小肝癌SCT包膜完整性与组织病理及免疫组化的多因素相关性研究  

Small Hepatocellular Carcinoma:Multivariate Regression Analysis of Correlation of Pseudocapsula Completion on Multiphase Spiral CT with Histopathological and Immunohistochemical Findings

作　　者：卢炳丰[1] 黄仲奎[1] 龙莉玲[1] 

机构地区：[1]广西医科大学第一附属医院放射科,广西南宁530021

出　　处：《实用放射学杂志》2005年第4期381-386,共6页Journal of Practical Radiology

基　　金：广西科学基金资助项目(桂科自 0007046)

摘　　要：目的　对小肝癌(SHCC)的SCT多期扫描肿瘤包膜完整性与组织分级、p53、p21、CD34、VEGF表达的相关性进行多因素分析,试图探讨SCT多期扫描包膜显示在评价SHCC的生物学特性中的作用。方法　手术病理证实小肝癌30例,共33个癌结节,术前均进行螺旋CT多期扫描,其中男26例,女4例。术后肿瘤行大体病理及其HE染色、免疫组化染色分析。结果　包膜完整6个病灶,包膜不完整15个病灶,无包膜12个病灶。多元线性回归分析结果表明,包膜显示情况相关的因素是癌结节大小、p21、VEGF、CD34(MVD记数);其中癌结节大小和VEGF为正相关因素,p21和CD34为负相关因素;癌结节大小的标准回归系数(0. 5115)最大,对包膜显示的贡献最大;其次为VEGF和CD34,两者的标准回归系数相当;p21对包膜显示的贡献最小。结论　肿瘤的大小与SHCC包膜的形成和完整性关系密切。包膜完整的肿瘤VEGF多为阳性表达;包膜显示不完整或无包膜的肿瘤VEGF多不表达。而p21多为阳性表达。p53蛋白表达水平、Edmondson组织病理分级与包膜显示的相关性无统计学意义。Objective To study the relationship among SCT features of tumor margin and tumor size, immunohistochemical findings, grade of cell differentiation, and to explore the potency of tumor marginal features on multiphase spiral CT for evaluating biological behavior of small hepatocellular carcinoma (SHCC).Methods Multiphase spiral CT scans were performed in 30 patients with 33 lesions of SHCC (≤3.0 cm in diameter) confirmed histopathologically. Of these patients,26 were male and 4 were female. Immunohistochemical and HE staining were performed in surgical samples of all patients with SHCC. All samples' size was measured and the number of masses in each patient was counted.Results Of all masses, 6 were complete capsule, 15 incomplete capsule and 12 non-capsule. In multiple linear regression analysis, the pseudocapsula presentation and completion of SHCC on SCT were positively related with tumor size and VEGF expression, negatively with CD34 and p21, and were not in association with p53 and histological grade. Tumor size was the strongest contributor to pseudocapsula completion(R=0.5115), and then VEGF(R=0.2917), CD34(R=-0.2981) and p21(R=-0.2726), which had the similar standardized regression coefficients.Conclusion Tumor size is the strongest relative factor that influenced pseudocapsula presentation and completion of SHCC. VEGF always expressed positively in SHCC with complete pseudocapsula, and negatively in the group of SHCC with incomplete pseudocapsula or without pseudocapsula. In the group of SHCC with incomplete pseudocapsula or without pseudocapsula, p21 always express positively. Neither p53 expression nor histological grade is in association with the pseudocapsula presentation and completion of SHCC on SCT.

关 键 词：小肝癌 体层摄影术 X线计算机 病理学 基因 血管内皮生长因子 抗原 

分 类 号：R735.7[医药卫生—肿瘤] R814.42[医药卫生—临床医学]