Combined multidetector computed tomography and gastrointestinal endoscopy for gastric cancer screening, preoperative staging, and lymph node metastasis detection.

BACKGROUND: Early screening, preoperative staging, and diagnosis of lymph node metastasis are crucial for improving the prognosis of gastric cancer (GC). AIM: To evaluate the diagnostic value of combined multidetector computed tomography (MDCT) and gastrointestinal endoscopy for GC screening, preoperative staging, and lymph node metastasis detection, thereby providing a reference for clinical diagnosis and treatment. METHODS: In this retrospective study clinical and imaging data of 134 patients with suspected GC who were admitted between January 2023 and October 2024 were initially reviewed. According to the inclusion and exclusion criteria, 102 patients were finally enrolled in the analysis. All enrolled patients had undergone both MDCT and gastrointestinal endoscopy examinations prior to surgical intervention. Preoperative clinical staging and lymph node metastasis findings were compared with pathological results. RESULTS: The combined use of MDCT and gastrointestinal endoscopy demonstrated a sensitivity of 98.53%, specificity of 97.06%, accuracy of 98.04%, positive predictive value of 98.53%, and negative predictive value of 97.06% for diagnosing GC. These factors were all significantly higher than those of MDCT or endoscopy alone (P < 0.05). The accuracy rates of the combined approach for detecting clinical T and N stages were 97.06% and 92.65%, respectively, outperforming MDCT alone (86.76% and 79.41%) and endoscopy alone (85.29% and 70.59%) (P < 0.05). Among 68 patients with confirmed GC, 50 (73.53%) were pathologically diagnosed with lymph node metastasis. The accuracy for detecting lymph node metastasis was 66.00% with endoscopy, 76.00% with MDCT, and 92.00% with the combined approach, all with statistically significant differences (P < 0.05). CONCLUSION: The combined application of MDCT and gastrointestinal endoscopy enhanced diagnostic accuracy for GC, provided greater consistency in preoperative staging, and improved the detection of lymph node metastasis, thereby demonstrating significant clinical utility.