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目的研究进展期胃癌的多层CT增强征象与肿瘤组织分化及P-糖蛋白(P-gp)表达的关系。方法胃癌患者66例,术前均行上腹部多层CT常规及双期增强检查,术后采用HE染色确定组织分化和免疫组化检测P-gp在胃癌中表达。比较胃癌的多层CT增强征象与其组织分化及P-gp在胃癌中表达之间的关系。结果胃癌的强化方式与其组织分化及P-gp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,75.0%(30/40)分层强化或不均匀强化的胃癌病理为低分化腺癌(P<0.05)。CT双期增强的强化率与胃癌组织分化无关;P-gp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)。P-gp表达与门脉期强化率有关(P<0.05),与动脉期强化率、胃壁浸润厚度、肿瘤大小和淋巴结转移无关(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P-gp阳性表达,提示胃癌的多层CT增强征象与其组织分化及P-gp表达有较密切的相关性。
Objective To investigate the relationship between multi-slice CT enhancement and differentiation and P-glycoprotein (P-gp) expression in advanced gastric cancer. Methods Sixty-six patients with gastric cancer were enrolled in this study. The upper abdominal multi-slice CT was performed routinely and double-phase enhanced examination. The expression of P-gp was detected by immunohistochemistry after HE staining. To compare the relationship between multi-slice CT enhancement of gastric cancer and its differentiation and P-gp expression in gastric cancer. Results The enhancement of gastric cancer was related to its differentiation and expression of P-gp in gastric cancer. 73.1% (19/26) of the well-differentiated gastric cancer showed high / moderately differentiated adenocarcinoma, 75.0% (30/40) Homogeneous gastric cancer was poorly differentiated adenocarcinoma (P <0.05). The enhanced rate of double enhancement of CT was not related to the differentiation of gastric cancer tissue. The positive expression of P-gp was significantly higher in gastric cancer with stratified or non-uniform enhancement than that in uniformly enhanced gastric cancer (P <0.05). The expression of P-gp was correlated with the enhancement rate of portal venous phase (P <0.05), but not with the enhancement rate of arterial phase, the thickness of gastric wall, tumor size and lymph node metastasis (P> 0.05). Conclusion The different enhancement modes and double-stage enhancement rate of gastric cancer reflect different tissue differentiation and P-gp expression in gastric cancer, suggesting that the multi-slice CT enhancement sign of gastric cancer is closely related to its differentiation and P-gp expression.