MVD和VEGF蛋白的表达及16层CT动态增强与脑膜瘤复发的关系  

The Relationship between Recurrence and MVD、Expression of VEGF、16-slice Helical Computed Tomography Dynamic Enhancement in Meningiomas

作　　者：王淳良[1] 万红萍[2] 梅金红[2] 周莉[3] 王珊珊[2] 徐姗[2] 秦兴义[1] 

机构地区：[1]南昌大学第一附属医院脑外科,南昌330006 [2]南昌大学第一附属医院病理科,南昌330006 [3]南昌大学第一附属医院影像科,南昌330006

出　　处：《实用临床医学（江西）》2008年第11期88-92,F0003,共6页Practical Clinical Medicine

基　　金：江西省教育厅科学技术研究项目(2005200)

摘　　要：目的探讨脑膜瘤中微血管密度(microvessel density,MVD)和血管内皮生长因子(vascular endothelialgrowth factor,VEGF)蛋白的表达以及16层CT动态增强扫描与脑膜瘤复发的关系及其临床应用价值。方法(1)采用MaxVisonTM法分别检测复发组脑膜瘤33例和非复发组脑膜瘤26例的MVD平均值和VEGF蛋白的表达情况;(2)16层超高速螺旋CT机动态增强扫描,测定CT值及到达峰值持续的时间,分析三者与肿瘤复发的相关性。结果(1)非复发组与复发组脑膜瘤的MVD平均值分别为34.292 3±17.242 2、71.410 0±39.475 0,复发组明显高于非复发组(P=0.000<0.05);其中复发组脑膜瘤Ⅰ级与Ⅱ、Ⅲ级的MVD平均值分别为54.730 4±25.308 01、09.780 0±39.642 0,Ⅱ、Ⅲ级的MVD平均值明显高于I级者(P=0.000<0.05)。(2)VEGF蛋白表达在复发组脑膜瘤I级的阳性率39.13%(9/23)高于非复发组的阳性率11.54%(3/26)(P=0.044<0.05)。(3)38例VEGF蛋白表达阴性的脑膜瘤中MVD平均值为37.926 3±15.230 0,21例VEGF蛋白表达阳性的脑膜瘤中MVD平均值为86.028 6±28.746 4,VEGF蛋白的表达与MVD平均值呈正相关(r=0.788 8,P<0.001)。(4)16层CT动态增强扫描D-T曲线斜率与MVD平均值呈正相关(r=0.33,P<0.01);峰值持续时间与MVD平均值呈负相关(r=-0.42,P<0.005)。结论16层CT动态增强扫描与VEGF蛋白和MVD联合检测可作为脑膜瘤手术前、后客观反映其生物学特性的一组重要指标,为脑膜瘤手术后的进一步治疗提供依据。Objective To investigate the relationship between recurrence and expression of VEGF,MVD and multislice helical computered tomography （MSCT） dynamic enhancement in meningiomas, and evaluate its clinical usefulness. Methods Thirty-three recurrence and 26 primary meni-Ngiomas were observed the expression of MVD and VEGF by immunohistochemistry MaxVisionTM. The finding of CT dynamic enhancement were reviewed, measuring the slope rate of time dentisy curves（SR-DTC） and time on peak. Results （1）the general average of MVD in the primary and recurrent meningiomas was respectively 34. 292 3±17. 242 2.71. 410 0±39. 475 0.It was significantly higher in the recurrent group（P= 0. 000〈0.05） ;The general average of MVD was respectively 54. 730 4±25. 308 0,109. 780 0±39. 642 0 in the recurrent meningiomas of grade Ⅰand grade Ⅱ, Ⅲ, and it was significantly higher in the recurrent meningiomas of gradeⅡ, Ⅲ （P= 0. 000%0.05）. （2） The expression of VEGF was respectively 39.13 % （9/23） and 11.54 % （3/26）in the recurrent meningiomas of gradeⅠand primary meningiomas. The former was higher than the latter（P=0. 044〈0. 05）. （3） The general average of MVD was 37. 926 3±15.230 0 in 38 meningiomas which was negative expression of VEGF, while it was 86.028 6±28. 746 4 in 21 meningiomas which was positive expression of VEGF. Expression of VEGF was positively correlated with general average of MVD （r=0. 788 8, P〈0. 001）. （4） The slope rate of time dentisy curves （SR-DTC） in 16-slice CT dynamic enhancement of meningiomas was positively correlated with general average of MVD（r=0.33,P〈0.01） ; MVD was negatively correlated with time on peak（r= -0.42 ,P〈0. 005）. Conclusion Expression of VEGF,MVD and 16-slice CT dynamic enhancement in meningiomas were examined combined, and they may be an important prediction marker for detecting the clinical pathological characteristics of meningiomas.

关 键 词：复发脑膜瘤 16层CT动态增强扫描 VEGF MVD 

分 类 号：R739.45[医药卫生—肿瘤]