胃癌MSCT表现和临床病理特征与HER2表达的相关性研究  

A relevant study of MSCT features,clinicopathological features and HER2 expression in gastric cancer

作　　者：赵瑾 陈海燕[2] 丁信法[2] 沈可人 余日胜[2] Zhao Jin;Chen Haiyan;Ding Xinfa;Shen Keren;Yu Risheng(Department of Radiology,Zhejiang Hospital,Hangzhou 310000,China;Department of Radiology,The Second Affiliated Hospital of Zhejiang University School of Medicine,Hangzhou 310000,China)

机构地区：[1]浙江医院放射科,浙江杭州310000 [2]浙江大学医学院附属第二医院放射科,浙江杭州310000

出　　处：《实用肿瘤杂志》2020年第3期201-207,共7页Journal of Practical Oncology

基　　金：浙江省胃癌诊治技术研究中心建设项目(JBZX-201802)。

摘　　要：目的探讨胃癌多层螺旋CT(multi-slice spiral CT,MSCT)影像表现、临床病理特征与人表皮生长因子受体2(human epidermal growth factor receptor 2,HER2)表达的关系。方法回顾性收集经手术病理证实的胃癌患者146例,根据免疫组织化学法检测得到的HER2表达情况分为HER2阴性组(0和1+)73例和HER2阳性组(2+和3+)73例,分析MSCT影像表现、临床病理特征与HER2表达的关系。结果HER2阴性组胃癌较阳性组表现出更高的cT分期(P<0.05)。HER2阳性组胃癌的平扫期CT值、门脉期CT值、平衡期CT值、门脉期强化值(CTP)及门脉期-动脉期强化差值(CTP-A)均较阴性组更小(均P<0.05)。HER2阳性组胃癌中59.9%的癌灶呈持续强化方式,30.0%呈渐进性强化方式(P<0.01)。中高分化腺癌HER2阳性表达率为72.6%,而低分化腺癌为27.4%(P<0.01);Lauren肠型HER2阳性表达率为63.0%,而弥漫型为16.4%(P<0.01)。多因素Logistic回归分析显示,影像表现中的病灶动态增强方式(持续强化:OR=1;渐进性强化:OR=0.146)和病理特征中的Lauren分型(肠型:OR=1;弥漫型:OR=0.133)是预测HER2表达的关键因素(均P<0.05)。结论胃癌MSCT影像表现与病理特征能预测HER2表达情况,尤其是动态增强方式-持续性强化方式及Lauren肠型胃癌与HER2过表达相关。Objective To investigate the relationship between multi-slice spiral CT(MSCT)features,clinicopathological features and the expression of human epidermal growth factor receptor 2(HER2)of gastric cancer.Methods Totally 146 cases of gastric cancer confirmed by operation and pathology were collected retrospectively.According to the expression of HER2 detected by immunohistochemistry,patients were divided into the HER2 negative group(0,1+)and HER2 positive group(2+,3+)with 73 cases in each group.The relationship between MSCT imaging,clinicopathological features and the expression of HER2 was analyzed.Results Gastric cancer patients in the HER2 negative group showed higher CT stage than that in the HER2 positive group(P<0.05).The CT value of plain scan,portal phase and balance phase,and portal phase contrast enhancement(CTP)and portal-arterial phase enhancement difference value(CTP-A)in the HER2 positive group were smaller than those in the HER2 negative group(all P<0.05).In the HER2 positive group,59.9%of the lesions showed continuous enhancement,and 30.0%showed progressive enhancement(P<0.01).The positive expression rate of HER2 was 72.6%in middle and high differentiated adenocarcinoma and 27.4%in low differentiated adenocarcinoma(P<0.01).The positive expression rate of HER2 in Lauren’s intestinal type was 63.0%,while that in diffuse type was 16.4%(P<0.01).Multivariate logistic regression analysis showed that the dynamic enhancement mode of lesions in imaging manifestations(continuous enhancement:OR=1;progressive enhancement:OR=0.146)and Lauren classification in pathological features(intestinal type:OR=1;diffuse type:OR=0.133)were the key factors to predict the expression of HER2(all P<0.05).Conclusions MSCT imaging and pathological features of gastric cancer can predict the expression of HER2,especially the dynamic enhancement mode-persistent enhancement mode and Lauren intestinal type gastric cancer.

关 键 词：胃癌 人表皮生长因子受体2 多层螺旋CT 

分 类 号：R735.2[医药卫生—肿瘤]