周围型肺癌动态CT增强与肿瘤血管生成的相关性研究  

The Study on the Correlation Between Dynamic CT Enhancement and TumorAngiogenesis in Peripheral Lung Cancer

作　　者：彭泽华[1] 白林[1] 董丹丹[2] 陶克言[1] 黄红云[1] 张晓军[1] 高燕[1] 杨靖逸[1] 杨红[2] 付凯[1] 赵世煜[1] 王雪海[3] 

机构地区：[1]四川省人民医院放射科,四川成都61007 [2]四川省人民医院病理科,四川成都61007 [3]四川省人民医院胸心外科,四川成都61007

出　　处：《实用放射学杂志》2005年第3期243-246,共4页Journal of Practical Radiology

基　　金：四川省医学科学院.四川省人民医院科研项目基金资助(编号 147)。

摘　　要：　　目的　探讨周围型肺癌CT增强表现与肿瘤血管生成的关系。方法　对 43例经手术病理证实的周围型肺癌(腺癌 20例,鳞癌 23例)采用LDP免疫组化法,检测肿瘤标本中MVD和VEGF,术前均行动态CT扫描 (剂量 1. 5ml/kg,注射速率 2. 5ml/s,分别在注射造影剂后 0. 5、1、2、3、4、5min扫描),并测量感兴趣区 (ROI)CT值。结果　 (1) 43例肺癌的平均强化峰值(PA)为(35. 53±8. 68)HU,峰值时间在注射造影剂后约 2min。(2)VEGF阳性率约 63% (27 /43),MVD平均值 27.00±7. 13,肺癌的PA值与肿瘤的MVD呈正相关(rs=0.623,Ρ<0. 001 ),VEGF阳性与阴性肺癌的PA值间有显著性差异(分别为 39. 78HU±6. 88HU及 27. 64HU±4. 62HU,P<0. 001);VEGF阳性肺癌的平均PA值与MVD呈正相关 (rs=0.691,Ρ<0.001),VEGF阳性与阴性肺癌的MVD值间有显著性差异(分别为 30. 93±5. 25及 20. 38±4. 49,P<0. 001);肺癌的VEGF与MVD间呈正相关(rs=0.610,Ρ<0. 001);但肺腺癌与鳞癌的平均PA值及MVD间均无显著性差异(P>0. 05)。结论　肺癌动态CT扫描的PA值与MVD具有相关性,可作为VEGF与肿瘤血管生成相关的一个指标。Objective To investigate the correlation of CT enhancement and tumor angiogenesis in peripheral lung cancer . Methods The expression of VEGF and MVD was estimated with LDP immunohistochemical technique in 43 cases with peripheral lung cancers ( adenocarcinoma in 20 cases and squamous cell carcinoma in 23 cases ) proved by surgery and pathology. The dynamic contrast-enhanced CT(0.5,1,2,3,4,5 min post-contrast)were performed in 43 cases and the CT attenuations of the region of interest(ROI) were measured.Results (1)The mean peak attenuation(PA) in 43 patients was (35.53±8.68) HU,and the PA appeared at 2 min after administration of contrast agent.VEGF positiveness of lung cancer was 63%(27/43),average value of MVD was 27.00±7.13.The mean PA of lung cancer correlated postively with MVD(r s=0.623,Ρ<0.001). (2)There was a significant difference in PA between VEGF-positive and VEGF-negative lung cancer (39.78 HU±6.88 HU and 27.64 HU±4.62 HU,Ρ<0.001). The mean PA of VEGF-positive lung cancer correlated positively with MVD(r s=0.691,Ρ<0.001). The mean MVD of VEGF-positive lung cancer were significantly higher than those of negative ones ( 30.93±5.25 and 20.38±4.49,Ρ< 0.001 ) . The expression of VEGF had positive correlation to their correspohding MVD values (r s=0.610 , Ρ<0.001 ) . The PA value and MVD of adenocarcinomas was not significantly different with squamous cell carcinomas (Ρ>0.05). Conclusion The PA value of dynamic CT is closely related to MVD of the peripheral lung cancer. It might be an index for VEGF-related tumor angiogenesis.

关 键 词：肺 肿瘤 体层摄影术 X线计算机 免疫组织化学技术 

分 类 号：R734.2[医药卫生—肿瘤] R814.42[医药卫生—临床医学]