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中华放射肿瘤学杂志
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中华放射肿瘤学杂志  2016, Vol. 25 Issue (1): 54-58    DOI: 10.3760/cma.j.issn.1004-4221.2016.01.014
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胰腺癌CTV范围的多排螺旋CT与病理学研究
董猛,常冬姝,胡琪璐,郑吉春,任力,石怀银,夏廷毅
100142 北京,解放军空军总医院放疗科(董猛、常冬姝、胡琪璐、夏廷毅),病理科(郑吉春、任力);解放军总医院病理科(石怀银);大连医科大学(董猛、胡琪璐、夏廷毅)
A study on clinical target volume of pancreatic cancer under the scope of ct scanning and patholog
Dong Meng,Chang Dongshu,Hu Qilu,Zheng Jichun,Ren Li,Shi Huaiyin,Xia Tingyi
Department of Radiation Oncology (Dong M,Chang DSH,Hu QL,Xia TY),Department of Pathology (Zheng JCH,Ren L),Air Force General Hospital of PLA,Beijing 100142,China;Department of Pathology ,General Hospital of PLA,Beijing 100039,China(Shi HY);Dalian Medical University (Dong M,Hu QL,Xia TY))
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摘要  目的 探索胰腺癌原发灶CT扫描与术后病理大小的关系及显微病灶浸润范围,以确定放疗靶区勾画中CTV范围。方法 对2013—2014年在解放军总医院和空军总医院收治的19例胰腺癌患者进行研究。15例被测量术前多排螺旋CT图像和术后大体标本上肿瘤横断面最大直径,19例被在显微镜下测量病理切片上肿瘤浸润范围和计算的实际浸润范围。配对t检验不同测量方法结果差异。结果 15例患者大体标本、CT测量的肿瘤最大直径分别为33.6、30.1 mm (P=0.000),二者差值的中位数、平均值分别为3.1 mm (1.2~8.0 mm)、(3.6±2.0) mm,95%CI为1.2~6.0 mm。19例患者最大实际浸润距离、最大测量距离分别为3.50、3.19 mm (P=0.000),二者差值的中位数和平均值分别为0.31 mm (0.15~0.50 mm)、(0.30±0.09) mm。原发灶边缘至浸润灶距离最大值为5.21 mm,中位数、平均值分别为3.34 mm (2.19~5.21 mm)、(3.50±0.88) mm,95%CI为2.19~5.06 mm。结论 增强CT低估了胰腺癌原发灶实际大小,在GTV基础上外扩5 mm作为CTV可能不够充分,建议再增加1~3 mm。
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董猛
常冬姝
胡琪璐
郑吉春
任力
石怀银
夏廷毅
关键词 体层摄影术X线计算机病理学胰腺肿瘤/放射疗法临床靶体积    
Abstract: Objective To compare the tumor sizes of primary lesions in pancreatic cancer based on CT scan and postoperative pathological analysis and measure the extent of filtration under a microscope, and to determine the CTV in radiotherapy target delineation. Methods A total of 19 patients with pancreatic cancer who were admitted to PLA General Hospital and Air Force General Hospital, PLA from 2013 to 2014 were analyzed. In 15 patients, the maximum diameters of tumor cross-section were measured based on the images of preoperative multi-slice spiral CT and postoperative gross samples, respectively. In 19 patients, the extent of tumor infiltration was measured on pathological sections under a microscope and the actual extent of infiltration was calculated. The paired t-test was applied to analyze the differences in the results of different measurement methods. Results In the 15 patients, the maximum tumor diameters measured with gross samples and CT scan were 33.6 mm and 30.1 mm, respectively (P=0.000), and the median and mean of the differences were 3.1 mm (1.2-8.0 mm) and 3.6±2.0 mm, respectively (95%CI 1.2-6.0). In the 19 patients, the maximum actual infiltration distance and the maximum distance measured were 3.50 mm and 3.19 mm, respectively (P=0.000), and the median and mean of the differences were 0.31 mm (0.15-0.50 mm) and 0.30±0.09 mm, respectively. The maximum distance between the margin of primary lesions and the infiltrating lesions was 5.21 mm, with a median of 3.34 mm (2.19-5.21 mm) and a mean of 3.50±0.88 mm (95%CI 2.19-5.06). Conclusions Contrast-enhanced CT scan underestimates the actual size of primary lesions in pancreatic cancer, and an extension of 5 mm outside gross tumor volume (GTV) as CTV may not be sufficient. It is recommended to extend another 1-3 mm outside GTV as CTV.
Key words Tomography,X-ray computed    Pathology    Pancreatic neoplasms/radiotherapy    Clinical target volume   
收稿日期: 2014-12-23     
通讯作者: 夏廷毅,Email:xiatingyi1959@163.com   
引用本文:   
董猛,常冬姝,胡琪璐等. 胰腺癌CTV范围的多排螺旋CT与病理学研究[J]. 中华放射肿瘤学杂志, 2016, 25(1): 54-58.
Dong Meng,Chang Dongshu,Hu Qilu et al. A study on clinical target volume of pancreatic cancer under the scope of ct scanning and patholog[J]. Chinese Journal of Radiation Oncology, 2016, 25(1): 54-58.
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