摘要
目的初步研究进展期胃癌的多层CT增强征象与肿瘤组织分化及p53、P-糖蛋白(P-gp)表达的关系。资料与方法手术切除且资料完整的胃癌患者66例。所有病例术前均行上腹部多层CT常规及双期增强检查,观察内容包括肿瘤部位、最大直径、胃壁浸润厚度、双期强化率、淋巴结转移等。术后标本经10%甲醛固定、石蜡包埋、组织切片,采用常规HE染色确定组织分化和免疫组织化学检测p53、P-gp在胃癌中表达。比较胃癌的多层CT增强征象与组织分化及p53、P-gp在胃癌表达间的关系。结果73.1%(19/26)均匀强化的胃癌为高/中分化腺癌,75%(30/40)分层强化或不均匀强化的胃癌为低分化腺癌,两者比较差异有统计学意义(P=0.000)。CT双期增强的强化率与胃癌组织分化无关(P>0.05);p53、P-gp在分层强化或不均匀强化的胃癌中阳性表达率显著高于在均匀强化的胃癌中阳性表达(P<0.05)。p53阳性表达还与动脉期强化率、肿瘤大小和淋巴结转移有关(P<0.05),与胃壁浸润厚度、门静脉期强化率无关(P>0.05);而P-gp表达与门静脉期强化率有关(P=0.005),与动脉期强化率、胃壁浸润厚度、肿瘤大小和淋巴结转移无关(P>0.05)。结论胃癌不同的强化方式和双期强化率反映了胃癌的不同组织分化和p53、P-gp阳性表达,提示胃癌的多层CT增强征象与其组织分化及p53、P-gp表达有较密切的相关性。
Objective To investigate the relationship of enhanced CT（MSCT） signs of gastric carcinoma to its histological differentiation and expression of p53 and P glucoprotein（P-gp）. Materials and Methods Total 66 patients of gastric carcinoma from April 2005 to April 2007 were preoperatively per＇formed routine and dual phase enhanced CT scan. Tumor location, maximum diameter, the wall depth of invasion, dual phase enhanced rate, lymph node metastasis about gastric carcinoma were analyzed. Tumor surgical specimens of all patients were collected. Routine hematoxylin and immunohistochemical staining of formalin fixed paraffin embedded tissue sections of those specimens was visualized for the histological differentiation and the expression of p53 and P-gp respectively. The correlation between enhanced MSCT signs of gastric carcinoma and its histological differentiation and expression of p53 and P-gp was analyzed. Results The correlation was found between enhanced characteristics of gastric carcinoma and its histological differentiation and expression of p53 and P-gp. 73.1% （19/26） homogenous enhancement showing highly/moderately differentiated adcnocarcinoma were statistically different from 75% （30/40） layered or inhomogenous enhancement showing poorly differentiated adenocarcinoma （ P = 0. 000）. Dual phase enhanced rate was no correlation with histological differentiation of gastric carcinoma（P 〉 0.05 ）. The positive expression of p53 ,P-gp in layered or inhomogenous enhanced characteristics of gastric carcinoma was significantly higher than that in homogenous enhanced characteristics （ P 〈 0.05）. The positive expression of p53 was also relative to arterial phased enhanced rate and tumor size and lymph node metastasis of gastric cancer（ P 〈 0.05 ）. P-gp expression of gastric carcinoma was associated with portal phased enhanced rate（ P=0.005 ）and not with arterial phased enhanced rate and the wall depth of invasion and tumor size and lymph node metastasis （P 〉 0.05）. Conclusion Tumor different enhancement and dual phase enhanced rate reflect various histological differentiation and the positive expression of p53 and P-gp in gastric carcinoma, which suggest that enhanced MSCT signs of gastric carcinoma are better correlative to its histological differentiation and expression of p53 and P-gp.
出处
《临床放射学杂志》
CSCD
北大核心
2008年第11期1516-1519,共4页
Journal of Clinical Radiology
