结直肠癌256层CT全肿瘤灌注与肿瘤血管生成间关系  

Coloreactal cancer whole tumor perfusion with 256-slice spiral CT： the relationship between quantitative measurements and tumor angiogenesis

作　　者：徐妍妍[1] 王武[1] 孙宏亮[1] 杨强[2] 姚力[3] 周雷[4] 

机构地区：[1]中日友好医院放射科,北京100029 [2]中日友好医院病理科,北京100029 [3]中日友好医院内镜室,北京100029 [4]中日友好医院普外科,北京100029

出　　处：《实用放射学杂志》2012年第9期1371-1375,共5页Journal of Practical Radiology

摘　　要：目的 初步探讨256层螺旋CT结直肠癌全肿瘤灌注成像与血管生成的相关性.方法 收集在本院普外科术前经纤维结肠镜检查并病理证实结直肠腺癌病例17例进行256层螺旋CT灌注成像检查,获得全肿瘤灌注图像.肿瘤位于直肠8例,乙状结肠4例,降结肠1例,升结肠2例,回盲部2例.17例病例中高分化6例,中分化6例,低分化5例.选取与病理切片相对应48个感兴趣区层面进行灌注分析.采用鼠抗人单克隆抗体105（CD105）进行免疫组化染色,测定肿瘤组织内血管生成情况.肿瘤灌注参数值、微血管密度（microvessel density,MVD）在肿瘤不同分化间比较运用单因素ANOVA检验,肿瘤灌注参数值与MVD间进行Spearman相关性分析.P＜0.05表明差异具有统计学意义.结果 肿瘤平均长度（8.57±2.16） cm（范围3～11.8 cm）,17例标本共做48块石蜡块（平均每人2.8块）.结直肠癌组织MVD计数为（37.33±19.14）/×200HP,计数得分为（3.73±1.30）/×200HP,高、中分化肿瘤与低分化肿瘤MVD数目分别存在统计学差异（P＜0.05）.高、中、低分化肿瘤间血流量（BF）值存在明显统计学差异（P＜0.05）,血容量（BV）值不存在明显的统计学差异（P=0.124）.达峰时间（TTP）值高分化-低分化之间存在统计学差异（P＜0.05）.BF与MVD正相关（r=0.698,P＜0.001）,TTP则与MVD负相关（r=-0.556,P＜0.001）,但BV值与MVD无明显相关性（r=0.281,P=0.053）.结论 256层螺旋CT灌注成像检查能够满足结直肠癌全肿瘤灌注,其灌注参数与MVD具有良好相关性,能够反映活体状态下肿瘤的微循环功能.Objective To assess whole tumor perfusion with 256-slice spiral computed tomography in patients with colorectal cancer and to investigate the relationship between quantitative measurements and tumor angiogenesis. Methods Seventeen patients with histologically proved colorectal cancer underwent 256-slice spiral CT ferfusion imaging. The lesions located in the rectum in 8 cases sigmoid colon in 4 eases,descending colon in 1 case,ascending colon in 2 cases and cecum in 2 case. The tumors were well-differentiated in 6, moderately differentiated in 6 and poorly differentiated in 5（including two cases of mucinous adenocarcinoma）. Overall, ＇18 regions of interest were selected on CT axial perfusion images corresponding to pathologic drawing slices for perfusion analysis. Tumor pathologic slices were dealed with immunohistochemical staining（ Envision two-step）using mouse anti-human monoclonal antibody（CD105）. All data was dealed with SPSS 17.0 commercial software. For tumor perfusion parameters and microvessel density （MVD}in the tumors of different differentiation were compared by using single-factor AN（）VA test. The correlation of tumor perfusion parameters with MVD,were analyzed with Spearman correlation analysis. P〈0.05 was considered to indicate a statistically significant difference. Results The average tumor length was （8.57 ± 2.16） cm（range 3--11.8 cm ）, 48 paraffin blocks were taken in 17 specimens（average 2. 8/per specimen）. Mean MVD of the tumors was {37. 33±19. 14）/×200 HP, and counting scores of the tumors was{ 3.73± 1.30 ）/×200 HP. There was a significant tendency for well differentiated tumor with high blood flow{ BF） values {P〈0.05 ） and high MVD count {P〈0.05）. Well-differentiated tumor showed statistically significant lower time to peak{TTP） values than poorly differentiated tumor（P〈0.05} . However , blood volume（ BV） values were not present statistically significant {P〈0. 124 ）. Conclusion Whole tumor perfusion is technically feasible w

关 键 词：结直肠癌 体层摄影术 X线计算机 血管生成 

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