【摘要】 目的总结AFP阳性胃癌(alpha-fetoprotein-producing gastric cancer,AFPGC)的CT表现,评估CT在AFPGC术前分期中的临床价值。方法由两名放射科医生共同回顾性阅读21例经病理证实的AFPGC术前CT图像,描述原发病灶、脏器受累、淋巴结转移、远处转移、血管侵犯等CT表现,并与病理结果比较,分析其用以术前分期的准确率。结果 21例AFPGC术前CT表现如下:15例(71.4%)原发灶为偏心性胃壁增厚,20例(95.2%)原发灶为不均匀强化,6例(28.6%)脏器侵犯,19例(91.5%)淋巴结转移,6例(28.6%)远处转移,13例(61.9%)血管侵犯。CT对AFPGC术前T分期、N分期、M分期及TNM分期的准确率分别为90.5%、71.4%、71.4%和71.4%。结论 AFPGC的CT影像表现为不均匀强化的偏心性胃壁增厚,有较强的肝转移、淋巴结转移及周围脏器和血管侵犯的倾向。CT能够较准确地判断AFPGC的术前分期。更多还原

【Abstract】 Objective To summarize CT manifestations of alpha-fetoprotein-producing gastric cancer (AFPGC) and investigate the value of CT in preoperative tumor staging. Methods The CT images of twenty one patients with histologically proven AFPGC were retrospectively evaluated by two radiologists. CT manifestations including primary tumor , adjacent organ invasion, lymphatic metastasis, distant metastasis and blood vessel involvement were noted and compared with clinicopathological staging. Results Consentaneous CT manifestations included eccentric gastric wall thickening in 15 (71.4% ), heterogeneous gastric wall enhancement in 20 (95.2%), adjacent organ invasion in 6 (28.6%), regional lymph node metastasis in 19 (91.5%), distant metastasis in 6 (28.6%), and blood vessel involvement in 13 (61.9%) cases. The accuracy of CT for T, N, M and TNM staging of AFPGC were 90.5%, 71.4%, 71.4% and 71.4%, respectively. Conclusions AFPGC often appears as eccentric gastric wall thickening and heterogeneous enhancement on CT images , which has a strong tendency of liver metastasis , lymph node metastasis, adjacent organ invasion and blood vessel involvement. CT is helpful in preoperative diagnosis and staging for AFPGC.更多还原