Chinese Medical Journal 2011 ； 124(3) ： A preliminary study on correlation triple-phase multi -slice CT scan with histological differentiation and intratumoral microvascular/lymphatic invasion in gastric cancer

Preliminary (pri‘liminəri ) 初步的 Intratumoral 肿瘤内的 histological differentiation 病理分化 identified 经过鉴定 parenchymal phase 实质期 Invasion 侵犯

Background Many studies have shown that cancer celI diferentiation and microvascuIar invasion play a principle role in cancer progression and metastasis 。 and non—invasive imaging techniques such as CT MRI and US assessing the diferentiation and the surgical resectibility and the prognosis of cancers are now of great importance ． This study aimed to explore the correlation of triple-phase multi-slice CT scan with the histological diferentiation and intratumor microvascular/lymphatic invasion of progressive gastric cancer

Methods The present study included 64 patients with gastric cancer ． alI of whom underwent routinaI and dual-phase contrast enhancement multi-slice CT examinations of the upper abdomen before surgery ． The post-operative specimens were used for determination of histologicaI differentiation,cancer celI invasion of intratumoraI microvascular/lymphatic vesseI identified by CD34 and D2-40 expression ． correlations between contrast enhancement ratio(CER)of triple- phase multi-slice CT scan in gastric cancer and histologicaI diferentiation as well as intratumoraI microvascular/lymphatic invasion were compared and analyzed ．

Materials Included in the present study were 64 cases of gastric cancer specimens surgically resected between January2006 and December 2009 in our hospita1 ． They included 48 males and 16 females who ranged in age from 37 years to 80 years ． The gastric cancer tumor was located in the upper stomach(fundus and cardia)in 30 cases ， in the lower stomach(antrum and pylorus)in 30 cases ， and in the body in 4 cases ． All the Patients underwent multi—slice CT routine and dual—phase contrast enhancement examination of the upper abdomen preoperatively,and surgery was performed 3 days 一 7 days after CT examination ． The postoperative specimens were routinely fixed with l0 ％ formalin ， and HE stained to determine histological diferentiation ．

Results There was a significant correlation between CER of triple—phase CT scan in gastric cancer and tumor histological diferentiation(P<0.05) ． CER of the arterial phase in gastric cancer with intratumoral microvascular invasion was significantly higher than that without invasion ： CER of the arterial-parenchymaI phase was significantly lower in gastric cancer with intratumoraI microvascular invasion than that without invasion However ， CER of the parenchymal phase in gastric cancer with intratumoraI Iymphatic invasion was significantly higher than that without invasion

Conclusions CER of triple-phase multi- slice CT scan in gastric cancer is closely correlated with intratumoraI microvascuIar and Iymphatic invasion ， and also could be used as a marker for histological diferentiation ．