Value of multidetector-row computed tomography in the preoperative T and N staging of gastric carcinoma: a large-scale Chinese study.
OBJECTIVE
To investigate the value of multidetector-row computed tomography (MDCT) in the preoperative T and N staging of gastric carcinoma and to further investigate the clinicopathological factors affecting the diagnostic accuracy.


METHODS
Seven hundred ninety gastric carcinoma patients underwent preoperative MDCT examination. The results of MDCT were compared with surgical and pathological findings.


RESULTS
Early gastric carcinoma patients whose primary tumor was detected by MDCT had higher incidence of lymph node metastasis, larger tumor size, and deeper invasion. The overall accuracy of MDCT in determining T stage of gastric carcinoma was 73.80% (T1 45.93%, T2 53.03%, T3 86.49%, and T4 85.79%). The overall accuracy of MDCT in preoperative N staging was 75.22% (N0 76.17%, N1 68.81%, and N2 80.63%). The overall diagnostic sensitivity, specificity, and accuracy of MDCT for determining lymph node metastasis was 86.26%, 76.17%, and 82.09%, respectively. Multivariate analysis showed that the diagnostic sensitivity of MDCT in determining lymph node metastasis related with tumor size, N stage, and number of metastatic lymph nodes.


CONCLUSIONS
The clinical value of MDCT in the preoperative T and N staging of gastric carcinoma is relatively high. MDCT can be the first choice for the preoperative evaluation of patients with gastric carcinoma.
Yan
Chao
C
Department of General Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China.
Zhu
Zheng-Gang
ZG
Yan
Min
M
Zhang
Huan
H
Pan
Zi-Lai
ZL
Chen
Jun
J
Xiang
Min
M
Chen
Ming-Min
MM
Liu
Bing-Ya
BY
Yin
Hao-Ran
HR
Lin
Yan-Zhen
YZ
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000473:pathology*; D002681:China; D005260:Female; D005743:Gastrectomy; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging / Q000379:methods*; D011300:Preoperative Care; D012372:ROC Curve; D012680:Sensitivity and Specificity; D013274:Stomach Neoplasms / Q000473:pathology*; D014057:Tomography, X-Ray Computed / Q000379:methods*