Value of MSCT Parameter in Evaluating TNM Staging of Gastric Cancer and Its Correlation with Clinicopathological Features / 医学研究杂志

Objective To explore the value of MSCT parameter in evaluating TNM staging of gastric cancer and its correlation with clinicopathological features.Methods Totally 120 cases with T2 gastric cancer in our hospital from December 2014 to December 2016 were selected into the clinical data.Preoperative MSCT parameters were used to evaluate the TNM staging,and the results were compared with the postoperative pathological findings.Logistic stepwise regression was used to analyze the clinicopathological features of the patients.Results The accuracy of T staging was 88.33％ (106/120).Compared with the postoperative pathology,the overall accuracy rate of N staging was 64.17％ (77/120),with Kappa =0.48.The overall accuracy of TNM staging was 68.33％ (82/120),with Kappa =0.51.TNM staging I stage (OR=1.679,95％ CI:1.119-2.519) and Ⅱ stage (0R=1.373,95％ CI:1.054-1.789),Ⅲ stage (OR=1.274,95％ CI:1.013-1.602) and Ⅳ stage (OR=1.510,95％ CI:1.210-1.884) were the protective factors.Conclusion MSCT parameters can better evaluate the TNM staging of gastric cancer,and the diagnosis is accurate.

The clinicopathology features of the T2 gastric cancer and value of enhanced multiphasic spiral CT in TNM staging of T2 gastric cancer / 重庆医学

Objective To explore the clinicopathological characters of T2 gastric cancer and the value of MSCT in the preop‐erative TNM staging of T2 gastric cancer .Methods A total of 93 patients with T2 gastric cancer were included in our study and un‐derwent preoperative MSCT staging ,who were confirmed by pathologic results .Then the results were compared with those of path‐ologic TNM staging .Also the clinicopathological features of the T2 gastric cancer were analyzed .Results There were no statistical‐ly significant differences in the clinicopathological characters among T2a and T2b patients (P>0 .05) .Comparing with pathologic TNM stage ,the T staging accuracy of MSCT was 91 .40% (85/93) ,the N staging accuracies of CT was 66 .67% (62/93) ,in which , 68 .18% (30/44) ,65 .00% (26/40) ,60 .00% (3/5) and 75 .00% (3/4) were for pN0 ,pN1 ,pN2 and pN3 .And the TNM staging ac‐curacies of CT was 67 .74% (63/93) ,in which ,68 .18% (30/44) ,64 .10% (25/39) ,60 .00% (3/5) and 100% (5/5) were for stageⅠ ,Ⅱ ,Ⅲ and Ⅳ .Conclusion There are no significant different on clinicopathology features among T2a and T2b patients .MSCT can clearly determine the preoperative TNM staging of T2 gastric cancer .

Clinicopathological Features and Prognostic Factors of T2 Gastric Cancer

PURPOSE: T2 gastric cancer is classified as advanced cancer, and defined as tumors invading into the muscularis propria or subserosa, but is limited within the gastric wall. The aim of this study was to evaluate the clinicopathological features and prognostic factors of T2 gastric cancer. METHODS: Out of 384 gastric cancer patients, 44 (11.5%), who underwent a gastrectomy for T2 gastric cancer, between January 2001 and December 2004 were analyzed. The clinicopathological features and prognostic factors were evaluated retrospectively. RESULTS: The male to female ratio was 3.4 to 1, with a mean age of 57 years. The most common lesion location was the lower one third of the stomach (63.6%). The median lesion size was 3.7 cm. Borrmann type II was the most common lesion gross type (52.3%) and a moderately differentiated carcinoma the most common histological type (36.4%). Lymph node metastasis was found in 19 patients (43.2%). According to the disease stage, the disease free survival rates were 92.9, 91.7, 66.7 and 0.0% in stages I, II, III and IV, respectively. From a univariate analysis, the tumor size and TNM stage were found to be significant prognostic factors for T2 gastric cancer. A further examination by multivariate analysis demonstrated that the TNM stage was the only significant prognostic factor. CONCLUSION: The TNM stage according to lymph node metastasis was the only significant prognostic factor for T2 gastric cancer. Extensive lymph node dissection should be performed to improve the disease free survival from T2 gastric cancer.

Clinicopathologic Features in T2 Gastric Cancer

PURPOSE: This study was done to evaluate the clinicopathologic features and survival rates for patients with T2 stage gastric cancer. METHODS: Ninety-six patients with T2 gastric cancer, were treated by radical gastrectomy (and D2 lymph node dissection) at Department of Surgery of Gospel Hospital, Kosin University College of Medicine from April 1996 to October 1998. We retrospectively analyzed age, gender, tumor site, tumor size, type of resection, histopathologic classification(WHO classification and Lauren classification), Borrmann type, TNM stage, blood type, perineural invasion, angioinvasion, lymphatic invasion and the survival rate. The survival rate was analyzed with the Kaplan-Meier method using the SPSS statistical program, and the other statistical analyses were performed using the cross table Chi-square test and the independent sample t-test. RESULTS: Lymph node metastasis was found in 39 patients (40.6%). There were no significant differences except for the Borrmann type, tumor size, angioinvasion and lymphatic invasion for the T2 gastric cancer with regard to patient age, gender, the histopathologic classification (WHO classification and Lauren classification), the type of resection, tumor site, blood type and perineural invasion. The 5 year survival rate for T2 gastric cancer patients was 82.3%. The TNM stage and angioinvasion were significant prognostic factors on the univariate analysis, but the TNM stage was a significant prognostic factor on the multivariate analysis (Relative risk; 10.943, P=0.001). CONCLUSION: The Borrmann type, tumor size, angioinvasion and lymphatic invasion were useful indicators of lymph node metastasis for T2 gastric cancer. The TNM stage was the only significant prognostic factor for T2 gastric cancer.

Lymphadenectomy for Stomach Cancer in T2 Stage

PURPOSE: Lymph node metastasis is an important prognostic variable in gastric cancer and most locoregional treatment failures are believed to be caused by insufficient nodal clearance. The aim of this study was to determine the clinicopathological features influencing lymph node metastasis, and an appropriate extent of lymphadenectomy, in T2 stage gastric cancer. METHODS: A retrospective review of eighty one patients with T2 gastric cancer, treated between 1987 and 1996, was performed, and included survival and statistical analysis to determine prognosticators and variables influencing lymph node metastasis. RESULTS: Lymph node metastasis was found in 36 patients (44.4%, 28 N1, 7 N2 and 1 N3), including 3 that had skipped to the second node group. The rate of lymph node metastasis was significantly higher in the subgroup with lymphatic invasion than in those without invasion (80.0% vs. 36.4%, P=0.002). There were no other clinical parameters for the detection of metastasis in regional lymph nodes. Operative curability was the only significant prognosticator in T2 stage gastric cancer (Relative risk; 7.9337, P=0.0049). CONCLUSION: There were no clinical parameters for the detection of metastasis in regional lymph nodes in T2 stage cancer, but assessment of the operative curability was very important for predicting the prognosis. For these reasons, radical lymphadenectomy, including at least the second node group, is the standard surgical procedure for gastric cancer in the T2 stage.