小肝癌SCT动脉期最大强化率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 peak contrast enhancement ratio in arterial phase on multiphase spiral CT with histopathological and immunohistochemical findings

作　　者：卢炳丰[1] 龙莉玲[1] 黄仲奎[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：《医学影像学杂志》2005年第9期801-805,共5页Journal of Medical Imaging

基　　金：广西科学基金资助项目(桂科自0007046)

摘　　要：目的:对小肝癌的SCT动脉期最大强化率与组织分级、p53、p21、CD34、VEGF表达的相关性进行多因素分析,探讨以SCT多期扫描评价SHCC的生物学特性,为SHCC的治疗和预后判断提供新的依据.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:癌结节直径≤1cm者2个病灶,1～2cm者13个病灶,大于2c m者18个病灶(≤3cm).与病灶动脉期最大强化率相关的因素为癌结节大小、VEGF和CD34,其中癌结节大小和CD34为正相关因素,WGF 为负相关因数.亦即,动脉期强化率高的肿瘤,直径多较大,CD34高表达,而VEGF多不表达 .CD34对动脉期强化率的贡献最大.结论:SCT多期增强扫描可比较全面观察肿瘤,反映SHCC的生物学特性,且无创、快捷、可重复运用.根据SHCC的SCT征象,可间接评价其相关基因的表达,为SHCC的治疗和预后判断提供新的有价值的依据.Objective：To study the relationship among multiphase spiral CT peak contrast enhancement ratio in arterial phase and grade of cell differentiation, p53,p21, VEGF, CD34 expressions of SHCC by using multiple linear regression analysis,explore the potency of SCT for evaluating biological features of SHCC, and search for new approaches to SHCC treatment and predicting prognosis. Methods： Multiphase spiral CT scans were performed in 30 patients with 33 lesions of SHCC （≤3.0cm in diameter） confirmed histopathologieaUy. Of these patients 26 were male and 4 were female, aged 34 to 70 （mean 50.1 years old）. 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, 2 were less than or equal to lcm in size, 13 were between 1 and 2cm in diameter, 18 were between 2 and 3cm in diameter. The peak contrast enhancement ratio （pCER） of SHCC in arterial phase was correlated with tumor size and CD34 expression positively, and negatively with VEGF. These indicated that SHCC with high pCER in arterial phase always have bigger size and higher level of CD34 expression, and lower level of VEGF expression. CD34 expression was the most important factor contributing to pCER of SHCC in arterial phase （R= 0.5216）. Conclusion： Multiphase spiral CT is an entire observational method to assess biological behaviors of SHCC in a noninvasive, quick and repeatable way. Genes expression of SHCC can be assessed indirectly, and valuable appreaches to SHCC treatment and predicting prognosis can be achieved by SCT features of SHCC.

关 键 词：小肝癌 体层摄影术 X线计算机 病理学 基因 p53 p21 血管内皮生长因子 抗原 CD34 

分 类 号：R735.7[医药卫生—肿瘤] R814.2[医药卫生—临床医学]