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目的 探讨CT扫描及CD44V6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48例胃癌进行术前分期;对47例胃切除标本组织进行CD44V6表达分析,与手术及术后病理结果对照;探讨二者在胃癌术前分期中的价值。20例胃良性病变组织检测CD44V6表达作为对照。结果 CT增强扫描对胃癌T分期准确度为74 .5%,N分期准确度为64 .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法(TNM分期)准确度为77 .8%。胃癌组织中CD44V6表达的阳性率为55 .6%,明显高于胃良性病变(χ2 =11 83,P<0 .01)。胃癌病理分期Ⅲ、Ⅳ期者其癌组织的CD44V6表达的阳性率明显高于Ⅰ、Ⅱ期(χ2 =8 71,P<0 .01 );伴有淋巴结转移者胃癌组织的CD44V6表达阳性率明显高于淋巴结转移阴性者。结论 CT增强扫描及CD44V6检测都有利于胃癌术前分期的判断,CD44V6的检测弥补了CT对于N分期准确度低的缺点,两者结合有利于提高分期诊断的准确率。
Objective To investigate the significance of combination of CT scan and CD44V6 expression in the preoperative staging of gastric cancer. Methods Forty-eight cases of gastric cancer were performed preoperative staging using CT-enhanced scanning. The expression of CD44V6 in 47 cases of gastric resection specimens was analyzed. The results were compared with the results of surgery and postoperative pathology. The value of the two methods in preoperative staging of gastric cancer was discussed. Twenty cases of benign gastric lesions were examined for CD44V6 expression as a control. Results The accuracy of T-scan staging for CT scan was 74.5%, and the accuracy of N-segment was 64.4%. The accuracy of CT for staging of gastric cancer, lymph node and metastasis (TNM staging) was 77. .8%. The positive rate of CD44V6 expression in gastric cancer was 55.6%, which was significantly higher than that in benign gastric lesions (χ 2 =11 83, P < 0.01). The positive rate of CD44V6 expression in gastric cancer tissues at stages III and IV was significantly higher than that at stage I and II (χ2=8 71, P<0.01). The positive rate of CD44V6 expression in gastric cancer tissues with lymph node metastasis was significantly higher. Higher than lymph node metastasis. Conclusion The enhanced CT scan and CD44V6 detection are favorable for the preoperative staging of gastric cancer. The detection of CD44V6 makes up for the shortcomings of CT with low accuracy of N staging. The combination of the two will help improve the accuracy of staging diagnosis.