肝细胞癌超声造影灌注参数与ANGPTL4表达水平相关性的初步研究  

Correlation between perfusion parameters of contrast-enhanced ultrasound and ANGPTL4 expression in hepatocellular carcinoma

作　　者：吴林德 蒿业红[2] 徐珊珊 方苑仲 Lin-De Wu;Ye-Hong Hao;Shan-Shan Xu;Yuan-Zhong Fang(Department of Ultrasonography,Deqing People’s Hospital,Huzhou 313200,Zhejiang Province,China;Department of Ultrasound,Zhejiang Xiaoshan Hospital,Hangzhou 311200,Zhejiang Province,China;Department of Laboratory Medicine,Hangzhou Yuhang Maternal and Child Health Hospital,Hangzhou 311100,Zhejiang Province,China)

机构地区：[1]浙江省德清县人民医院超声科,浙江省湖州市313200 [2]浙江萧山医院超声科,浙江省杭州市311200 [3]杭州市余杭区妇幼保健院检验科,浙江省杭州市311100

出　　处：《世界华人消化杂志》2020年第10期378-383,共6页World Chinese Journal of Digestology

摘　　要：背景血管生成素样蛋白4(angiopoietin like 4,ANGPTL4)是一种血管生成素样蛋白家族中的分泌型糖蛋白,其表达上调可促进肿瘤微小血管新生.超声造影(contrast-enhancedultrasound,CEUS)能客观地反映肿瘤微循环血流灌注状态,为临床提供血流动力学信息.目的探讨原发性肝细胞癌(hepatocellular carcinoma,HCC)的CEUS灌注参数与ANGPTL4表达水平的相关性.方法选取在浙江萧山医院行手术切除的84例HCC患者作为研究对象(共84个肿瘤).根据ANGPTL4表达结果分为:ANGPTL4阳性表达组(48例)和ANGPTL4阴性表达组(36例).所有患者术前3d内行CEUS检查,分析病灶的血流灌注参数:增强强度(enhancementintensity,EI)和达峰时间(peaktotime,TTP),同期测定患者血清血管内皮生长因子(vascular endothelialgrowthfactor,VEGF)水平,术后测定组织标本ANGPTL4表达水平及微血管密度(microvessel density,MVD).分析CEUS灌注参数与ANGPTL4表达水平的相关性.结果ANGPTL4阳性表达组病灶的EI明显高于ANGPTL4阴性表达组,差异有统计学意义(P<0.05);ANGPTL4阳性表达组病灶的TTP明显短于ANGPTL4阴性表达组,差异有统计学意义(P<0.05);ANGPTL4阳性表达组的MVD和VEGF水平明显高于ANGPTL4阴性表达组,差异有统计学意义(P<0.05);HCC的EI与ANGPTL4表达水平呈正相关(r=0.753,P<0.05),TTP与ANGPTL4表达水平呈负相关(r=-0.730,P<0.05).结论HCC的CEUS灌注参数与ANGPTL4表达水平具有一定相关性,能无创性反映活体HCC的ANGPTL4表达水平,间接评估其血管新生状态.BACKGROUND Angiopoietin like protein 4(ANGPTL4)is a secreted glycoprotein of the angiopoietin like protein family.Upregulation of ANGPTL4 expression can promote tumor angiogenesis.Contrast-enhanced ultrasound(CEUS)can objectively reflect tumor microcirculation perfusion and provide the hemodynamic information.AIM To investigate the correlation between ANGPTL4 expression and the perfusion parameters of CEUS in hepatocellular carcinoma(HCC).METHODS Eighty-four HCC patients(84 tumors)who underwent surgical resection at Zhejiang Xiaoshan Hospital were selected as study subjects.According to the ANGPTL4 expression status,the patients were divided into either an ANGPTL4 positive expression group(48 cases)or an ANGPTL4 negative expression group(36 cases).All patients underwent CEUS within 3 d before operation.The perfusion parameters were analyzed,including enhancement intensity(EI)and peak to time(TTP).Serum vascular endothelial growth factor(VEGF),ANGPTL4 expression,and microvessel density(MVD)were measured.The correlation between the perfusion parameters of CEUS and the ANGPTL4 expression was analyzed.RESULTS The EI in the ANGPTL4 positive expression group was significantly higher than that in the ANGPTL4 negative expression group(P<0.05).The TTP in the ANGPTL4 positive expression group was significantly shorter than that in the ANGPTL4 negative expression group(P<0.05).The MVD and VEGF in the ANGPTL4 positive expression group were significantly higher than those in the ANGPTL4 negative expression group(P<0.05)There was a positive correlation between EI and ANGPTL4 expression in HCC(r=0.753,P<0.05),and a negative correlation between TTP and ANGPTL4 expression(r=-0.730,P<0.05).CONCLUSION There is a certain correlation between the perfusion parameters of CEUS and ANGPTL4 expression in HCC.Thus,the perfusion parameters of CEUS can reflect the ANGPTL4 expression level in HCC in vivo and indirectly evaluate its angiogenesis.

关 键 词：原发性肝细胞癌 超声造影 时间-强度曲线 血管生成素样蛋白4 微血管密度 

分 类 号：R735.7[医药卫生—肿瘤]