APPLICATION VALUE OF CT AND DOUBLE CONTRAST-ENHANCED ULTRASOUND IN TNM STAGING OF GASTRIC CANCER PATIENTS BEFORE OPERATION

Xin Li^#, Huabo Liang^#, Qiong Luo, Jun Wang^*

Department of Radiology, Jingmen People’s Hospital NO.2, Jingmen, Hubei, 44800, China

According to the TNM staging of gastric cancer patients before operation, CT and dual contrast-enhanced ultrasound were used to diagnose the tumors, and the diagnostic value was analyzed to provide the corresponding reference for clinical practice. The clinical data of 100 patients with gastric cancer admitted to Jingmen Second People's Hospital from January 2017 to December 2018 were retrospectively analyzed. All patients were confirmed by endoscopy and pathology. Three days before the operation, all patients were examined by CT and double contrast-enhanced ultrasound, and were staged according to the examination. Patients' satisfaction with the two methods of examination was compared and analyzed. The results were compared with the results of pathological TNM staging after the operation. Statistical analysis was carried out. Before CT examination, the accuracy rate of judging T1, T2, T3, T4 and T stages was 62.07%, 65.71%, 65.38%, 30.00% and 61.00%, respectively. The preoperative accuracy of double contrast-enhanced ultrasonography was 79.31%, 85.71%, 80.77%, 70.00% and 81.00% for T1, T2, T3, T4 and T stages respectively. By comparing the two diagnostic methods, double contrast-enhanced ultrasound was higher than CT, and the difference was statistically significant (P<0.05). Postoperative pathology confirmed that 47 cases had no lymph node metastasis (N0), 53 cases had lymph node metastasis (N+). Preoperative CT examination showed that the accuracy of N0 phase was 74.47%, N+ phase was 75.47%, and total N phase was 75.00%. Preoperative double contrast-enhanced ultrasonography showed that the accuracy of N0 phase was 78.72%, N + phase was 81.13%, and total N phase was 80.00%. Compared with the two diagnostic methods, double contrast-enhanced ultrasonography was higher than CT, but there was no significant difference (P>0.05). Postoperative pathology confirmed 61 patients in M0 stage and 39 patients in M1 stage. Preoperative CT examination showed that the accuracy of M0, M1 and M stages was 93.44%, 84.62% and 90.00%, respectively. The accuracy of preoperative double contrast-enhanced ultrasonography was 95.08% for M0, 89.74% for M1 and 93.00% for M. Compared with the two diagnostic methods, double contrast-enhanced ultrasound was higher than CT, but there was no significant difference (P>0.05). The total satisfaction rate of double contrast-enhanced ultrasound patients was 94.00% (94/100), and that of CT patients was 91.00% (91/100), with no significant difference (P>0.05). In the diagnosis of TNM staging of gastric cancer patients before operation, the accuracy of T staging before double contrast-enhanced ultrasound is higher than that of CT and the accuracy of N and M staging is higher and similar. Overall, the diagnostic effect of double contrast-enhanced ultrasound is better than that of CT, but it is suggested that clinical preoperative examination should be combined to improve the accuracy of preoperative TNM staging diagnosis, so as to provide more valuable reference for the formulation of treatment plan.