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

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2.	Amin MB, Edge S, Greene F, et al. AJCC Cancer Staging Manual. 8th ed. New York: Springer, 2017: 93-99.
3.	李涛, 陈凛. SOX方案新辅助化疗应用于进展期胃癌的有效性和安全性研究. 中华胃肠外科杂志, 2011, 14(2): 104-106.
4.	唐磊. 从UICC/AJCC第8版TNM分期看胃癌影像学T分期的发展方向. 中华胃肠外科杂志, 2017, 20(7): 735-739.
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6.	王之龙, 唐磊, 李子禹, 等. 多排螺旋CT检查对食管胃结合部腺癌新辅助化疗后临床分期评估的应用价值. 中华消化外科杂志, 2018, 17(8): 861-868.
7.	周斌, 陈环球. Ⅳ期胃癌转化治疗的实践. 中国肿瘤外科杂志, 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.	朱正纲. 胃癌术前分期的现状及其对术前精准分期的思考. 中华胃肠外科杂志, 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, 郑红, 张海兵, 等. 口服超声造影与增强CT对胃癌术前 T分期的对比分析. 临床超声医学杂志, 2016, 18(6): 380-383.
12.	李婷, 来彦博, 郭玉林, 等. 3.0T MRI与64层螺旋CT在进展期胃癌术前T分期的诊断价值比较. 实用放射学杂志, 2015, 31(1): 91-94.
13.	张军, 李哲, 于继群, 等. MSCT对原发性胃癌患者T 分期的对比分析. 中华普外科手术学杂志(电子版), 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.
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18.	赵群, 李勇, 胡子龙, 等. 多排螺旋CT对胃癌术前分期及肿瘤最长径的评估价值. 中华胃肠外科杂志, 2015, 17(3): 227-231.
19.	严超, 燕敏, 朱正纲, 等. 胃癌术前分期的临床应用及其价值. 中华胃肠外科杂志, 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.	刘祎, 李小毅, 薛华丹, 等. CT体积测量在进展期胃癌患者新辅助化疗疗效评价中的应用价值研究. 癌症进展, 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, 赵振华, 杨建峰, 等. 64排多层CT与超声胃镜在胃癌术前评估的对比研究. 全科医学临床与教育, 2016, 14(3): 256-259, 283.

1. 胡祥. Ⅳ期胃癌的外科治疗. 中华消化外科杂志, 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. 李涛, 陈凛. SOX方案新辅助化疗应用于进展期胃癌的有效性和安全性研究. 中华胃肠外科杂志, 2011, 14(2): 104-106.
4. 唐磊. 从UICC/AJCC第8版TNM分期看胃癌影像学T分期的发展方向. 中华胃肠外科杂志, 2017, 20(7): 735-739.
5. 中国临床肿瘤学会指南工作委员会. 中国临床肿瘤学会(CSCO)原发性胃癌诊疗指南(2017. V1). 北京: 人民卫生出版社, 2017: 20-24.
6. 王之龙, 唐磊, 李子禹, 等. 多排螺旋CT检查对食管胃结合部腺癌新辅助化疗后临床分期评估的应用价值. 中华消化外科杂志, 2018, 17(8): 861-868.
7. 周斌, 陈环球. Ⅳ期胃癌转化治疗的实践. 中国肿瘤外科杂志, 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. 朱正纲. 胃癌术前分期的现状及其对术前精准分期的思考. 中华胃肠外科杂志, 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, 郑红, 张海兵, 等. 口服超声造影与增强CT对胃癌术前 T分期的对比分析. 临床超声医学杂志, 2016, 18(6): 380-383.
12. 李婷, 来彦博, 郭玉林, 等. 3.0T MRI与64层螺旋CT在进展期胃癌术前T分期的诊断价值比较. 实用放射学杂志, 2015, 31(1): 91-94.
13. 张军, 李哲, 于继群, 等. MSCT对原发性胃癌患者T 分期的对比分析. 中华普外科手术学杂志(电子版), 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. 胃癌影像学分期与评效—多学科诊疗的需求与对策. 中华胃肠外科杂志, 2015, 18(3): 208-212.
18. 赵群, 李勇, 胡子龙, 等. 多排螺旋CT对胃癌术前分期及肿瘤最长径的评估价值. 中华胃肠外科杂志, 2015, 17(3): 227-231.
19. 严超, 燕敏, 朱正纲, 等. 胃癌术前分期的临床应用及其价值. 中华胃肠外科杂志, 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. 刘祎, 李小毅, 薛华丹, 等. CT体积测量在进展期胃癌患者新辅助化疗疗效评价中的应用价值研究. 癌症进展, 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, 赵振华, 杨建峰, 等. 64排多层CT与超声胃镜在胃癌术前评估的对比研究. 全科医学临床与教育, 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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