CTによる胃癌の術前リンパ節転移診断の現状

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  • THE ACCURACY OF CT IMAGING DIAGNOSIS OF LYMPH NODES METASTASIS OF GASTRIC CANCER

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In surgical resection of gastric cancer, upper abdominal CT scan is usually performed, but the diagnosing method of the presence of abdominal lymph node metastasis has not been established as yet. The purpose of this study was to evaluate the accuracy of diagnosing criteria for the lymph nodes metastasis that was designed based on CT imagings of cases of gastric cancer. Subjects were 72 cases of advanced gastric cancer who underwent gastrectomy with lymph noede dissection at the hospital. In our criteria, lymph node with the diameter of 1cm or more and smooth circumference on CT imaging was designated positive lymph node. The dissected lymph nodes from the 72 cases were analyzed according to our criteria, and compared with histological findings for the accuracy of CT imaging diagnosis. The corect diagnosing rates by locations were as low as 56.5%, 47.8%, and 75.0% at the lesser curvature area, greater curvature area, and celiac artery area, respectively.<br> In conclusion, the diagnosing ability of metastasis of gastric cancer to lymph nodes by CT is poor at present, and examinations other than CT are required for more accurate assessment.

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