Objective To investigate the value of 18F-FDG SUVmax in gastric cancer diagnosis with coincidence imaging.Methods The coincidence imaging was performed in 92 patients with gastric diseases (60 males,32 females,age 65 (32-85) years; 78 malignant cases,14 benign cases).The malignant cases included 3 remnant gastric cancers and 75 primary gastric cancers (staging: 4 of Tis,13 of T1,9 of T2,33 of T3,11 of T4 and 5 without surgery).The well-,moderately-and poorly-differentiated adenocarcinomas were 22,15 and 28,respectively.Images were analyzed retrospectively with visual method and 18F-FDG SUVmax,and the diagnostic results were compared with the histopathological findings.The ROC curve was used to analyze the SUVmax.The Pearson's correlation analysis was performed to evaluate the relationship between SUVmax and tumor size.The Wilcoxon rank sum test was applied to determine the difference of SUVmax between early and advanced gastric cancers.The Kruskal-Wallis test was used to analyze the difference of SUVmax in various types of differentiated adenocarcinoma.Results No matter visual method or SUVmax was used,the sensitivity,specificity and accuracy of coincidence imaging in diagnosis of gastric cancer were 64.1％(50/78),64.3％(9/14) and 64.1％(59/92),respectively.The AUC of SUVmax was 0.695 and the cut-off value was 0.700.SUVmax Was positively correlated with tumor size significantly(r=0.489,P＜0.001).There was statistically significant difference between SUVmax of Tis-1 and that of T2-4(0.676± 1.288 vs 3.851 ±3.764;Z=-3.754,P＜0.001).However,there was no statistically significant difference among SUVmax of various grades of differentiated adenocarcinoma(2.805±4.008,3.447±2.365,3.413± 3.737 ; x2 =2.459,P＞ 0.05).Conclusions SUVmax provides more information than visual method in assessing gastric cancer with 18F-FDG coincidence imaging.Appropriate cut-off value of SUV is necessary for improvement of the diagnostic efficiency.Relationships between SUV and pathological T stage,histopathological types and differentiation degree need further investigation.

Objective To investigate the expression of Vacuolar-H +-ATPase (V-ATPase) and P-glyeoprotein (P-gp) protein in colon carcinoma tissues,the correlation between the expression of V-ATPase and P-gp and their clinicopathological significance.Methods In samples from 80 cases of colon cancer,20 cases of colon adenoma and 10 cases of normal colonic mucosa tissues,the expression of V-ATPase and P-gp protein were detected by immunohistochemical method,their relationship was analyzed,the clinicopathological features and prognosis were evaluated.Results In colon cancer,V-ATPase and P-gp protein expression was 72％ and 80％,higher than that in colon adenomas (40％,35％),and in normal colon mucosa (20％,20％),the difference was statistically significant (P ＜ 0.05).There was a positive correlation between the expression of V-ATPase and that of P-gp (r =0.567,P ＜0.01).V-ATPase and P-gp protein expression in colon cancer was associated with TNM stage,lymph node metastasis and tumor differentiation (P ＜ 0.05).Patients with high V-ATPase expression had lower 5-year survival rate than those with low V-ATPase expression (P =0.023),and 5-year recurrence rate was higher than those with low expression (P =0.024).Conclusions The expression of V-ATPase is up-regulated in colon cancer,there is a positive correlation with colon cancer progress and metastasis,and high V-ATPase protein expression predicts poor prognosis.

Objective To investigate the effect of omeprazole combined with FOLFOX scheme as an adjuvant therapy for stage Ⅱ or Ⅲ colon cancer patients after a radical resection.Methods 98 stage Ⅱ or Ⅲ colon cancer patients in our hospital from January 2008 to December 2009 were randomly divided into study group (48 cases) receiving regimen of omeprazole combined with FOLFOX and control group (50 cases) treated with FOLFOX chemotherapy after radical colectomy.Surgical specimens were examined for expression of V-ATPase protein.Chemotherapy period was 6 months,8-12 courses.We observed results of follow-up curative effect,comparing the side effects and postoperative 2 year,3 year and 5 year disease-free survival rate (DFS) difference using statistical analysis.Results Study was completed in all 93 cases,5 cases were lost to follow-up.The baseline data distribution in the two groups were balanced basically.In study group the gastrointestinal side effects of chemotherapy was lower than the control group (x2 =4.924 6,P =0.026).In the two groups,the 2-year,3-year and 5-year DFS were 73％ vs 60％ (x2 =1.743 7,P =0.187),62％ vs50％ (x2 =1.4075,P=0.235),49％ vs40％ (x2 =0.8159,P=0.366) (P＞0.05).V-ATPase protein expression was 71％ (70/98) in all samples.The 2-year and 3-year DFS of patients for V-ATPase protein positive expression in the two groups were 75％ vs 51％ (x2 =3.970 8,P =0.046),66％ vs 40％ (x2 =4.399 5,P =0.036).Compared with the control group,the 2-year,3-year DFS increased in the study group (P ＜ 0.05).In stage Ⅲ colon cancer patients,the 2-year DFS was 73％ vs 47％ (x2 =4.504 5,P =0.034).Conclusions PPI combined with FOLFOX in V-ATPase protein positive expression or Ⅲ stage colon cancer patients after radical colectemy improves long-term survival,as well as reduces the gastrointestinal side effects of chemotherapy.