| Background: Gastric carcinoma is one of the malignant tumors, which is threatening people's life and health. Its invasion and metastasis are the leading cause of death. Investigating the relationship between outwards appearance and molecular mechanism in the development and metastasis of gastric carcinoma, therefore, is significant to radiology, pathology and molecular biology. Spiral CT can provide sufficient and accurate reflection on the characteristics of gastric carcinoma. So it is considered to be a practical and credible method to diagnose gastric carcinoma. Phosphatase and tensin homlogy deleted on chormosome ten (PTEN) is a novel suppressor gene implicated in multiple cancers, which inhibits tumor angiogenesis, metastasis, diffusion and adhesion. The abnormalities or silence of the PTEN gene is associated with gastric carcinoma occurrence and progression. On the contrary, basic fibroblast growth factor (bFGF) is a strong angiogenetic promoter, and plays on important role in tumor angiogenesis and invasion. In general, imaging feature of gastric carcinoma is determined by the pathologic alteration, and the latter is determined by its biologic characteristic. To investigate the molecular pathologicbasement of SCT features of gastric carcinoma, improve the accurate diagnosis of gastric carcinoma in metastasis and infiltration, and provide more valuable information to clinical doctors, here we compare macroscopically SCT signs with microscopically pathologic features and expressions of PTEN and bFGF in gastric carcinoma.Materials and methods: 83 patients were performed SCT examination before operation. Non-enhancment was performed with 120Kv, 280mAs, 10mm collimation, pitch = 1:1. A total of 100ml of Omnipaque ( 300mgl/ml ) , was administered with a power injector at a flow rate of 3ml/sec. The triphasic enhanced scans were obtained at 25s, 65s and 2-3min after the start of injection. In enhanced scan, the parameters were 120Kv, 280mAs, 5-10mm collimation, pitch = 1:1. Two experienced radiologists assessed the TNM staging before operation by blind method. Multiple plane reconstruction (MPR) technique was adopted if necessary. Operation was performed within one week after SCT scan. The specimens were embedded with paraffin to obtain 5 m thickness tissues and stained with HE and immunohistochemistry. Statistical analysis was performed with SPSS 10.0 software and statistically significant level was considered as " alpha equals 0.05 " .Results: 1.On enhanced scan, the normal gastric wall presented monolayer structure in 35 patients (42.2%), and 2~3 layers in 48 patients (57.8%).2. All lesions could be accurately detected by SCT. 3. In all patients, the accuracy of SCT for T and N staging was 94.0% (78/83) and 89.2% (74/83), respectively, and the accuracy for Lauren classification was 96.3% (80/83) . Statistically significant difference existed between SCT and pathologic diagnosis (p <0.001). 4. In the 83 gastric carcinomas, the PTEN-positive expression rate was 47.0% (39/83). And in the tumors with TM and T2 staging, with and without lymph node metastasis, diffused and intestinal gastric carcinoma, the PTEN-positive expression rates were 40.9% (29/71) and 83.3% (10/12),38.3% (23/60) and 69.6% (16/23), 32.6% (14/43) and 62.5% (25/40), respectively, the differences were statistically significant in each of the groups (p <0.05). 5. In 83 gastric carcinomas, the bFGF-positive expression rate was 63.9% (53/83). And in the tumors with T3-4 and T2 staging, with and without lymph nodemetastasis, diffused and intestinal gastric carcinomas, the bFGF-positive expression rates were 25.0% (3/12) and 70.4% (50/71), 71.7% (43/60) and 43.5% (10/23), 74.4% (32/43) and 52.5% (21/40). The differences were statistically significant in each of the groups (p <0.05). 6. In 83 gastric carcinomas, both PTEN-positive expression and bFGF-positive expression were detected in 16 specimens, r=- 0.447, p <0.001, and expression of PTEN was negative correlation with of bFGF.Conclusions: 1. Enhanced SCT scan was a credible examinat... |
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