Evaluation of laser Doppler flowmetry for the study of benign and malignant gastric blood flow in vivo

Background - Tumour vascularisation is a determinant of the development of metastases. Aims - To measure blood flow in normal stomach and gastric adenocarcinomas by laser Doppler flowmetry and correlate blood flow with vascularisation after immunohistochemical staining of resected specimens for CD31 and von Willebrand factor. Patients - Twenty two undergoing resection for gastric adenocarcinoma and 10 undergoing cholecystectomy. Results - Mean (SD) gastric blood flow was 208 (35) perfusion units (PU) in patients undergoing cholecystectomy and 190 (75) PU in the undiseased part of the stomach in patients with gastric adenocarcinoma. Gastric blood flow was higher in the border of gastric adenocarcinomas (322 (120) PU, p<0.01 υ normal stomach) but lower in the centre (74 (27) PU, p<0.01 υ normal stomach and tumour border). Blood flow was higher in tumours staged T≥3 than in those staged T<3. Blood vessel density in normal stomach was 41 (8) stained cells/field viewed and was 1.9-3.4 times higher in gastric adenocarcinomas. Conclusion - Laser Doppler flowmetry is a valuable tool for studying the pathophysiological alterations of malignant blood flow in the human stomach in vivo.