Predictive value of combination of endoscopic ultrasound and 64-slice dual-source computed tomography in regional clinical staging and peritoneal metastases of gastric cancer / 中华消化杂志

ABSTRACT

Objective To analyze the predictive value of combination of endoscopic ultrasound (EUS)and 64-slice dual-source computed tomography(DSCT)in regional clinical staging and peritoneal metastases of gastric cancer.Methods From July 2011 to May 2017,365 patients with gastric cancer diagnosed by endoscopic biopsy were enrolled.The patients received EUS and DSCT examination with the gold standard of postoperative pathological diagnosis,the accuracies of EUS alone,DSCT alone and the combination of EUS and DSCT were evaluated in original gastric tumor,regional lymph nodes and peritoneal metastases.The accuracy,sensitivity,specificity,the positive predictive value,the negative predictive value,consistency(the value of K ap pa)and area under curve(AUC)of receiver operating characteristic(ROC)curve were calculated.Results A total of 263 patients were enrolled into the study on the depth of tumor invasion and clinical staging of regional lymph nodes and 289 patients were recruited into the clinical prediction study on peritoneal metastasis.The accuracy of EUS in clinical staging of the depth of tumor invasion was 75.29% and the sensitivity,specificity,the value of Kappaand AUC of EUS in clinical staging of regional lymph nodes were 86.26%,81.81%,0.681 and 0.840,respectively.The sensitivity,specificity,the value of Kappaand AUC of DSCT in clinical staging of regional lymph nodes were 74.81%,87.12%,0.620 and 0.813,respectively.The sensitivity,specificity,the value of Kappa and AUC of EUS in the prediction of peritoneal metastases were 38.24%,97.25%,0.432 and 0.668, respectively.The sensitivity,specificity,the value of Kappa and AUC of DSCT in the prediction of peritoneal metastases were 41.18%,100.00%,0.553 and 0.706,respectively.The accuracy and the value of Kappaof the combination of EUS and DSCT in clinical staging of the depth of tumor invasion were 75.29% and 0.639;the sensitivity,specificity,positive predictive value,negative predictive value, Kappa,AUC in clinical staging of regional lymph nodes were 93.13%,87.88%,88.41%,92.80%, 0.810 and 0.905,respectively;and the sensitivity,specificity,positive predictive value,negative predictive value,Kappa,AUC in the prediction of peritoneal metastases were 58.82%,97.25%, 74.07%,94.66%,0.616 and 0.774,respectively.Conclusions The combination of EUS and DSCT which is superior to single examination is very helpful in the depth of gastric cancer invasion and regional lymph nodes,and is helpful in the prediction of peritoneal metastasis. The combination of two complementary examinations can improve the accuracy of the depth of gastric cancer invasion,clinical staging of regional lymph nodes,and the prediction of peritoneal metastasis.