Yin Xin-dao, Huang Wen-bin, Zhang Lin, Wang Li-ping, Lu Ling-quan, Wang Li-wei, Xie Guang-hui, Wu Qian-zhi, Wang Shu-zhi, Gu Jian-ping
Department of Radiology, The First Affiliated Nanjing Hospital, Nanjing Medical University, Nanjing 210006, China.
Zhonghua Wei Chang Wai Ke Za Zhi. 2010 Oct;13(10):728-31.
To explore the associations of triple-phase enhancement multi-slice CT scan with histological differentiation and lymphovascular invasion in advanced gastric cancer.
Patients with gastric cancer undergoing surgical resection between January 2006 and December 2009 were included, all of whom underwent routine and two-phase contrast enhancement multi-slice CT examinations of the upper abdomen before surgery. Patients with incomplete data were excluded. Postoperative specimens were used for evaluation of histological differentiation, microscopic lymphovascular invasion, and CD34 and D2-40 expression. Associations between contrast enhancement ratio (CER) of triple-phase multi-slice CT scan and differentiation as well as lymphovascular invasion were analyzed.
A total of 64 patients were included. There were significant associations between CER and tumor differentiation (P<0.05). Compared to those without microvascular invasion, CER of the arterial phase in gastric cancer with microvascular invasion was significantly higher (0.61±0.28 vs. 0.46±0.14, P<0.05), and that of the arterial-parenchymal phase was significantly lower(1.81±0.39 vs. 2.28±0.80, P<0.05). However, gastric cancers with lymphatic invasion were associated with significantly higher CER of the parenchymal phase than their counterparts(1.25±0.57 vs. 1.00±0.35, P<0.05).
CER of triple-phase multi-slice CT scan can reveal the differentiation of gastric cancer and is associated with microvascular and lymphatic invasion.
探讨多排螺旋CT三期增强扫描与进展期胃癌组织学分化及脉管侵犯的相关性。
纳入2006年1月至2009年12月期间接受手术切除的胃癌患者，所有患者术前均接受上腹部常规及双期对比增强多排螺旋CT检查。排除数据不完整的患者。术后标本用于评估组织学分化、微血管侵犯以及CD34和D2-40表达。分析多排螺旋CT三期增强扫描的对比增强率（CER）与分化程度以及脉管侵犯之间的相关性。
共纳入64例患者。CER与肿瘤分化之间存在显著相关性（P<0.05）。与无微血管侵犯的患者相比，有微血管侵犯的胃癌患者动脉期CER显著更高（0.61±0.28 vs. 0.46±0.14，P<0.05），而动脉-实质期CER显著更低（1.81±0.39 vs. 2.28±0.80，P<0.05）。然而，有淋巴侵犯的胃癌患者实质期CER显著高于无淋巴侵犯的患者（1.25±0.57 vs. 1.00±0.35，P<0.05）。
多排螺旋CT三期增强扫描的CER可显示胃癌的分化情况，并与微血管和淋巴侵犯相关。
