16层螺旋CT及TopoⅡ表达分析在直肠癌术前分期中的价值  

Role of 16-Slice Spiral CT and TopoⅡ Assay in Preoperative Staging for Rectal Carcinoma

作　　者：丁莹莹[1] 李鹍[1] 谭静[1] 封俊[1] 

机构地区：[1]云南省肿瘤医院放射科,昆明650118

出　　处：《放射学实践》2009年第5期526-529,共4页Radiologic Practice

摘　　要：目的:探讨螺旋CT扫描及回旋酶(topoⅡ)表达相结合在直肠癌术前分期诊断中的意义。方法:应用螺旋CT增强扫描对111例直肠癌进行术前分期;对111例直肠切除标本组织进行topoⅡ表达分析,与手术及术后病理对照;探讨二者在直肠癌术前分期中的价值。结果:螺旋CT扫描对直肠癌T分期准确度为79.3%,N分期准确度86.5%,M分期准确度90.9%,综合判断CT对直肠癌TNM分期总准确度为89.2%。直肠癌组织中topoⅡ表达阳性率85.6%。直肠癌病理分期为Ⅱ、Ⅲ、Ⅳ期者其癌组织的topoⅡ表达阳性率明显高于Ⅰ期;伴有淋巴结转移者直肠癌组织的topoⅡ表达阳性率明显高于淋巴结转移阴性者。结论:16层螺旋CT扫描及topoⅡ检测都有利于直肠癌术前分期的判断,topoⅡ检测弥补了CT对于N分期判断准确度低的缺点,两者结合有利于提高分期诊断的准确率。Objective： To evaluate the significance of 16-slice spiral CT in combination with expression of topoisomerase Ⅱ alpha（topo Ⅱ ） in pre operation staging for rectal carcinoma. Methods： Of 111 patients with rectal carcinoma, 16-slice spiral CT was performed and expression of topo Ⅱ of the surgically reseded specimens was studied by immunohistoehemistry. CT findings were correlated with the histopathology. The value of these two methods in pre-surgieal staging were studied. Results： The accuracy of 16-slice spiral CT in T,N,and M staging of rectal carcinoma was 79.3%,86.5% and 90.9%, respectively. The total accuracy in determining TNM slaging was 89.2%. The positive rate of topo Ⅱ expression was 85.6% in rectal carcinoma tissue. When compared with Stage Ⅰ , the positive rate of topo Ⅱ expression was much higher in that of stage Ⅱ ,Ⅲ ,Ⅳ. The positive rate of topo Ⅱ expression in rectal carcinoma with lymph node metastases was obviously higher than that without. Conclusion： Both 16-slice spiral CT as well as topo Ⅱ expression were useful in the evaluation of preoperative TNM staging of rectal carcinoma. The shortcoming of CT for N staging could be compensated by topo Ⅱ examination. Accuracy of pre-operative staging of rectal carcinoma could be improved by CT in combination with topo Ⅱ measurement.

关 键 词：直肠肿瘤 体层摄影术 X线计算机 肿瘤分期 免疫组织化学 

分 类 号：R735.37[医药卫生—肿瘤]