低剂量CT灌注成像对胃癌分化程度评估及Her2、EGFR水平相关性研究

目的探讨低剂量CT灌注成像对术前胃癌分化程度评估及与Her2、EGFR表达的相关性。 方法选取2019年8月至2020年1月江苏省苏北人民医院就诊的43例胃癌患者，术前1周行低剂量320排多层螺旋CT灌注扫描，得到灌注参数：血流量(BF)、血容量(BV)、毛细血管通透性(PS)和平均通过时间(MTT)，根据术后病理结果将低分化腺癌、印戒细胞癌和黏液腺癌分A组，将中高分化腺癌分为B组。再根据免疫组化结果，EGFR表达(-)为阴性组，EGFR表达(1＋、2＋)为阳性组；Her2表达(0、1＋)为阴性组，Her2表达(3＋)为阳性组，应用SPSS 19.0软件计算。 结果A组与B组间BF、BV、PS值有统计学差异，Her2、EGFR表达水平与各灌注参数均无明显相关性，同时，BF、PS值在EGFR表达阴性与阳性组间有统计学差异。 结论CT灌注成像可从体外非侵入性获得肿瘤内部血流灌注情况，灌注参数BF、BV、PS值对术前评估胃癌分化程度意义较大，而Her2、EGFR表达水平与灌注参数相关性较差，可作为辅助性观察指标。

Role of low-dose CT perfusion imaging in the evaluation of differentiation degree of gastric cancer and its correlation with Her2 and EGFR levels

ObjectiveTo investigate the role of low-dose CT perfusion imaging in the preoperative evaluation of differentiation degree of gastric cancer and its correlation with the expression of Her2 and EGFR in gastric cancer. MethodsA total of 43 patients with gastric cancer were selected from August 2019 to January 2020 in Jiangsu Subei People′s Hospital.Low-dose 320-row multi-slice spiral CT perfusion scan was performed one week before surgery, and perfusion parameters were obtained, including blood flow(BF), blood volume(BV), capillary permeability(PS)and mean passage time(MTT). According to the postoperative pathological results, the poorly differentiated adenocarcinoma, signet-ring cell carcinoma and mucinous adenocarcinoma were divided into group A, and the moderately well-differentiated adenocarcinoma was divided into group B. According to the results of immunohistochemistry, EGFR expression(-)was the negative group, and EGFR expression(1+ , 2+ )was the positive group.The expression of Her2(0, 1+ )was the negative group, and the expression of Her2(3+ )was the positive group.SPSS19.0 software was used for calculation. ResultsThe values of BF, BV and PS were statistically different between group A and group B, and there was no significant correlation between the expression levels of Her2 and EGFR and the perfusion parameters.Meanwhile, the values of BF and PS were statistically different between the EGFR negative and positive groups. ConclusionCT perfusion imaging can obtain tumor internal blood flow perfusion from non-invasive in vitro.The perfusion parameters BF, BV and PS are of great significance in preoperative evaluation of gastric cancer differentiation, while the expression levels of Her2 and EGFR are poorly correlated with the perfusion parameters, which can be used as auxiliary observation indicators.