肝细胞癌MR动态增强与癌细胞核DNA含量的相关性研究  

Hepatocellular carcinoma:the enhanced dynamic MR findings and the content of nuclear DNA in tumor cell

作　　者：孙黎明 徐坚民 李肃 龚静山 王晓玫 王新根 

机构地区：[1]暨南大学医学院附属深圳市人民医院放射科,518020

出　　处：《影像诊断与介入放射学》2006年第4期175-178,共4页Diagnostic Imaging & Interventional Radiology

摘　　要：目的探讨肝细胞癌(Hepatocellularcarcinoma,HCC)动态增强MRI表现与癌细胞核DNA含量及病理的相关性。方法分析经手术及病理证实的42例HCC。根据肿瘤动态强化特征分为三型(Ⅰ型:肿瘤信号动脉期高于或等于肝实质,门脉期低于肝实质;Ⅱ型:肿瘤信号动脉期和门脉期均高于或等于肝实质;Ⅲ型:肿瘤信号动脉期和门脉期均低于肝实质)。采用流式细胞仪(flowcytometry,FCM)测定石蜡包埋肿瘤标本的癌细胞核DNA含量,得出DNA指数(DNAindex,DI)和S期细胞分数(S-phasefraction,SPF)。分析HCC的MR动态增强分型与DNA含量及病理分级之间的关系。结果42例中Ⅰ型增强29例,Ⅱ型12例,Ⅲ型1例。①Ⅰ型增强与Ⅱ型增强HCC的癌细胞SPF有显著性差异(P=0.001),Ⅰ型增强HCC的DI显著高于Ⅱ型(P=0.009)。②肿瘤的病理分级与DI及SPF有显著性差异,病理为III、IV级的肿瘤DI及SPF明显高于I、II级(P=0.027;P=0.035)。③MR增强类型与病理分级有显著性差异,Ⅰ型增强的HCC病理分化比Ⅱ型差(P=0.014)。结论HCC动态增强MRI表现与癌细胞核DNA含量(DI)、S期细胞分数(SPF)及病理分级有相关性,可在一定程度上间接反映HCC的恶性生物学行为,为临床选择治疗方案及评价预后提供信息。Objective A correlative study of the enhanced dynamic MRI features with the content of nuclear DNA in tumor cell and the pathology of the lesions of hepatocellular carcinoma （HCC） . Methods In total 42 patients with pathologically confirmed HCC were enrolled in this study. The enhanced dynamic MRI manifestations of HCC were classified into three categories： Ⅰ hyperintense in arterial phase （AP） and hypointense in portal phase （PP）; Ⅱhyper-or isointense in both AP and PP, Ⅲ： hypointense in both AP and PP. DNA index （DI） and S-phase fraction （SPF） were measured by flow cytometry with paraffin-embedded specimens from lesions. The relationship between dynamic MRI features and nuclear DNA content, and the pathology of lesions was investigated. Results In 42 cases, there were 29 cases of type Ⅰ, 12 cases of type Ⅱ, 1 case of type Ⅲ. SPF and DI of type Ⅰ were significantly higher than those of type 11 （ P = 0. 001; P = 0. 009）. DI and SPF of HCC in Grade Ⅲ and Ⅳ were higher than those in Grade Iand Ⅱ （ P = 0. 027; P = 0. 035） . Tumor differentiation of type Ⅰ was poorer than that of type 11 （ P = 0. 014）. Conclusion The enhanced dynamic MRI manifestations correlate with the nuclear DNA content and the differentiation of tumor cell in cases of hepatocellular carcinoma, indicating the malignant biological nature of HCC, which provides valuable information for the clinical management and prognosis anticipation.

关 键 词：肝细胞癌 磁共振成像 动态增强 脱氧核糖核酸 流式细胞仪 

分 类 号：R735.7[医药卫生—肿瘤]