胃癌的多层CT增强征象与其组织分化、p53表达的相关性探讨

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表达的关系。材料与方法：66例胃癌患者术前均行上腹部多层CT常规及双期增强检查。术后标本经常规HE染色确定组织分化和免疫组化检测p53的表达。比较胃癌的多层CT增强征象与其组织分化及p53在胃癌中表达之间的关系。结果：本组研究结果表明胃癌的强化方式与其组织分化及p53在胃癌中表达有关，73．1％（19／26）均匀强化的胃癌病理为高／中分化腺癌，75％（30／40）分层强化或不均匀强化的胃癌病理为低分化腺癌，两者比较有显著差异（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在分层强化或不均匀强化的胃癌中阳性表达显著高于在均匀强化的胃癌中阳性表达（P〈0．05）。p53阳性表达与动脉期强化率、肿瘤大小和淋巴结转移有关（P〈0．05），与肿瘤胃壁浸润厚度、门脉期强化率无关（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阳性表达，提示胃癌的多层CT增强征象与其组织分化及p53表达有较密切的相关性。

A correlative study of MSCT enhancement presentation with histo-differentiation and p53 expression in gastric cancer

Objective: To investigate the relationship of enhanced MSCT signs of gastric carcinoma to its histological dif-ferentiation and expression of p53. Materials and Methods: Total 66 patients of gastric carcinoma were routinely studied preoperatively with dual-phase enhanced CT scan. Routine hematoxylin and immunohistochemical staining of the surgical tumor specimens of all patients was visualized for the histological differentiation and the expression of p53 respectively. The correla-tion between enhanced MSCT signs of gastric carcinoma and its histological differentiation and expression of p53 were ana-lyzed. Results: The correlation was found between enhanced characteristics of gastric carcinoma and its histological differentia-tion and expression of p53. Homogenous enhancement showed high/moderate differentiation of adenocarcinoma in 73.1%(19/26). Layered or inhomogenous enhancement showed poorly differentiated adenocarcinoma in 75%(30/40),the difference had statisti-cally significance (P=0.000). Dual-phase enhanced rate had no correlation with histological differentiation of gastric carcinoma (P>0.05). The positive expression of p53 in layered or inhomogenous enhanced characteristics of gastric carcinoma was signifi-cantly different from that in homogenous enhanced characteristics(P<0.05). The positive expression of p53 was relative to arte-rial-phased enhanced rate and tumor size and lymph node metastasis of gastric cancer (P<0.05). Conclusion: Tumor different enhancement and dual-phase enhanced rate reflects various histological differentiation and the positive expression of p53 in gastric carcinoma,which suggests that enhanced MSCT signs of gastric carcinoma are closely correlative to its histological dif-ferentiation and expression of p53.