Diagnostic Value of 64-Slice Spiral CT Combined with Serum Tumor Markers in Lymph Node and Distant Metastasis of Gastric Cancer

Abstract

Background: Preoperative staging is of great significance in determining treatment strategies and outcome evaluation. This study aims to investigate the diagnostic value of 64-slice spiral computed tomography (CT) in combination with serum tumor markers for lymph nodes and distant metastasis in gastric cancer. Methods: We retrospectively analyzed the clinical data of 124 gastric cancer patients who underwent surgical treatment between April 2015 and April 2020. Based on the occurrence of lymph nodes and distant metastasis, the differences in CT examination results and tumor markers such as carcinoembryonic antigen (CEA), carbohydrate antigen 199 (CA199), and CA125 were compared. Results: The serum CEA and CA199 levels and the rate of positive lymph node identified through CT were significantly lower in the N0 group compared to the N1-3 group (p < 0.05). Similarly, the serum CEA, CA125 levels, and the rate of the positive lymph node were significantly lower in the M0 group than those in the M1 group (p < 0.05). Additionally, in diagnosing preoperative lymph node metastasis in gastric cancer, the areas under the curve of serum CEA, CA199 levels, and their combined detection were 0.602, 0.694, and 0.708, respectively. The areas under the curve of serum CEA and CA125 levels and their combined detection in the diagnosis of preoperative distant metastasis of gastric cancer were 0.657, 0.838, and 0.888, respectively. The sensitivity, specificity, and accuracy of 64-slice spiral CT in the diagnosis of preoperative lymph node metastasis in gastric cancer were 87.32%, 90.56%, and 88.71%, respectively. The combined diagnosis with serum CEA and CA199 levels exhibited a sensitivity of 91.55%, a specificity of 86.79%, and an accuracy of 89.52%. The sensitivity, specificity, and accuracy of 64-slice spiral CT in the diagnosis of preoperative distant metastasis in gastric cancer were 71.43%, 90.63%, and 86.29%, respectively. The combined diagnosis with serum CEA and CA125 levels demonstrated a sensitivity of 92.86%, a specificity of 88.54%, and an accuracy of 89.52%. Conclusion: 64-slice spiral CT combined with serum tumor markers can improve the diagnostic value of lymph node and distant metastasis of gastric cancer.