胃癌螺旋CT征象与磷酸酶基因、碱性成纤维细胞生长因子表达间关系的研究

Study on the correlation between spiral CT features and expression of phosphatase and tensin homlogy deleted on chormosome ten,basic fibroblast grouth factor in gastric carcinoma

目的探讨胃癌浸润转移的螺旋CT表现及与磷酸酶基因(PTEN)、碱性成纤维细胞生长因子(bFGF)表达的相关关系。方法对83例进展期胃癌行螺旋CT平扫及三期动态增强扫描。术后标本常规石蜡包埋及5μm切片后行HE及PTEN、bFGF免疫组织化学染色。将螺旋CT征象与PTEN、bFGF的表达相对照。结果(1)CT对T_2与T_(3～4)期胃癌诊断正确率为94．0%(78/83),淋巴结有无转移正确率为89．2%(74/83)。(2)胃癌组织中PTEN表达率为47．0%(39/83),T_(3～4) (40．8%,29/71)、淋巴结转移组(38．3%,23/60)PTEN表达率明显低于T_2(10/12)、非淋巴结转移组(16/23),差异有统计学意义(X^2=7．439,P=0．006；X^2=6．511,P=0．011)。(3)胃癌组织中bFGF高表达率为63．9%(53/83),T_(3～4)(70．4%,50/71)、淋巴结转移组(71．7%,43/60)bFGF高表达率明显高于T_2(3/12)、非淋巴结转移组(10/23),差异有统计学意义(X^2=7．314,P=0．007；X^2=5．724,P=0．017)。(4)16例PTEN表达同时bFGF高表达,PTEN(41．0%,16/39)与bFGF(30．2%,16/53)表达呈负相关(r=-0．447,P=0．000)。结论螺旋CT增强扫描与分子生物学相结合可提高对胃癌侵袭、转移和预后评估的准确性。

Objective To investigate the spiral CT features of gastric carcinoma in the invasion and metastasis and its correlation with the expression of phosphatase and tensin homlogy deleted on chormosome ten （PTEN） and basic fibroblast grouth factor （bFGF）. Methods Spiral CT plain scan and triphasic enhanced scans were performed in 83 patients. The postoperative specimens were embedded with paraffin to obtain 5μm thickness tissues and stained with HE and immunohistochemistry. Spiral CT findings were compared with the expression of phosphatase and tensin horology deleted on chormosome ten （ P-FEN ） and basic fibroblast growth factor （bFGF）. Results （ 1 ）The accuracy of spiral CT in T and N staging of gastric carcinoma was 94. 0% （ 78/83 ） and 89. 2% （74/83）, respectively. （ 2 ） The expression of P-FEN was 47.0% （ 39/83 ） in gastric carcinoma. The expression of PTEN in T3-4 （ 40. 8% , 29/71 ） and N1 ＋2 （38.3%, 23/60）gastric carcinoma was significantly lower than that of T2 （ 10/12 ） and No （ 16/23 ）gastric carcinoma, respectively （χ^2 =7.439, P =0. 006; χ^2 =6. 511, P =0. 011 ）. （3） The expression of bFGF was 63.9% （53/83） in gastric carcinoma. The expression of bFGF in T3-4 （70. 4%, 50/71 ）and N1 ＋2 （71.7 %, 43/60 ） gastric carcinoma was significantly higher than that of T2 （ 3/12 ） and NO （ 10/23 ） gastric carcinoma, respectively （ χ^2 = 7. 314, P = 0. 007; χ^2 = 5. 724, P = 0. 017 ）. （4） Both PTEN-positive expression and bFGF-positive expression were detected in 16 specimens. The expression of PTEN（41.0% , 16/39） was negatively correlated with that of bFGF （30. 2%, 16/53 ） （ r = - 0. 447, P = 0. 000）. Conclusion Spiral CT triphasic enhanced scans combined with biologic characteristics can improve diagnostic accuracy of gastric carcinoma in the invasion, metastasis and prognosis.