| Background and purpose: Gastric carcinoma (GC) is one of the malignant tumors which are threatening to people's life and health in our country. Moreover, invasion and metastasis of GC cells are the main reasons for death of patients with GC. Therefore, investigating the macroscopical exhibition and the microscopical molecular basis of neoplasm metastasis are always significant problems in the fields of imageology, pathology and molecular oncology. Spiral CT scan can provide sufficient and accurate reflection on the characteristics of gastric cancer. So it is considered to be a practical and credible way for the diagnosis of GC. CD44 splice Variant 6 (CD44V6), a variant cell surface adhesion molecule, can influence and alter the process of recognizatiom adhesion and information transmission among cells so that tumor cells obtain the ability of infinitely propagating and the ability of detaching from the primary tumor site, penetrating through the basement membrane, and invading the normal surrounding structures. Matrix Metalloproteinase-2(MMP-2) is a kind of metalloproteinases that degrade the components of the extracellular matrix(ECM) and basement membrane especially collagen IV. The extensive expression of MMP-2 leads to tumor cells proliferating outside from the default of ECM. SCT features of GC depend on the pathologic alteration determined by the biologic characters of GC. We Compared SCT signs with pathologic features and the expression of CD44V6 and MMP-2, to investingate the molecular pathologic basement of the SCT features of GC, search for biologic markers related to invasion and metastasis of GC, predict invasion, metastasis and prognosis of GC correctly at the level of molecule, and provide the clinic doctors with more valuable information.Materials and methods: 46 gastric cancers confirmed at surgery and pathology were devided into 25 intestinal GC and 21 diffuse GC according to Lauren classification. The expression of CD44V6 and MMP-2 were detected immunohistochemically with SP assay in 46 GC, 10 adjacent dysplastic gastric mucosa and 9 naerby normal mucosa respectively. All patients underwent SCT before operation were asked on an empty stomach. Intramuscular injection of hypotonic agent hydrochloric 654-2 20mg was done 10 minutes before the examination. Then the patients were all asked to intake 800ml- 120ml warm boiled water as oral contrast medium. Usually in the supine position, according to the lesion location,the prone position and the lateral position were added if it is necessary. Non-enhancment scanning was performed with 120Kv, 280mAs, 10mmcollimation, 1:1 pitch. A total of 90ml- 100ml (1.5mg/kg weight) of nonionic contrast medium (Omnipaque 300mg.I/ml or ultravist 300ng.I/ml) was administered with a power injector at a flow rate of 2.5-3ml/s. The triphasic spiral scans were obtained at 25s (arterial dominant phase), 65s (parenchymal phase) and 3 min (equilibrium phase) or the monophase scan at 50s after the start of intravenous injection. In enhancement scanning, the parameters were 120Kv, 260mAs, 5- 10mm collimation, 1:1 pitch. Statistical analysis was executed by SPSS 10.00 software. All binary data were compared using chi-square test or Fisher's exact test, significant difference was defined as P<0.05.Result: GC with multi-stomach districts implicated, N2 lymph nodes metastasis (N2LN Mets) or distant metastasis (M) seen by SCT was more frequently diffuse GC in pathology. Comparing with SCT showing single stomach district implicated, No/Ni lymph nodes metastasis (No/N1 LN Mets) or no distant metastasis (M0), the distinction appears significant (P<0.05). (2) Diagnostic accuracy of SCT for serosal invasion and distant metastasis were 84.8%(39/46) and 100%(9/9) respectively. Invasive scope of GC, condition of serosal membrane, No/Ni LN or N2 LN involved and distant metastasis or not on SCT manifestation were all consistent with degree of invasion, distant metastasis and UICC TNM staging in pathology (P<0.05). LN Mets or not was related to UICC TNM staging(P<0.05),...
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