| Background & Purpose: Gastric cancer is the most common malignant tumor of gastrointestinal tract, with high incidence rate, high death rate and bad prognosis. It has been always in progression before it is detected. Its invasion and metastasis are the leading cause of death. Investigating the relationship between outwards appearance and molecular mechanism of the invasion and metastasis in gastric cancer, therefore, is significant topic to radiology, pathology and molecular biology. Spiral CT (SCT) can provide sufficient and accurate information on the characteristics of gastric cancer. So it is considered to be a practical and credible method to diagnose gastric cancer. Syndecan-1(CD138) belongs to the syndecan family of cell surface transmembrane heparin-sulfate proteoglycans (HSPGs), which synthesized by many cells. Its expression plays an important role during the development and metastasis of tumor.In general, imaging features of gastric caner is determined by the pathologic alteration, while the latter is determined by its biologic characteristic. The purpose this study is to investigate is the relationship between the SCT features and pathology,expression of syndecan-1 and FAK of gastric cancer. We want to improve the accuracy of diagnosis and provide more valuable information to the clinical.Materials and methods: 56 patients were performed non-enhancement scan and triphasic enhancement SCT scan before operation. Scan was performed with 120kv, 240mAs, 5-10mm collimation and pitch=1. A total of 100ml of omnipaque (300mgl/ml) was administered with a power injector at a flow rate of 3.0ml/sec. The triphasic enhanced scans were obtained at 25s, 65s and 2-3min after the start of injection. All the patients hadn't received any radiotherapy and chemotherapy before the operation, and were operated within a week after the CT examination. All 56 tumor specimen were collected. The expression of syndecan-1 and FAK were detected with immunohistochemistry and reverse transcription polymerase chain reaction (RT-PCR). Statistically analysis was performed with SPSS13.0 software package, and statistically significant level was considered as "a=0.05".Results: 1. All lesions could be accurately detected by SCT. 2.In all patients, the accuracy of SCT for T and N staging was 75.00%(42/56) and 89.29%(50/56) respectively, the accuracy of Lauren classification was 91.07%(51/56). There were significant differences between SCT and pathologic diagnosis (p<0.05).3.The difference of the expression of syndecan-1 and FAK between gastric carcinoma and normal was statistically significant(p<0.05).4. Immunohistochemistry show that the low-expression of syndecan-1 was 69.64%. In tumors with stage T2 ,T3and T4, with and without lymph nodes metastasis, the low-expression of syndecan-1 were statistically significant(p<0.05).In diffused and intestinal tumors, the low-expression of syndecan-1 were not statistically significant(p=0.450). The over-expression of FAK was 62.50%. In tumors with stage T2 ,T3 and T4, with and without lymph nodes metastasis, the over-expression of FAK were statistically significant(p<0.05).In diffused and intestinal tumors, the over-expression of FAK were not statistically significant(p=0.265).5.RT-PCR show that in tumors with stage T2, T3 and T4, with and without lymph nodes metastasis, and in diffused and intestinal tumors, the expression of syndecan-1 were 0.7720±0.01281,0.7220±0.01895,0.6856±0.02542, 0.7096±0.02406,0.7651±0.01766, 0.7315±0.03454,0.7290±0.35670, the expression of FAK were 1.0059±0.01134,1.0452±0.01748,1.06046±0.02859,1.0487±0.01804,1.0160±0.02734,1.0352±0.2520,1.0380±0.2968. The difference between stage T2 ,T3 and T4, with and without lymph nodes metastasis was statistically significant(p< 0.05 ). But the difference between diffused and intestinal tumors were not statistically significant(p=0.790,p=0.701).6.The thickness of tumor over and below 15mm has statistically significant with T and N staging.7. The size of tumor over and below 4cm has statistically significant with T and N staging.Conclusions: 1. Enhanced SCT scan was a credible examination. It could well display the imaging features and the molecular pathologic basement of gastric cancer.2.The low-expression of syndecan-1 was negatively related to depth of invasion and lymph node metastasis in SCT features of gastric carcinoma, which indicated that syndecan-1 can restrain the invasiveness and metastasis of gastric carcinoma.3.The over-expression of FAK was positively related to depth of invasion and lymph node metastasis in SCT features of gastric carcinoma, which indicated that FAK can promote the invasiveness and metastasis of gastric carcinoma.4. Enhanced SCT scan combined with pathology and molecular biology technique might improve diagnostic accuracy of invasion,metastasis and prognosis evaluation in gastric cancer.5.Enhanced SCT scan combined with pathology technique might improve diagnostic accuracy of invasion and metastasis and evaluation prognosis in gastric carcinoma.
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