Department of Radiology & Imaging, Nanjing First Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu 210006, China.
Chin Med J (Engl). 2011 Feb;124(3):347-51.
Many studies have shown that cancer cell differentiation and microvascular invasion play a principle role in cancer progression and metastasis, and non-invasive imaging techniques such as CT, MRI and US assessing the differentiation and the surgical resectibility and the prognosis of cancers are now of great importance. This study aimed to explore the correlation of triple-phase multi-slice CT scan with the histological differentiation and intratumor microvascular/lymphatic invasion of progressive gastric cancer.
The present study included 64 patients with gastric cancer, all of whom underwent routinal and dual-phase contrast enhancement multi-slice CT examinations of the upper abdomen before surgery. The post-operative specimens were used for determination of histological differentiation, cancer cell invasion of intratumoral microvascular/lymphatic vessel identified by CD34 and D2-40 expression. Correlations between contrast enhancement ratio (CER) of triple-phase multi-slice CT scan in gastric cancer and histological differentiation as well as intratumoral microvascular/lymphatic invasion were compared and analyzed.
There was a significant correlation between CER of triple-phase CT scan in gastric cancer and tumor histological differentiation (P < 0.05). CER of the arterial phase in gastric cancer with intratumoral microvascular invasion was significantly higher than that without invasion (0.61 ± 0.28 vs. 0.46 ± 0.14, P < 0.05); CER of the arterial-parenchymal phase was significantly lower in gastric cancer with intratumoral microvascular invasion than that without invasion (1.81 ± 0.39 vs. 2.28 ± 0.80, P < 0.05). However, CER of the parenchymal phase in gastric cancer with intratumoral lymphatic invasion was significantly higher than that without invasion (1.25 ± 0.57 vs. 1.00 ± 0.35, P < 0.05).
CER of triple-phase multi-slice CT scan in gastric cancer is closely correlated with intratumoral microvascular and lymphatic invasion, and also could be used as a marker for histological differentiation.
许多研究表明，癌细胞分化和微血管侵犯在癌症进展和转移中起着重要作用，现在非侵入性成像技术如 CT、MRI 和 US 评估癌症的分化、手术可切除性和预后非常重要。本研究旨在探讨三期多层 CT 扫描与进展期胃癌的组织学分化及肿瘤内微血管/淋巴管侵犯的相关性。
本研究纳入 64 例胃癌患者，所有患者均在术前接受常规和双期增强多层 CT 上腹部检查。术后标本用于确定组织学分化、CD34 和 D2-40 表达鉴定的肿瘤内微血管/淋巴管侵犯的癌细胞浸润。比较并分析三期多层 CT 扫描胃癌对比增强率（CER）与组织学分化及肿瘤内微血管/淋巴管侵犯的相关性。
胃癌三期 CT 扫描 CER 与肿瘤组织学分化有显著相关性（P<0.05）。伴有肿瘤内微血管侵犯的胃癌动脉期 CER 明显高于无侵犯者（0.61±0.28 比 0.46±0.14，P<0.05）；伴有肿瘤内微血管侵犯的胃癌动脉-实质期 CER 明显低于无侵犯者（1.81±0.39 比 2.28±0.80，P<0.05）。然而，伴有肿瘤内淋巴管侵犯的胃癌实质期 CER 明显高于无侵犯者（1.25±0.57 比 1.00±0.35，P<0.05）。
胃癌三期多层 CT 扫描 CER 与肿瘤内微血管和淋巴管侵犯密切相关，也可作为组织学分化的标志物。
