肾细胞癌螺旋CT征象与病理、微血管密度及血管内皮生长因子表达间关系的研究  

Study on the correlation between SCT features and pathology, MVD, expressions of VEGF in renal cell carcinoma

作　　者：陈学军[1] 高剑波[1] 杨学华[1] 周志刚[1] 郭华[1] 岳松伟[1] 

机构地区：[1]郑州大学第一附属医院放射科,450052

出　　处：《中华放射学杂志》2005年第4期394-398,共5页Chinese Journal of Radiology

摘　　要：目的探讨肾细胞癌(renalcellcarcinoma,RCC)的螺旋CT(spiralCT,SCT)征象与病理、微血管密度(microvesseldensity,MVD)及血管内皮生长因子(vascularendothelialgrowthfactor,VEGF)表达间的关系。方法对34例行SCT检查并经手术证实的RCC,采用免疫组织化学抗生物素生物素过氧化物酶复合法(SABC法)染色,检测肿瘤中MVD及VEGF的表达。结果(1)SCT双期增强扫描对34例RCC的检出率为100%,定性诊断率为100%,分期的准确度为94%。(2)SCT上瘤周有环状低密度影者14例,病理检查12例有完整的假包膜(85.7%);细胞核分级在瘤体直径>3.0cm组、瘤周无环状低密度影组、瘤体中心有坏死不强化区组,分别高于瘤体直径≤3.0cm组、瘤周有环状低密度影组、瘤体内无坏死区组(P值均<0.01)。(3)34例RCC的平均MVD为(89.5±56.0)条/视野,VEGF阳性表达24例(70.6%)。(4)SCT上,瘤周无环状低密度影组、肿瘤中心有坏死不强化区组,VEGF阳性表达及MVD分别高于瘤周有环状低密度影组、肿瘤内无坏死区组(P值均<0.05)。SCT增强早期,肿瘤密度高于或等于肾皮质组,MVD高于肿瘤密度低于肾皮质组(t=3.069,P<0.05);MVD在静脉内有癌栓组高于无癌栓组(t=11.95,P<0.01)。结论(1)SCT双期增强扫描是RCC可靠的检查方法,能准确反映其病理学基础。(2)RCC的部分SCT征象?Objective To evaluate the correlation between spiral CT (SCT) features and pathology, MVD, and expressions of VEGF in renal cell carcinoma (RCC). Methods Thirty-four patients with RCC diagnosed by pathology underwent SCT examinations. MVD and expressions of VEGF were examined immunohistochemically using SABC techniques. Results (1) The detection and characterization as well as accuracy of staging in 34 RCC on two-phase enhanced SCT scans were 100%, 100%, and 94%, respectively. (2) Tumors with low density ring on SCT scans mostly had pseudocapsules at pathological examination. The nuclear grade was higher in groups of tumor without low density ring, with central necrosis, and the diameter larger than 3.0 cm than in those of tumor with low density ring, without central necrosis, and the diameter less than 3.0 cm (P<0.01, P<0.01, P<0.01, respectively). (3) In 34 cases of RCC, the mean MVD was 89.5 ±56.0. The positive expression of VEGF was 70.6% (24/34). (4) The MVD and positive expressions of VEGF in groups of tumor without a low density ring, with central necrosis on SCT scans were higher than in those tumor with a low density ring, without central necrosis (P<0.05 respectively in each of the groups). On early enhanced scans, MVD was closely correlated with tumor enhancement (P<0.05). MVD was higher in tumors with intravenous tumor emboli than in tumors without emboli (P<0.01). Conclusion (1) Two-phase enhanced SCT scan was a reliable technique in the detection, characterization and staging of RCC. (2) Some SCT features were closely correlated with MVD and expressions of VEGF in RCC, which could be a noninvasive method in predicting aggressiveness and metastasis.

关 键 词：血管内皮生长因子 微血管密度 CT征象 肾细胞癌 螺旋 CT双期增强扫描 carcinoma 低密度影 VEGF factor 免疫组织化学 瘤体直径 肿瘤密度 MVD RCC SCT检查 SABC法 过氧化物酶 病理学基础 侵袭和转移 cell 手术证实 抗生物素 

分 类 号：R737.11[医药卫生—肿瘤]