原发性肝细胞癌超声造影表现与DNA增殖水平关系探讨  

Relationship of hepatocellular carcinoma between enhanced-ultrasonography characterization and DNA proliferation

作　　者：杨龙[1] 林礼务[1] 薛恩生[1] 林学英[1] 何以敉[1] 高上达[1] 林晓东[1] 

机构地区：[1]福建医科大学附属协和医院超声科福建省超声医学研究所,福州350001

出　　处：《中华医学超声杂志（电子版）》2007年第1期24-27,共4页Chinese Journal of Medical Ultrasound(Electronic Edition)

基　　金：福建省科技厅重点资助项目(2000Z138)

摘　　要：目的探讨原发性肝细胞癌(HCC)超声造影增强表现与肝癌细胞DNA增殖水平的关系及其临床意义。方法48例分为3组,A组(HCC典型组):超声造影呈“快进快退”28例;B组(HCC非典型组):呈“快进慢退”7例;C组:肝内局灶性结节性增生(FNH)13例。造影后记录各肿瘤结节的造影始增时间、峰值时间、始退时间及增强持续时间,并行统计学分析。造影结束后48例均行超声引导经皮穿刺活检并送病理组织学检查与流式细胞术检查,记录各肿瘤结节细胞增殖的DNA各期比率以及增殖系数(PI),计算各组间DNA非整倍体(异倍体)干系的百分比率,并行统计学分析。最后,对所有肝癌结节及A、B两组肝癌结节的造影增强持续时间和肿瘤细胞DNAS期比率及增殖系数做相关性分析。结果超声造影检查:始退时间A组(36.96±4.73)s明显短于B组(64.14±5.43)s与C组(59.69±7.45)s(均P<0.05);增强持续时间A、B与C组分别为(54.26±10.98)s,(116.71±12.96)s和(169.15±35.03)s,3组间差异均具有统计学意义(均P<0.05)。肿瘤细胞DNA分析:A组肝癌细胞表现为高增值的S期比率及增殖系数分别为(34.60±4.18)%、(50.26±5.64)%,均显著高于B组的(23.65±3.34)%、(33.46±4.63)%和C组的(2.74±0.38)%、(4.31±0.92)%(均P<0.05),而B组的S期比率与增殖系数也明显高于C组(P<0.05)。A组异倍体峰出现率高达57.14%(16/28),B、C组则无一例出现异倍体峰。相关性分析:35例HCC造影增强持续时间与其S期比率及PI间呈负相关关系,相关系数rs=-0.77,rPI=-0.81,P<0.05。结论肝癌超声造影呈短增强持续时间者,其DNA呈高增殖状态,恶性度高;而呈长增强持续时间者,其DNA呈低增殖状态,恶性度低。Objective To investigate the relationship of hepatocellular carcinoma(HCC)between enhanced-ultrasonography characterization and DNA proliferation and its clinical value.Methods Thirty-five patients with HCC and 13 with focal nodular hyperplasia(FNH)underwent grey scale enhanced ultrasound. The HCC patients were divided into typical group(group A) with 28 patients and atypical group(group B) with 7 patients according to the period from contrast agent enhancing to washing out. Group C included 13 focal nodular hyperplasia (FNH). After the Sono Vue(contrast agent) was injected into the ulnar vein, the contrast agent enhanced beginning time, peak time, washing-out time and persistence time were recorded and statistical analysis was done. After enhanced ultrasonographic examination, all nodular tissues were acquired from ultrasound-guided biopsy and the DNA content was examined on FCM. The rates of the different period of DNA content and the proliferation index(PI) were recorded and aneuploid rates of different groups were counted. Then the statistical analysis was done. In each group of HCC and in all HCC nodules, correlation analysis between enhanced persistence time and tumor cell S phase fraction, proliferation index was done.Results In examination of grey scale enhanced ultrasound, there was significant difference between group A 36.96±4.73 s and group B 64.14±5.43 s in washing-out time(P<0.05), at the same time, there was significant difference between group A and group C 59.69±7.45s (P<0.05). There was significant difference among group A 54.26±10.98s, group B 116.71±12.96 s and group C 169.15±35.03 s in persistence time(P<0.05). In FCM examination, there was significant difference in group A 34.60±4.18%, 50.26±5.64%; in group B 23.65±3.34%, 33.46±4.63% and group C 2.74±0.38%, 4.31±0.92% in tumor cell S phase fraction and proliferation index(P<0.05).The aneuploid tumor cells were found in 16 HCC nodules of group A(16/28), but there was no aneuploid cells found in group B and group C. In all thirty f

关 键 词：肝细胞癌 造影剂 超声检查 流式细胞术 

分 类 号：R735.7[医药卫生—肿瘤]