胃癌螺旋CT诊断与癌组织中环氧合酶-2蛋白的测定

Spiral CT diagnosis of gastric carcinoma and cyclooxygenase-2 detection in carcinoma tissue

目的:探讨螺旋CT对胃癌的诊断价值及螺旋CT征象与癌组织中环氧合酶-2(COX-2)蛋白表达间的关系。方法:胃癌患者55例(男39例,女16例;TNM分期:Ⅰ期5例,Ⅱ期13例,Ⅲ期20例,Ⅳ期17例;浸润深度:T29例,T329例,T417例;淋巴结转移:N018例,N111例,N226例)行低张力水充盈螺旋CT三期增强扫描,术后采用免疫组织化学SP法检测肿瘤组织中COX-2的表达,并将螺旋CT结果与病理、COX-2表达进行对比分析。结果:螺旋CT三期增强扫描对55例胃癌患者T分期诊断的准确性为83.6%(46/55),N分期的准确性为78.2%(43/55),TNM分期的准确性为80.0%(44/55)。55例胃癌组织中COX-2阳性表达率为63.7%(35/55),与螺旋CT征象的浆膜浸润、淋巴结转移及TNM分期均相关(χ2=4.243,P=0.039;χ2=10.228,P=0.001;χ2=14.556,P=0.000)。结论:螺旋CT可较准确反映胃癌的浸润、转移及TNM分期,螺旋CT与COX-2测定相结合,可以提高对胃癌浸润、转移的诊断准确性。

Aim ： To investigate the diagnostic value of spiral CT and the correlation between spiral CT features and the expression of cyclooxygenase-2（COX-2） in gastric carcinoma tissue, Methods：A total of 55 patients with gastric cancer （man 39, woman 16; 5, 13, 20, 17 cases at TNM stage Ⅰ ,Ⅱ ,Ⅲ , Ⅳ; 9, 29, 17 cases of T2, T3, T4 stage; 18, 11., 26 cases of No , N1, N2 stage）were evaluated with triphasic spiral CT with water filling method and hypotonic agent. The protein expression of COX-2 was detected with immuohistochemistry. Spiral CT findings were compared with pathology and the expression of COX-2. Results： The accuracy of spiral CT was 83.6% （46/55） in T staging, 78.2% （43/55） in N staging, and 80.0% （44/55） in TNM staging of gastric carcinoma. The positive rate of COX-2 protein was 63.7% （35/55）. The COX-2 expression was related to spiral CT features including serosal invasion, lymph node metastasis, and TNM staging of gastric carcinoma （X^2 = 4. 243, P = 0.039 ; X^2 = 10. 228, P = 0. 001 ; X2 = 14. 556, P = 0. 000）. Conclusion ： Triphasic spiral CT could accurately reveal the invasion, metastasis, and TNM staging of gastric cancer. The combination of spiral CT features and the expressions of COX-2 is helpful to improve the diagnostic accuracy of invasion, metastasis in gastric carcinoma.