胃癌浸润转移:螺旋CT与病理、COX-2蛋白及mRNA表达的相关性研究

目的 探讨胃癌螺旋CT浸润转移与病理及环氧合酶（COX）-2蛋白表达间的关系。资料与方法 对57例胃癌行低张力水充盈螺旋CT三期增强扫描，所有病例均行手术切除，术后标本采用免疫组织化学SP法、原位杂交实验检测肿瘤组织中COX-2蛋白、mRNA表达。将螺旋CT结果与病理结果、COX-2表达进行对照。结果 57例胃癌螺旋CT浸润深度的准确性为82．5％（47／57），淋巴结转移的准确性为78．9％（45／57），4例胃癌发生远处转移螺旋CT均正确诊断，TNM分期的准确性为80．7％（46／57）。COX-2蛋白及mRNA阳性表达率分别为61．4％（35／57）和73．7％（42／57）。CT对胃癌浸润深度、淋巴结转移、TNM分期与病理一致性良好，与COX-2蛋白及mRNA表达率均密切相关（P〈0．05）。结论 螺旋CT可较准确地反映胃癌浸润转移的病理学及生物学特性，从而可指导手术、化学预防和治疗以及评估预后。

The Study of Correlation with Spiral CT and Pathology, the Protein and mRNA Expression of COX-2 in Invasion and Metastasis of Gastric Carcinoma

Objective To investigate the correlation with spiral CT and pathology, the expression of COX-2 in invasion and metastasis of gastric carcinoma. Materials and Methods A total of 57 patients with gastric cancer were evaluated with triphasic spiral CT with water filling method and hypotonic agent. All the patients were performed operative excision. The protein and mRNA expression of COX-2 was detected with immunohistochemical techniques and in situ hybridization techniques. Spiral CT findings were compared with results of postoperative pathology and the expression of COX-2.Results The accuracy of spiral CT was 82.5% (47/57) for the degree of invasion, 78.9% (45/57) for the lymph node meatastasis and 80.7% (46/57) for TNM staging in gastric carcinoma. Spiral CT accurately diagnosed 4 cases of distant metastasis. The protein and mRNA positive rate of COX-2 protein was 61.4% (35/57) and 73.7% (42/57) respectively. Spiral CT features included serosal invasion, lymph node metastasis and TNM staging were correlated with postoperative pathology and the expression of COX-2 of gastric carcinoma (P< 0.05). Conclusion Triphasic spiral CT can accurately reveal the depth of invasion, lymph node metastasis and TNM staging of gastric carcinoma, which could help us to know the pathological and biological characteristics of invasions and metastasis in gastric carcinoma, and to guide operation and prognosis.