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KMID : 1103720130690050391
Journal of the Korean Society of Radiology
2013 Volume.69 No. 5 p.391 ~ p.398
Preoperative Multidetector CT Manifestations of Perigastric Lymph Nodes in Patients with Early Gastric Cancer and pN0
Kang Jung-Hyun

Yu Jeong-Sik
Chung Jae-Joon
Kim Joo-Hee
Cho Eun-Suk
Kim Ki-Whang
Abstract
Purpose: To find the determinant of lymph node (LN) manifestations on preoperative multidetector CT (MDCT) in early gastric cancer (EGC) patients with pN0.

Materials and Methods: One hundred and eighty-six consecutive patients with pT1pN0, the largest perigastric LN on preoperative MDCT, were categorized into two groups according to 8 different parameters [short (SD) and long diameter (LD) 4/6/8 mm, average attenuation 100 Hounsfield unit, short-to-long diameter-ratio (SLR) 0.7], and correlated with the size, gross type, depth of invasion and microscopic type of their primary lesions by the chi-square test and multiple logistic regression analysis.

Results: When the primary lesion was larger than 3 cm, the LNs were larger in 4 parameters (SD or LD, 4/6 mm; p < 0.05); gross type IIb patients showed smaller LNs in 5 parameters (SD 4/6 mm, LD 4/6/8 mm; p < 0.05); and patients with microscopically-undifferentiated lesions showed larger LNs in SD 4 mm or LD 8 mm by the chi-square test and multiple logistic regression analysis. The depth of invasion showed no significant difference in LN size. No factors revealed significant difference in LN attenuation or SLR.

Conclusion: Benign regional LN enlargement is more frequent in EGC patients with larger size primary lesions or lesion with poor microscopic differentiation. However, this condition is less frequent in gross type IIb patients.
KEYWORD
Stomach Neoplasm, Lymph Nodes, Neoplasm Staging, Multidetector Computed Tomography
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