14.	Yoshikawa T, Tanabe K, Nishikawa K, et al. Accuracy of CT staging of locally advanced gastric cancer after neoadjuvant chemotherapy: cohort evaluation within a randomized phase II study. Ann Surg Oncol, 2014, 21(Suppl3): S383-S389.
15.	Lee SL, Ku YM, Jeon HM, et al. Impact of the cross-sectional location of multidetector computed tomography scans on prediction of serosal exposure in patients with advanced gastric cancer. Ann Surg Oncol, 2017, 24(4): 1003-1009.
16.	Yan C, Zhu ZG, Yu YY, et al. Expression of vascular endothelial growth factor C and chemokine receptor CCR7 in gastric carcinoma and their values in predicting lymph node metastasis. World J Gastroenterol, 2004, 10(6): 783-790.
17.	唐磊. 胃癌影像學分期與評效—多學科診療的需求與對策. 中華胃腸外科雜志, 2015, 18(3): 208-212.
18.	趙群, 李勇, 胡子龍, 等. 多排螺旋CT對胃癌術前分期及腫瘤最長徑的評估價值. 中華胃腸外科雜志, 2015, 17(3): 227-231.
19.	嚴超, 燕敏, 朱正綱, 等. 胃癌術前分期的臨床應用及其價值. 中華胃腸外科雜志, 2013, 16(2): 114-117.
20.	Kwee RM, Kwee TC. Imaging in local staging of gastric cancer: a systematic review. J Clin Oncol, 2007, 25(15): 2107-2116.
21.	Fukuya T, Honda H, Hayashi T, et al. Lymph-node metastasis: efficacy for detection with helical CT in patients with gastric cancer. Radiology, 1995, 197(3): 705-711.
22.	劉祎, 李小毅, 薛華丹, 等. CT體積測量在進展期胃癌患者新輔助化療療效評價中的應用價值研究. 癌癥進展, 2010, 8(5): 420-424.
23.	Sun ZQ, Yan G, Ge YX, et al. Can low-dose CT perfusion imaging accurately assess response of advanced gastric cancer with neoadjuvant chemotherapy? Xray Sci Technol, 2017, 25(6): 981-991.
24.	王谷一, 趙振華, 楊建峰, 等. 64排多層CT與超聲胃鏡在胃癌術前評估的對比研究. 全科醫學臨床與教育, 2016, 14(3): 256-259, 283.

1. 胡祥. Ⅳ期胃癌的外科治療. 中華消化外科雜志, 2017, 16(3): 223-226.
2. Amin MB, Edge S, Greene F, et al. AJCC Cancer Staging Manual. 8th ed. New York: Springer, 2017: 93-99.
3. 李濤, 陳凜. SOX方案新輔助化療應用于進展期胃癌的有效性和安全性研究. 中華胃腸外科雜志, 2011, 14(2): 104-106.
4. 唐磊. 從UICC/AJCC第8版TNM分期看胃癌影像學T分期的發展方向. 中華胃腸外科雜志, 2017, 20(7): 735-739.
5. 中國臨床腫瘤學會指南工作委員會. 中國臨床腫瘤學會(CSCO)原發性胃癌診療指南(2017. V1). 北京: 人民衛生出版社, 2017: 20-24.
6. 王之龍, 唐磊, 李子禹, 等. 多排螺旋CT檢查對食管胃結合部腺癌新輔助化療后臨床分期評估的應用價值. 中華消化外科雜志, 2018, 17(8): 861-868.
7. 周斌, 陳環球. Ⅳ期胃癌轉化治療的實踐. 中國腫瘤外科雜志, 2016, 8(4): 217-222.
8. Amin MB, Greene FL, Edge SB, et al. The Eighth Edition AJCC Cancer Staging Manual: continuing to build a bridge from a population-based to a more “personalized” approach to cancer staging. CA Cancer J Clin, 2017, 67(2): 93-99.
9. 朱正綱. 胃癌術前分期的現狀及其對術前精準分期的思考. 中華胃腸外科雜志, 2016, 19(2): 126-131.
10. Hwang SW, Lee DH, Lee SH, et al. Preoperative staging of gastric cancer by endoscopic ultrasonography and multidetectorrow computed tomography. J Gastroenterol Hepatol, 2010, 25(3): 512-518.
11. 周柱玉, 鄭紅, 張海兵, 等. 口服超聲造影與增強CT對胃癌術前 T分期的對比分析. 臨床超聲醫學雜志, 2016, 18(6): 380-383.
12. 李婷, 來彥博, 郭玉林, 等. 3.0T MRI與64層螺旋CT在進展期胃癌術前T分期的診斷價值比較. 實用放射學雜志, 2015, 31(1): 91-94.
13. 張軍, 李哲, 于繼群, 等. MSCT對原發性胃癌患者T 分期的對比分析. 中華普外科手術學雜志(電子版), 2017, 11(6): 468-471.
14. Yoshikawa T, Tanabe K, Nishikawa K, et al. Accuracy of CT staging of locally advanced gastric cancer after neoadjuvant chemotherapy: cohort evaluation within a randomized phase II study. Ann Surg Oncol, 2014, 21(Suppl3): S383-S389.
15. Lee SL, Ku YM, Jeon HM, et al. Impact of the cross-sectional location of multidetector computed tomography scans on prediction of serosal exposure in patients with advanced gastric cancer. Ann Surg Oncol, 2017, 24(4): 1003-1009.
16. Yan C, Zhu ZG, Yu YY, et al. Expression of vascular endothelial growth factor C and chemokine receptor CCR7 in gastric carcinoma and their values in predicting lymph node metastasis. World J Gastroenterol, 2004, 10(6): 783-790.
17. 唐磊. 胃癌影像學分期與評效—多學科診療的需求與對策. 中華胃腸外科雜志, 2015, 18(3): 208-212.
18. 趙群, 李勇, 胡子龍, 等. 多排螺旋CT對胃癌術前分期及腫瘤最長徑的評估價值. 中華胃腸外科雜志, 2015, 17(3): 227-231.
19. 嚴超, 燕敏, 朱正綱, 等. 胃癌術前分期的臨床應用及其價值. 中華胃腸外科雜志, 2013, 16(2): 114-117.
20. Kwee RM, Kwee TC. Imaging in local staging of gastric cancer: a systematic review. J Clin Oncol, 2007, 25(15): 2107-2116.
21. Fukuya T, Honda H, Hayashi T, et al. Lymph-node metastasis: efficacy for detection with helical CT in patients with gastric cancer. Radiology, 1995, 197(3): 705-711.
22. 劉祎, 李小毅, 薛華丹, 等. CT體積測量在進展期胃癌患者新輔助化療療效評價中的應用價值研究. 癌癥進展, 2010, 8(5): 420-424.
23. Sun ZQ, Yan G, Ge YX, et al. Can low-dose CT perfusion imaging accurately assess response of advanced gastric cancer with neoadjuvant chemotherapy? Xray Sci Technol, 2017, 25(6): 981-991.
24. 王谷一, 趙振華, 楊建峰, 等. 64排多層CT與超聲胃鏡在胃癌術前評估的對比研究. 全科醫學臨床與教育, 2016, 14(3): 256-259, 283.

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CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

The application value of multi-slice spiral CT in the evaluation of clinical T stage and N stage after transformation treatment of local advanced gastric cancer

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