肝细胞癌血管生成的螺旋CT动脉期同层动态扫描与α-平滑肌素免疫组织化学表达的相关性  

Angiogenesis in hepatocellular carcinoma: correlation of single-level dynamic spiral CT scans in arterial phase and expression of α-smooth muscle actin

作　　者：刘燕[1] 闵鹏秋[1] 陈卫霞[1] 张林[2] 

机构地区：[1]四川大学华西医院放射科 [2]四川大学基础与法医学院

出　　处：《中华放射学杂志》2005年第6期646-651,共6页Chinese Journal of Radiology

摘　　要：目的针对肝细胞癌(HCC)血管生成情况,探讨螺旋CT动脉期同层动态扫描特征与α平滑肌素(ASMA)免疫组织化学(简称免疫组化)检查结果之间的相关性。方法术前33例HCC行螺旋CT动脉期同层动态扫描,绘制时间密度曲线(TDC)并计算相应参数;分析HCC强化征象。术后对标本切片进行常规苏木素伊红染色(HE)和ASMA免疫组化染色。对免疫组化染色结果和影像学发现进行相关性分析。结果将33例HCCTDC按强化峰值(PV)>80、40HU<PV<80HU及PV<40HU分为Ⅰ、Ⅱ和Ⅲ型,分别有3、17和13例,PV分别为103.30、57.65和33.55HU。ASMA免疫组化显示新生血管按照形态可分为A和B2型。Ⅰ、Ⅱ和Ⅲ型TDC中肿瘤实质内新生血管数目平均分别为10、4.59和1支,和不同类型TDC相关(r=-0.567,P<0.01)。33例HCC中,肿瘤均匀强化4例,不均匀强化27例,无明显强化2例。肿瘤均匀强化与肿瘤实质内B型血管相关(r=0.381,P<0.051),不均匀强化与肿瘤间质内血管部位相关(r=0.384,P<0.05)。结论螺旋CT动脉期同层动态扫描可成为在活体评估HCC血管生成情况的较好的方法。Objective To investigate the correlation between the single-level dynamic spiral CT scans (SDCT) of hepatocellular carcinoma (HCC) in arterial phase (AP) and the immunohistochemistry expression of α-smooth muscle actin (ASMA). Methods 33 cases of suspected HCC undergoing spiral CT plain scan of the whole liver, the single-level dynamic scan of the target level of lesion in AP and finally the whole liver scan in portal-venous phase before operations and proved after were included into the study. After the SDCT, a time-density curve (T-DC) was drawn according to the density change of the region of interest (ROI) of the tumor parenchyma with some parameters calculated, and signs of enhancement evaluated. Slices of post-operation specimen underwent hemotoxylin-eosin (HE) and ASMA immunohistochemistry staining. Then the slices were evaluated with emphases on the ASMA-positive neovasculatures in the parenchyma and mesenchyma of carcinomas, and the average count in a low microscopic field (×100) was recorded (5 low microscopic field were observed and then an average was calculated.). Finally the immunohistochemistry and histologic results were correlated with image findings. Results According to the PV of the tumor parenchyma, T-DC was divided into type Ⅰ,Ⅱ and Ⅲ in which the criteria were PV>80, 40 HU<PV<80 HU and PV<40 HU respectively. In the 33 cases, type Ⅰ,Ⅱ and Ⅲ of T-DC were 3, 17 and 13 cases with PV of 103.30,57.65 and 33.55 HU respectively. In ASMA immunohistochemistry study, ASMA-positive neovasculatures were devided into type A with a thick wall and B with a thin wall. The mean count of neovasculatures of tumor parenchyma in type Ⅰ,Ⅱ and Ⅲ of T-DC were 10,4.59 and 1 respectively. Statistically, different types of T-DC were significantly correlated with the count of neovasculatures in the parenchyma of carcinomas(r=-0.567,P<0.01). Homogeneous and inhomogeneous enhancement of carcinomas during SDCT in AP were correlated with the neovasculature of type B in the parenchyma(r=0.381,P<0.05)and

关 键 词：同层动态扫描 免疫组织化学 Α-平滑肌 螺旋CT 血管生成 肝细胞癌 动脉期 苏木素-伊红染色 时间-密度曲线 免疫组化染色 新生血管数目 ASMA 肿瘤实质 相关性分析 HCC 检查结果 标本切片 染色结果 强化 影像学 DC 同类型 

分 类 号：R735.7[医药卫生—肿瘤] R735.2[医药卫生—临床医学]