肝癌放疗CTV精确界定的临床病理学研究  

Clinicopathological study of definition of clinical target volume for radiotherapy in patients with hepatocelluar carcinoma

作　　者：王国栋[1] 党亚正[1] 陆婉玲[1] 王倩云[1] 刘军[1] 

机构地区：[1]中国人民解放军第323医院综合内科,陕西西安710054

出　　处：《西部医学》2015年第9期1338-1339,1343,共3页Medical Journal of West China

基　　金：陕西省自然科学基金(CWS105B07)

摘　　要：目的探讨肝癌放疗临床靶体积与临床病理特征间的关系,以指导肝癌放疗临床靶体积的精确划定。方法68例肝癌手术标本HE染色后,显微镜下观察亚临床灶的有无和浸润范围,计算亚临床灶的阳性率。结果64.7%(44/68例)的病例出现亚临床病灶,其阳性率与性别、年龄、有无肝炎、生化指标、肿瘤体积大小无关(均P>0.05),与AFP水平、肝癌Edmondson分级、病理分化程度有关(均P<0.05)。ME范围仅与病理分级有关,其中Ⅰ级为(0.1±0.2)mm,最大值0.3mm;Ⅱ级为(1.1±0.9)mm,最大值5.1mm;Ⅲ级为(2.1±2.4)mm,最大值8.5mm,3组间差异均有统计学意义(均P<0.05)。结论在不同病理分级的肝癌放疗中,CTV边界范围以GTV外扩8.5mm为宜。Objective To define precisely the clinical target volume for radiotherapy in patients suffering from hepatocelluar carcinoma （HCC）. Methods Using a microscope assessed, all the slides were stained with hematoxylin and eosin （HE）, and then, to identify the evidence of microscopic extension（ME）. If ME was confirmed as positive, measured the longest distance. Finally, differences of ME extent were conducted by statistic software spss17.0. Results 64.7% （44/68）of all patients were confirmed as positive. ME incidence was positively related to AFP level, Edmondson classification of HCC and pathologic differentiation, while, nosignificant correllation with size of gross tumour, age, gender, hepatitis B virus infection, biochemical indicators. ME extent was only negatively related to Edmondson classification. The mean distance of ME was （0. 1±0.2mm,maximum 0.3mm ） in grade 1, （1.1±0.9mm,maximum 5. 1mm ） in grade 2, （2.1±2.4mm,maximum 8.5mm ） in grade 3 respectively （P〈0.05）. Conclusion It is reasonalble to recommend CTV margins extending to≤8.5mm beyond the GTV for all tumor grades in patients with HCC.

关 键 词：肝细胞癌 CTV 临床病理学 

分 类 号：R735.7[医药卫生—肿瘤]