Prognostic value of EUS combined with MSCT in predicting the recurrence and metastasis of patients with gastric cancer.
OBJECTIVE
This study aims to explore the prognostic value of endoscopic ultrasonography combined with multi-slice spiral computed tomography in predicting the recurrence and metastasis of gastric cancer, as well as investigate the correlation of fragile histidine triad protein expression with the tumor-node-metastasis stage of gastric cancer patients.


METHODS
A total of 81 gastric cancer patients were selected in our study. All patients were examined by endoscopic ultrasonography and multi-slice spiral computed tomography before operation, and gastric cancer tissues and adjacent normal tissues were obtained after operation. Immunohistochemistry was performed to detect fragile histidine triad expression. All patients were followed up for 3 years after operation. Univariate and multivariate analysis of risk factors were conducted for the prognosis of gastric cancer patients.


RESULTS
Endoscopic ultrasonography combined with multi-slice spiral computed tomography could increase the accuracy of preoperative tumor-node-metastasis stage of gastric cancer patients. In gastric cancer tissues, fragile histidine triad expression was mostly weakly positive with a positive rate of 60.5%. In gastric cancer adjacent normal tissues, the positive fragile histidine triad expression was mostly moderate with a positive rate of 79.0%. The fragile histidine triad expression was negatively correlated with tumor-node-metastasis stage of gastric cancer patients. The fragile histidine triad expression decreased along with the increase of T-stage, N-stage and M-stage of gastric cancer patients. Univariate and multivariate analysis showed that T-stage and N-stage were risk factors for the recurrence/metastasis and 3-year mortality of gastric cancer patients, while fragile histidine triad expression was a protective factor.


CONCLUSIONS
Our study demonstrated that endoscopic ultrasonography combined with multi-slice spiral computed tomography may be more accurate in assessing the preoperative tumor-node-metastasis stage of gastric cancer patients.
Department of Radiology, Jiangsu Shengze Hospital, Suzhou.
Jun-Hua
JH
Li
Department of Radiology, Jiangsu Shengze Hospital, Suzhou.
Wei-Zhong
WZ
Shen
Department of Radiology, Jiangsu Shengze Hospital, Suzhou.
Xiao-Qing
XQ
Gu
Department of Gastroenterology, Jiangsu Shengze Hospital, Suzhou.
Wei-Kang
WK
Hong
Department of Medical Imaging, Xiangnan University, Chenzhou, P.R. China.
Zhi-Qiang
ZQ
Wang
D017766:Acid Anhydride Hydrolases / Q000378:metabolism; D000368:Aged; D019160:Endosonography; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008207:Lymphatic Metastasis / Q000175:diagnosis* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009363:Neoplasm Proteins / Q000378:metabolism; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000000981:diagnostic imaging* / Q000473:pathology; D009367:Neoplasm Staging; D011379:Prognosis; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000000981:diagnostic imaging* / Q000401:mortality / Q000473:pathology*; D036542:Tomography, Spiral Computed; D000099170:Bis(5'-adenosyl)triphosphatase
D017766:Acid Anhydride Hydrolases; D009363:Neoplasm Proteins; D000099170:Bis(5'-adenosyl)triphosphatase
endoscopic ultrasonography; fragile histidine triad; gastric cancer; metastasis; multi-slice computed tomography; prognosis; recurrence