肾细胞癌的CT征象与PCNA、VEGF表达和MVD的关系研究  

STUDY ON THE CORRELATION BETWEEN CT FEATURES AND EXPRESSIONS OF VEGF、PCNA AND MVD IN RENAL CELL CARCINOMA

作　　者：许银实[1] 赵志梅[1] 

机构地区：[1]延边大学医院麻醉科,延边133000

出　　处：《现代预防医学》2009年第23期4520-4524,共5页Modern Preventive Medicine

摘　　要：[目的]探讨肾细胞癌中细胞增殖核抗原(proliferating cell nuclear antigen,PCNA)、血管内皮生长因子(vascular endothelial growth factor,VEGF)在肾癌中的表达以及MVD与CT征象的关系。[方法]选择手术切除、经病理证实且CT资料完整的肾细胞癌41例,采用免疫组化方法检测PCNA、VEGF的表达水平和MVD。螺旋CT检查用东芝AsteionMSCT机。观察CT图像上肿瘤大小,有无坏死、液化、囊变,强化峰值,肿瘤边界,有无肾周脂肪浸润、淋巴结肿大,静脉侵犯,邻近器官侵犯或/和远处转移等,并与免疫组化结果相比较。[结果]①MSCT双期增强扫描对41例肾细胞癌的检出率为100%,定性诊断率为100%,分期准确度为94%;②41例肾细胞癌中PCNA、VEGF的阳性表达率分别为100%、75.6%;MVD为87.80±38.91条/视野。③PCNA、VEGF的阳性表达与CT图像上肿瘤直径,瘤体坏死、液化、囊变,增强程度,肿瘤边界,肾周脂肪浸润,淋巴结肿大,静脉侵犯,邻近器官侵犯或/和远处转移有关,同时与MVD有关(P﹤0.05);④肾细胞癌的VEGF表达与MVD呈正相关(相关系数r=0.497,P﹤0.01)。[结论]①螺旋CT双期增强扫描可以对肾细胞癌进行较准确的术前诊断,是肾细胞癌可靠的检查方法。②肾细胞癌的部分CT征象与PCNA、VEGF的表达和MVD有关,提示肾细胞癌的部分CT征象可间接反映肾细胞癌的生物学行为与恶性程度。[Objective]To evaluate the correlation between CT features and expressions of VEGF、 PCNA and MVD in renal cell carcinoma （RCC）. [Methods] Forty-one patients with RCC diagnosed by pathology, operation resection and integrated CT data underwent SCT （spiral CT used the Asteion MSCT） examinations and expressions of VEGF, PCNA and MVD were examined immunohistochemically using the PC10 clone. CT imagines were observed for tumor size, necrosis, liquefaction, cystic degeneration, enhanced peak, tumor margin, perirenal fat infiltration, lymph nodes metastases, invasion of renal vein or inferior vena cava, and invasion of adjacent organs or distant metastases. All were compared with the immunohistochemical result. [Results] ① The detection rate, qualitative diagnosis rate, staging accuracy of MSCT dual-phase enhanced scanning in 41 cases of renal cell carcinoma was 100%, 100%, and 94%, respectively. ② In 41 cases of RCC, the MVD was 87.80±38.91/ken. The positive expression rates of VEGF and PCNA were 75.6% and 100%, respectively. ③ The positive expressions of VEGF and PCNA were significantly correlated with perirenal fat infiltration, lymph nodes metastases, invasion of renal vein or inferior cava, invasion of adjacent organs or distant metastases on CT scan （P﹤0.05）. At the same time they were correlated with MVD. ④ MVD and the expression of VEGF showed a positive correlation in renal cell carcinoma （related parameter r=0.497, P﹤0.01）. [Conclusion] ① MSCT dual-phase enhanced scanning was a reliable technique in pre-operative diagnoses and the detection in RCC. ② The detection of VEGF、 PCNA and MVD in RCC combined with CT features was useful in diagnosing RCC and objectively evaluating the biological behavior and malignance.

关 键 词：肾细胞癌 螺旋CT双期增强扫描 CT征象 PCNA VEGF MVD 

分 类 号：R737.11[医药卫生—肿瘤]