结直肠癌螺旋CT灌注成像与肿瘤血管生成的相关性  

Colorectal carcinoma:correlation between spiral CT perfusion imaging and tumor angiogenesis

作　　者：彭李青 黄菊花 曾粦春 刘剑峰 孙灿辉[2] 孟悛非[2] 李子平[2] 娄明武[3] 杨广夫[3] 李燕梅 陈金品 

机构地区：[1]深圳市龙岗区坑梓人民医院放射科,广东深圳518122 [2]中山大学附属第一医院放射科,广东广州510080 [3]深圳市龙岗中心医院影像科,广东深圳518166

出　　处：《中国医学影像技术》2006年第7期1051-1054,共4页Chinese Journal of Medical Imaging Technology

基　　金：广东省社会发展领域科技计划项目(200413960)

摘　　要：目的探讨结、直肠癌螺旋CT(SCT)灌注成像与其血管生成的相关性。方法对30例结、直肠癌患者进行SCT单层动态增强扫描,绘制所选层面的癌灶、靶动脉的感兴趣区的时间-密度曲线(TDC)。根据TDC计算癌灶的血流灌注量(PF)。测定癌组织的微血管密度(MVD)和血管内皮生长因子(VEGF)的表达。将结、直肠癌的PF与MVD、VEGF的表达进行比较,且三者亦分别与临床病理因素(Dukes分期、浆膜浸润及淋巴结转移)进行比较。结果结、直肠癌的PF随着病理分期期别的升高有下降趋势,与MVD的趋势一致。VEGF的表达阳性率为87%(26/30)。PF与MVD、VEGF的表达之间均无显著相关性(r分别为0.16,0.19,P值均>0.05)。MVD与VEGF间也无显著相关性(r=-0.03,P>0.05);PF、MVD及VEGF在Dukes分期、浆膜浸润、淋巴结转移比较中差异均无统计学意义。结论SCT灌注成像与MVD、VEGF均能反映结、直肠癌的血管生成状况,但它们之间无明显相关性。Objective To evaluate the correlation between spiral CT perfusion imaging in colorectal carcinoma and microvessel density （MVD） and vascular endothelial growth factor （VEGF）. Methods Dynamic contrast-enhanced spiral CT was performed in 30 patients with pathologically verified colorectal carcinoma. Time-density curves （TDC） were created from the region of interest drawn over the tumor, target artery by spiral CT with perfusion functional software. MVD, VEGF were evaluated by using immunohistochemical staining of surgical specimens with anti-CD34, anti-VEGF monoclonal antibody. The correlation between MVD, VEGF, and that of the three parameters and clinicopathological factors （Dukes＇ stages, depth of invasion and lymph node metastasis） was also studied. Results Both perfusion and MVD decreased with increasing Dukes＇ stage. There was no significant correlation between perfusion and MVD, VEGF expression （r= 0. 16, 0. 19, P〉0.05）, and the parameters of spiral CT perfusion. The positiity rate of VEGF expression was 87 %. Perfusion, MVD and VEGF were not associated with invasive depth, metastasis and disease stage. Conclusion Spiral CT perfusion imaging, MVD and VEGF may reflect angiogenic activity, but no significant correlation was found among them.

关 键 词：体层摄影术 X线计算机 灌注 结直肠肿瘤 肿瘤血管生成 微血管密度 血管内皮生长因子 

分 类 号：R735.3[医药卫生—肿瘤] R814.42[医药卫生—临床医学]