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目的:探讨胃癌侵犯胃裸区(GBA)的CT解剖特点及其临床意义。方法:回顾性分析81例CT资料和临床资料完整的胃癌连续性病例,21例侵犯GBA,近侧胃癌(PGC)42例,远侧胃癌(DGC)39例。着重观察GBA受侵后宽度、厚度、密度的变化、左侧膈肌脚受累情况及腹膜后淋巴结转移情况。结果:(1)PGC与DGC在浸润深度、淋巴结转移、TNM分期方面有显著性差异;(2)PGC侵犯GBA发生率(40.5%)明显高于DGC(10.3%);(3)21例胃癌侵犯GBA病例中,有18例CT表现为GBA内软组织肿块(85.7%),9例左侧膈肌脚受侵(42.9%),10例膈下腹膜后淋巴结肿大(47.6%)。结论:胃癌侵犯GBA有一定的CT表现特征和解剖基础,CT术前评价胃癌侵犯GBA有重要意义。
Objective: To investigate the CT anatomical characteristics and clinical significance of stomach cancer invading gastric naked area (GBA). Methods: A retrospective analysis of 81 cases of CT data and clinical data of complete continuity of gastric cancer, 21 cases of violations of GBA, 42 cases of proximal gastric cancer (PGC), 39 cases of distal gastric cancer (DGC). The changes of the width, thickness and density of the GBA after invasion, the involvement of the left diaphragm and the retroperitoneal lymph node metastasis were observed. Results: (1) There was significant difference between PGC and DGC in the depth of invasion, lymph node metastasis and TNM staging. (2) The incidence of GBA in GBC was higher than that in DGC (40.5%) (10.3%). (3) Of the cases of GBA invasion, 18 cases showed soft tissue mass (85.7%) in GBA, 9 cases of diaphragm left foot (42.9%) and 10 cases of retroperitoneal lymph node enlargement (47.6%). Conclusion: There are certain CT features and anatomical bases for GBA invasion of gastric cancer. It is important to evaluate the invasion of GBA by gastric cancer before operation.