Assessment of Lymph Node Status in Gastric Cancer. Part 2: Diagnostic Efficacy of Computed Tomography for the Detection of Lymph Node Metastases in Gastric Cancer Patients

The aim of the study was to determine the diagnostic efficacy of computed tomography (CT) in detecting of regional lymph nodes metastases in gastric cancer patients. Materials and methods. Work is based on the comparison of clinical and pathologic features in 69 gastric cancer patients (42 (61%) men, 27 (39%) women, ranging in age from 24 to 79 years). All of the patients underwent preoperative multidetector computed tomography (MDCT). Parameters of lymph nodes evaluated were presence or absence of nodes in the regional areas, their number, size and shape. Statistical analyses were performed with SPSS statistical software version 13.0. The qualitative data were evaluated with Pearson х² test; the diagnostic values of lymph node shape for delectability of lymph node metastasis were evaluated by Receiver Operating Characteristic (ROC) analysis. Results. The frequency of lymph node metastasis was associated significantly with their number (three or more) (х² = 8.395; p = 0.004), size (up to 10 mm or more than 10 mm) (х² = 8.448; Р=0,002), and node shape (the ratio of long and short diameters <1.5 site) (х² = 9.996; Р = 0.001). Sensitivity of computed tomography in the assessment of metastatic lymph nodes were 86.4%, specificity - 89.4%, accuracy - 88.4%, positive predictive value - 79.2%, and its negative predictive value - 93.3%. Conclusion. The use of CT criteria and regional lymph node assessment scheme improves the preoperative evaluation and allows the radiologist to examine successively every possible zone of regional lymph nodes localization. Combination of factors such as: the location of lymph nodes, three or more nodes, and enlargement 10 mm or more, their rounded shape was the optimal diagnostic criterion for lymph node metastasis in patients with gastric cancer.

рак желудка, регионарные лимфатические узлы, метастазы, компьютерная томография, gastric cancer, regional lymph nodes, metastases, computed tomography

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