螺旋CT及E-cad表达在胃癌术前分期中的价值

The significance of spiral CT and E-cad expression in preoperative staging of gastric carcinoma

目的探讨CT扫描及E-cad表达相结合在胃癌术前分期诊断中的意义。方法应用CT增强扫描对66例胃癌进行术前分期;对66例胃切除标本进行E-cad表达分析,与手术及术后病理结果对照,以探讨二者在胃癌术前分期中的价值。结果 CT增强扫描对胃癌T分期准确度为81.8%,N分期准确度为89.4%,综合判断CT对于胃癌肿瘤原发灶、淋巴结和转移情况分期(TNM分期)准确度为80.3%。胃癌组织中E-cad表达阳性率为65.15%。胃癌病理分期Ⅲ、Ⅳ期者其癌组织的E-cad阳性表达率明显高于Ⅰ、Ⅱ期(P<0.05);浸润深度为T3、T4胃癌患者其癌组织的E-cad阳性表达率明显高于浸润深度为T1、T2者(P<0.01)。结论 CT增强扫描及E-cad检测都有利于胃癌术前分期的判断,两者结合有利于提高分期诊断的准确率。

Objective Toevaluate the significance ofthe combination ofspiral computed tomography（SCT）and the expression of E-cad in preoperative staging of gastric carcinoma.Methods Triphasic enhanced SCT was performed in 66 patients with gastric carcinoma,while whose E-cad expression was detected by immunohistochemistry method in surgically resected specimens.CT findings in all patients were compared with postoperative pathology.Results The accuracy of triphasic SCT in T and N stage of gastric carcinoma was 81.8% and 89.4%,respectively.The total accuracy in determining TNMstaging was 80.3%.The positive rate of E-cad expression in gastric carcinoma tissues was 65.15%.The expression of E-cad in gastric carcinoma staging Ⅲ and Ⅳ was significantly higher than that in staging Ⅰ and Ⅱ（P0.05）,while the expression of E-cad in T3 and T4 patients was significantly higher than that in T1 and T2 patients（P0.01）.Conclusion Triphasic SCT as well as E-cad detection could be useful to identify the preoperative TNM staging of gastric carcinoma.The detection of E-Cad may compensate for the T staging of CT.The combination of SCT and E-cad expression may elevate the accuracy of preoperative staging of gastric carcinoma.