| Background and purpose: Esophageal carcinoma is a kind of common malignant tumour in digestive system and is threatening health of human being. Esophage-ctomy is one of the dominating means to treat the desease. But the effectiveness of esophagectomy is not optimistical, most patients died of tumor recurrence. Medical imagiing plays an important role in following - up of esophagectomy. As computed tomography ( CT) has a high density resolution and can provide exact diagnostic information , it is a common and reliable mean in following - up of post - esophagectomy .Biologic behavior of tumor has its molecular basis. The growth, invasiveness and metastasis of tumor depend on tumor angiogenesis , angiogenesis of tumor is modulated and controlled by angiogenesis factors. VEGF ( vascular endothelial growth factor) is the most important one in all angiogenesis factors. E - cad(e - cadherin) is one transfer - membrane glycoprotein which conducts adherin among same type of cells. It forms a complex with cell skeleton frame through catenin. Its activeness canalso influence tight junction, gap junction and desmosome junction. Many researches indicated that absence of E - cad is a important element relative to tumor metastasis . The purpose of this research is to evaluate the value of SCT in recurrent carcinoma after operation , and to discuss pathologic and molecular basis of recurrent carcimoma after operation.Materials and methods : 27 cases which were diagnosed as recurrent esophage-al carcinoma after esophagectomy were collected , each case has detailed SCT scan recorder and the SCT signs were analyzed; at the same time, 22 cases in which no recurrence sign was found in at least 2 years after esophagectomy were also collected as contrast. The differentiation of tumor cell , lesion lenth , invasive depth of tumor , lymph node status during operation were reviewed. All specimen were detected the expression of VEGF, MVD and E - cad by SP method. The relationship between tumor recurrence and pathology and molecule expression was analyzed. CT scan machine is TOSHIBA Xvision/GX or GE Prospeed AI. Neckchest scan parameter is 120 kV,250mAs; chest scan parameter is 120kV , 150mAs ; abdomen scan parameter is 120kv,200mAs. The contrast was non - ion . Scanning thickness was 10mm or 7mm.Results: (1) Locoregional recurrence was 18 in all 27 ,the SCT signs of 14 in 18 were enlargement of cervical , mediastinal or abdominal lymph nodes ,4 in18 were soft tissue tumor around anastomose or chest stomache. Hematogenous and mixed recurrence occounted fou 9 of 27 , the SCT sings were organ metastisis or locoregional recurrence accompanying remote metastasis ; ( 2 ) The ratio of invading into deep muscle layer vs not invading into deep muscle layer, positive lymph node metastasis vs negative lymph node metastasis in operation , lesion lenth >5cm vs 5 cm in recur-rence group and contrast group was 23:4, 14: 13 ,11: 16 and 11: 11 , 2- 20,3: 19, respectively. The difference if significant ( P = 0. 008 , P = 0. 001 , P = 0. 017 ) . ( 3 ) MVD in recurrence and contrast group was 64. 59 12. 36 and 35. 09 15. 65 , respectively , the previous one was higher than the latter one signigicantly ( P = 0. 0001 ) ; invading into deep muscle layer vs not invading into deep muscle layer, positive lymph node metastasis vs negative lymph node metastasis in operation , poor differentiation vs moderate and high differenciation , MVD were 55. 94 19. 22 vs 40. 93 19. 14 ,66. 00 13. 06 vs 44.24 19.37,65. 10 12.58 vs 47. 82 20. 43, MVD of previous ones were significantly higher than latter ones without exception (P =0. 0151 ,P = 0. 0002, P = 0. 0144). MVD in VEGF positive and negative expression group was 63. 00 13. 86 and 45. 55 16. 91 ,the MVD in positive expression group was higher significantly than in negative expression group (P =0. 0004). (4) In group of invading into deep muscle layer vs not invading into deep muscle layer and group of positive lymph node metastasis vs negative lymph node metastasis in operation , the ratio of E -...
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