宫颈癌中淋巴管密度与CT灌注成像及D2-40表达的相关性研究  

A comparative study of the computed tomography perfusion imaging and the expression of D2-40 with lymphatic vessel density in cervical carcinomas

作　　者：马赟[1] 肖立志[2] 龚颖萍[1] 

机构地区：[1]湖南省妇幼保健院妇科,长沙410008 [2]中南大学湘雅二医院PET-CT中心

出　　处：《中国医师杂志》2014年第10期1358-1360,共3页Journal of Chinese Physician

基　　金：湖南省科技厅课题资助项目（2011FJ3177）

摘　　要：目的 探讨宫颈癌淋巴管密度与CT灌注参数和癌组织淋巴管生成之间的关系.方法 对42例宫颈癌患者进行CT灌注检查,测定肿瘤组织中D2-40标记的淋巴管密度（LVD）水平,分析宫颈癌有无淋巴结转移组之间CT灌注参数和LVD的差异.结果 宫颈癌淋巴结转移组血流量（BF）、血容量（BV）、强化峰值（PEI）均高于无淋巴结转移组（t=-2.206、-2.29、-2.336,P＜0.05）,淋巴结转移组的强化峰值时间（TTP）值显著短于无淋巴结转移组（t=6.908,P＜0.01）.D2-40标记的微淋巴管呈棕黄色环状,结构清晰.肿瘤病灶周边有大量微淋巴管增.宫颈癌有淋巴结转移组BF、BV、PEI与LVD呈正相关（r =0.65、0.56、0.61,P＜0.01）,而无淋巴结转移组TTP与LVD呈负相关（r=-0.55,P＜0.01）.结论 宫颈癌CT灌注成像及D2-40 LVD的参数有助于甄别淋巴结的转移,高LVD值与宫颈癌进展、转移发生密切相关,其参数预测淋巴结转移的风险和预后,对临床治疗转归具有指导意义.Objective To investigate the correlation between the characteristics of the computed tomography （CT） perfusion parameters and the expression of D2-40 with lymphatic vessel density （LVD） in cervical carcinomas.Methods A total of 42 patients with cervical carcinoma was divided into two groups with and without lymph node metastasis.Patients were evaluated with CT perfusion scan before operation.Monoclonal antibody D2-40 was used for immunohistochemistry to detect the LVD in the carcinoma tissue specimen.CT perfusion parameters and LVD of two groups were compared,and their relationship was analyzed.Results CT perfusion parameters including blood flow （BF）,peak enhancement image （PEI）,and blood volume （BV） in the lymph node metastasis group were significantly higher than those in the no lymph node metastasis group （t =-2.206,-2.29,-2.336,P 〈 0.05）.The time to peak （TTP） was significantly lower in the lymph node metastasis group than the no node metastasis group （t =6.908,P 〈 0.01）.The LVD in the lymph node metastasis group was significantly higher than the no lymph node metastasis group （t =-5.092,P 〈 0.01）.The CT perfusion parameters （BF,PEI,BV） and LVD of cervical carcinomas had a significantly positive correlation （r =0.65,0.56,0.61,P 〈 0.01）.The TTP and LVD had a significantly negative correlation（r =-0.55,P 〈 0.01）.Conclusions CT perfusion imaging and higher LVD help to diagnose the lymph node metastasis of a cervical carcinoma,and have important guidance role in the surgical options for cervical cancers.

关 键 词：宫颈肿瘤/病理学 宫颈肿瘤/放射摄影术 体层摄影术 X线计算机 淋巴转移 

分 类 号：R737.33[医药卫生—肿瘤]