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中华消化病与影像杂志(电子版)

中华消化病与影像杂志(电子版) ›› 2024, Vol. 14 ›› Issue (05) : 422 -425. doi: 10.3877/cma.j.issn.2095-2015.2024.05.008

论著

胃癌旁肿瘤沉积与CT影像学特征、血清指标及病理特征的关联性分析
甘曦1, 廖鑫1,†()   
  1. 1. 400050　重庆市九龙坡区人民医院放射科
  • 收稿日期:2023-10-19 出版日期:2024-10-01
  • 通信作者: 廖鑫

Correlation analysis of tumor deposition near gastric cancer with CT imaging characteristics, serum indexes and pathological characteristics

Xi Gan1, Xin Liao1,†()   

  1. 1. Department of Radiology, Jiulongpo District People's Hospital of Chongqing, Chongqing 400050, China
  • Received:2023-10-19 Published:2024-10-01
  • Corresponding author: Xin Liao
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甘曦, 廖鑫. 胃癌旁肿瘤沉积与CT影像学特征、血清指标及病理特征的关联性分析[J]. 中华消化病与影像杂志(电子版), 2024, 14(05): 422-425.

Xi Gan, Xin Liao. Correlation analysis of tumor deposition near gastric cancer with CT imaging characteristics, serum indexes and pathological characteristics[J]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2024, 14(05): 422-425.

目的

分析胃癌旁肿瘤沉积与CT影像学特征、血清指标及病理特征的关联性。

方法

选取重庆市九龙坡区人民医院2020年1月至2023年1月收治的93例经病理检查明确胃癌诊断的患者，按照其肿瘤沉积情况，将患者分别纳入阳性组、阴性组。比较2组患者CT影像学特征、血清指标、病理特征的差异，使用Logistic多因素回归分析，评估上述特征与肿瘤沉积的关联。

结果

93例患者中，26例检出肿瘤沉积，肿瘤沉积阳性率为27.96%。阳性组与阴性组影像学分期、病灶静脉期强化特点比较，差异有统计学意义（P<0.05）。阳性组与阴性组血清癌胚抗原比较，差异有统计学意义（P<0.05）。阳性组与阴性组病理分期、脉管侵犯特点比较，差异有统计学意义（P<0.05）。Logistic多因素回归模型分析结果示，影像学分期T3～T4期、病理分期N3期、存在脉管侵犯为肿瘤沉积的独立危险因素（P<0.05）。

结论

部分胃癌患者存在癌旁肿瘤沉积，更高的影像学分期、病理分期以及脉管侵犯的发生均可能与肿瘤沉积有关。

关键词: 胃癌, 肿瘤沉积, CT影像学, 病理特征
Objective

To analyze the correlation between tumor deposition near gastric cancer and CT imaging features, serum indexes and pathological features.

Methods

A total of 93 patients with gastric cancer diagnosed by pathological examination in Jiulongpo District People's Hospital of Chongqing from January 2020 to January 2023 were selected and divided into positive group and negative group according to their tumor deposition. The differences of CT imaging features, serum indexes and pathological features between the two groups were compared, and the relationship between the above features and tumor deposition was evaluated by Logistic multivariate regression analysis.

Results

Among 93 patients, 26 patients were found with tumor deposition, and the positive rate of tumor deposition was 27.96%. There was statistically significant difference between the positive group and the negative group in imaging staging and enhancement characteristics of venous phase (P<0.05). There was statistically significant difference in serum CEA between the positive group and the negative group (P<0.05). There were statistically significant differences between the positive group and the negative group in pathological stages and vascular invasion characteristics (P<0.05). Logistic multivariate regression model analysis showed that imaging stage T3-4, pathological stage N3 and vascular invasion were independent risk factors for tumor deposition (P<0.05).

Conclusion

Some patients with gastric cancer have tumor deposition near cancer, and higher imaging staging, pathological staging and vascular invasion may be related to tumor deposition.

Key words: Gastric cancer, Tumor deposition, CT imaging, Pathological features
表1 2组患者CT影像学特征比较[例（%）]
组别 例数 影像学分期 病灶静脉期厚度 病灶静脉期强化 R
T2期 T3~T4a期 <1.8 cm ≥1.8 cm 均匀 不均匀 <0.96 ≥0.96
阳性组 26 2(7.69) 24(92.31) 11(42.31) 15(57.69) 10(38.46) 16(61.54) 13(50.00) 13(50.00)
阴性组 67 30(44.78) 37(55.22) 38(56.72) 29(43.28) 41(61.19) 26(38.81) 35(52.24) 32(47.76)
χ2值   11.414 1.56 3.908 0.038
P值   <0.001 0.212 0.048 0.846
组别 例数 动脉期R 静脉期R 延迟期R
<0.09 ≥0.09 <0.31 ≥0.31 <0.35 ≥0.35
阳性组 26 15(57.69) 11(42.31) 12(46.15) 14(53.85) 14(53.85) 12(46.15)
阴性组 67 31(46.27) 36(53.73) 34(50.75) 33(49.25) 32(47.76) 35(52.24)
χ2值   0.978 0.158 0.277
P值   0.323 0.691 0.598
表2 2组患者血清指标差异比较[例（%）]
组别 例数 CEA CA19-9 CA12-5 AFP
<5 ng/mL ≥5 ng/mL <37 U/mL ≥37 U/mL <35 U/mL ≥35 U/mL <9 ng/mL ≥9 ng/mL
阳性组 26 11(42.31) 15(57.69) 16(61.54) 10(38.46) 17(65.38) 9(34.62) 19(73.08) 7(26.92)
阴性组 67 44(65.67) 23(34.33) 52(77.61) 15(22.39) 55(82.09) 12(17.91) 56(83.58) 11(16.42)
χ2值   4.231 2.462 2.99 1.324
P值   0.04 0.117 0.084 0.391
表3 2组患者临床及病理特征比较[例（%）]
组别 例数 年龄 性别 病理分期 脉管侵犯 神经侵犯
<60岁 ≥60岁 男 女 N0~N2期 N3期 无 有 无 有
阳性组 26 7(26.92) 19(73.08) 19(73.08) 7(26.92) 6(23.08) 20(76.92) 4(15.38) 22(84.62) 8(30.77) 18(69.23)
阴性组 67 24(35.82) 43(64.18) 45(67.16) 22(32.84) 45(67.16) 22(32.84) 40(59.70) 27(40.30) 34(50.75) 33(49.25)
χ2值   0.667 0.305 14.701 14.758 3.018
P值   0.414 0.581 <0.001 <0.001 0.082
表4 多因素回归模型赋值表
变量名 变量 变量赋值
Y 肿瘤沉积 阴性=0，阳性=1
X1 影像学分期 T2期=1，T3~T4期=2
X2 静脉期强化 均匀=0，不均匀=1
X3 血清CEA <5 ng/mL=0，≥5 ng/mL=1
X4 病理分期 N0~N2期=1，N3期=2
X5 脉管侵犯 无=0，有=1
表5 影响胃癌旁肿瘤沉积的多因素回归分析结果
影响因素 β SE(β) Wald χ2值 P值 OR 95% CI
影像学分期T3~T4期 1.152 0.371 9.642 0.007 3.165 1.529~6.548
静脉期强化不均匀 0.589 0.495 1.416 0.136 1.802 0.683~4.755
血清CEA≥5 ng/mL 0.416 0.393 1.120 0.295 1.516 0.702~3.275
病理分期N3期 1.084 0.286 14.366 0.011 2.956 1.688~5.179
存在脉管侵犯 0.971 0.232 17.517 0.018 2.641 1.676~4.161
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