目的 研究术前多模态MRI成像与MSCT图像评价胃癌T分期价值.方法 2017年1月至2019年12月于医院接受MRI成像与MSCT检查的胃癌患者术80例,根据检测方式分为对照组和实验组各40例;对照组采用MSCT检测;实验组采用MRI检测;分别对胃癌的术前T分期进评估,将检查结果与以手术组织学检测结果为"金标准"进行比较,比较两种方法的诊断效能.结果 对照组对胃癌T1期和T2期诊断符合率分别为75.00％、88.98％与实验组诊断符合率77.78％、88.89％差异无统计学意义(P>0.05);实验组对胃癌T3期和T4期诊断符合率分别为81.81％、90.91％显著高于对照组45.45％、50.00％(P<0.05);两种方式对T1期和T2胃癌的诊断效能差异无统计学意义,MRI对胃癌T3期和T4期诊断效能显著高于MSCT.结论 MRI成像与MSCT图像对于评价T1期和T2期胃癌无明显优势,但对于T3期和T4期MRI成像具有较大的优势.

目的 探讨多模态磁共振成像(MRI)与多层螺旋CT(MSCT)对胃癌患者术前临床病理(TNM)分期、浸润程度的评估价值.方法 选取自2020年1月至2022年5月于邯郸市中心医院接受治疗的80例胃癌患者为研究对象.根据TNM分期,将患者分为Ⅰ～Ⅱ期组(n=31)与Ⅲ～Ⅳ期组(n=49).根据浸润程度,将患者分为早期组(n=13)与进展期组(n=67).对所有患者进行多模态MRI与MSCT检查,分析两种方法的一致性.比较不同TNM分期、浸润程度患者MSCT检查指标、多模态MRI检查指标.结果 MSCT与多模态MRI对胃癌诊断一致性Kappa值为0.652,一致性较高.Ⅰ～Ⅱ期组患者肿瘤直径、肿瘤厚度、强化差值、不均匀强化比例低于Ⅲ～Ⅳ期组患者,差异有统计学意义(P＜0.05).进展期组患者肿瘤直径、肿瘤厚度、强化差值、不均匀强化比例高于早期组患者,差异有统计学意义(P＜0.05).Ⅲ～Ⅳ期组患者表观扩散系数、血管外细胞外间隙体积百分数、转运常数、速率常数高于Ⅰ～Ⅱ期组患者,差异有统计学意义(P＜0.05).早期组患者表观扩散系数、血管外细胞外间隙体积百分数、转运常数、速率常数高于进展期组患者,差异有统计学意义(P＜0.05).结论 基于多模态MRI与MSCT的影像学资料能够有效区分胃癌患者术前不同TNM分期和浸润程度.

OBJECTIVE:The aim of this study was to analyze the clinical characteristics and prognostic factors in patients with cancer of unknown primary site (CUP). METHODS:The clinical and follow-up data of 68 CUP patients (46 adenocarcinoma patients, 22 squamous cell carcinoma patients), were retrospectively analyzed. Univariate and multivariate analysis were conducted to determine the correlation of survival with clinical features, tumor markers, blood test, liver function and so on. RESULTS:The median survival time of the 68 CUP patients was 123 days. The results from univariate Cox regression analysis showed that the prognostic factors were related to a performance status, presence or absence of liver metastases, the number of metastatic sites, carcinoembryonic antigen (CEA), lactate dehydrogenase (LDH), hypoalbuminemia, hypohemoglobinemia and lymphocyte count. Multivariate Cox regression analysis of the clinical factors identified that a performance status (PS) ≥ 2, liver metastasis, elevated serum carcinoembryonic antigen (CEA) and lactate dehydrogenase (LDH) levels, hypoalbuminemia (< 35 g/L) and lymphopenia (≤ 0.7 × 10(9)/L) were significant independent unfavorable predictive factors. Based on the number of the unfavorable predictive factors, we divided all the patients into three subgroups: subgroup involving 0-1 unfavorable factor, subgroup involving 2 - 3 unfavorable factors and subgroup involving 4 - 6 unfavorable factors. The median survival time was 390 days, 138 days and 77 days, respectively, in the 3 subgroups. Compared with the other two groups, the survival of the subgroup involving 0 - 1 unfavorable factor was significantly longer (P < 0.05), the survival between the subgroup involving 2 - 3 unfavorable factors and subgroup involving 4 - 6 unfavorable factors was not significantly different (P > 0.05). CONCLUSIONS:A performance status ≥ 2, liver metastasis, elevated serum carcinoembryonic antigen and lactate dehydrogenase levels, hypoalbuminemia and lymphopenia are independent unfavorable prognostic factors in patients with cancer of unknown primary site. The patients who had more than 2 unfavorable prognostic factors have a worse prognosis.

便秘是恶性肿瘤的常见并发症,严重影响患者的生活质量.医学的目标不只是保存生命与改善器官功能,患者的生活质量已成为另一个公认的疗效评价指标[1,2].本研究以恶性实体肿瘤患者为观察对象,调查便秘的发生现状,为其治疗提供依据.