肾细胞癌MSCT灌注参数与细胞增殖活性的相关性研究  

The correlation of MSCT perfusion parameters with cell multiplication in renal cell carcinoma

作　　者：陈英鑫[1] 陈康[1] 李苏建[2] 陈君坤[1] 朱斌[1] 饶秋[3] 周正扬[1] 麦筱莉[1] 王冬梅[1] 窦鑫[1] 

机构地区：[1]南京大学医学院附属鼓楼医院放射科,江苏南京210008 [2]南京军区南京总医院医学影像科,江苏南京210002 [3]南京大学医学院附属鼓楼医院病理科,江苏南京210002

出　　处：《医学影像学杂志》2009年第3期308-312,共5页Journal of Medical Imaging

摘　　要：目的:探讨肾细胞癌螺旋CT灌注扫描参数与增殖细胞核抗原Ki-67的相关性。方法:选择24例经手术病理证实肾细胞癌患者与15例健康自愿者,行肾区CT平扫后选择经肿瘤的最大层面或正常肾脏选肾门平面为靶平面再行同层动态增强扫描,经过灌注软件处理分析,分别获得肾癌组织及双侧肾皮质的血流量(BF)、相对血容比(rBV)、平均通过时间(TTP)、通透性(Pm)及时间密度曲线(TDC图)。24例肿瘤组织切片采用免疫组化方法(SP法)检测肾肿瘤Ki-67的表达。将所获灌注参数与免疫组化指标进行比较研究。结果:①各级别肾细胞癌间及肾细胞癌与正常肾皮质BF、rBV、Pm均有显著性差异。各级别肾细胞癌间及肾细胞癌与正常肾皮质TTP无显著性意义;②各级别肾细胞癌间Ki-67表达均有显著性意义;③CT灌注参数中,BF、rBV、Pm与肾细胞癌Ki-67有明显相关关系;TTP与Ki-67间无显著相关性。结论:MSCT灌注成像能定量检测肾细胞癌血流灌注和血管通透性改变,有助于推测肾细胞癌的术前分级,评价肿瘤细胞增殖状态,为术前诊断及治疗提供依据。Objective：To investigate the correlation of MSCT perfusion parameters with tumor Ki-67 antigen in RCC. Methods：The study included 24 eases of RCC proven histopathologieally and 15 bealthy volunteers as control. Target-slice dynamic enhanced scanning was performed by MSCT for all patients. Parameters including blood flow （BF）, relative blood value （rBV）, time to peak（TTP）, permeability （Pm） and time-density curve （TDC） were analyzed using perfusion software. Ki-67 antigen expression was measured with immunohistology ehemistry technique （SP technique）. The results were compared with MSCT perfusion imaging. Results：① There were significant differences for BF, rBVand Pm between different tumor cell grades, RCC and normal renal cortex. There was no significant association for TIP between different tumor cell grades, RCC and normal renal cortex; ② There were significant differences for Ki-67 antigen between different tumor cell grades; ③ CT perfusion parameters, including BF, rBV and Pm had significant eorrelations with Ki-67 antigen of lesions. TIP had no correlation with Ki-67 antigen of lesions. Conclusion： Blood flow peffusion and permeability of RCC can be quantitatively measured by MSCT perfusion imaging. MSCT perfusion provides useful information for pre-surgieal staging and is a valuable means to assess tumor angiogenesis and cell multiplication, which is significant in the diagnosis and treatment of RCC.

关 键 词：肾细胞癌 体层摄影术 X线计算机 灌注 KI-67 

分 类 号：R737.11[医药卫生—肿瘤] R814.42[医药卫生—临床医学]