侵袭性前列腺癌的CT、MRI表现与生物因子表达及淋巴结转移的相关性研究  

Correlation Study of CT,MRI Manifestations of Invasive Prostate Cancer with Expression of Biological Factors and Lymph Node Metastasis

作　　者：杨留洋 贾招辉[1] 潘冬 卞盼 张伟[2] 窦中岭[1] YANG Liu-yang;JIA Zhao-hui;PAN Dong;BIAN Pan;ZHANG Wei;DOU Zhong-ling(Department of Urology Surgery,The First Affiliated Hospital of Henan University of Science and Technology/School of Clinical Medicine,Henan University ofScience and Technology,Luoyang,Henan 471000,China;DepartmentofClinical Laboratory,Zhengzhou People's Hospital/People's Hospital ofHenan University of Traditional Chinese Medicine,Zhengzhou,Henan,450053,China)

机构地区：[1]河南科技大学第一附属医院/河南科技大学临床医学院泌尿外科,河南洛阳471000 [2]郑州市人民医院/河南中医药大学人民医院检验科,河南郑州450053

出　　处：《现代生物医学进展》2022年第9期1779-1784,共6页Progress in Modern Biomedicine

基　　金：河南省医学科技攻关项目计划省部共建项目(SBGJ2018060)

摘　　要：目的:探讨侵袭性前列腺癌的电子计算机断层扫描(CT)磁共振成像(MRI)表现与生物因子表达及淋巴结转移的相关性研究。方法:收集2016年2月-2021年2月于我院确诊前列腺癌患者117例,所以患者均行前列腺根治切除+盆腔淋巴结清扫术,术前均完善CT、MRI影像学检查,根据术后病理结果Gleason评分分为侵袭性前列腺癌组(63例)和非侵袭性前列腺癌组(54例),分析患者CT、MRI表现特征。采用免疫组织化学染色分析前列腺特异抗原(PSA)、增殖细胞核抗原(PCNA)、血管内皮生长因子(VEGF)、细胞核增殖相关抗原(Ki-67)及肿瘤抑制蛋白(P53)的阳性表达情况。分析侵袭性前列腺癌的CT、MRI表现与生物因子表达及淋巴结转移之间的关系。结果:侵袭性前列腺癌患者CT、MRI均可见不同程度的前列腺异常改变,主要表现为结节.状、波浪状突起,边缘模糊、毛糙,前列腺癌突破包膜并累及邻近精囊腺、膀胱、直肠及周围脂肪组织,可见盆腔肿大淋巴结转移,测量表观扩散系数(ADC)值及动态增强MRI定量参数可大致区分病灶良恶性及恶性程度分级情况。侵袭性前列腺癌组PSA的表达低于非侵袭性前列腺癌组,而PCNA、VEGF Ki-67、P53的表达及淋巴结转移高于非侵袭性前列腺癌组,差异均有统计学意义(P<0.05)。侵袭性前列腺癌患者肿瘤边缘表现为模糊、清晰时PSA、PCNA阳性表达率及淋巴结转移率组间差异均有统计学意义(P<0.05);肿瘤直径≤2cm、>2 cm时的淋巴结转移率组间差异具有统计学意义(P<0.05)。侵袭性前列腺癌组ADC值低于非.侵袭性前列腺癌组,而Kep和Ktrans高于非侵袭性前列腺癌组患者差异均有统计学意义(P<0.05)。侵袭性前列腺癌患者ADC值与PSA阳性表达呈正相关性(P<0.05),与PCNA、Ki-67、P53阳性表达及淋巴结转移呈负相关(P<0.05)。侵袭性前列腺癌患者Kep.、Ktrans与PSA阳性表达呈负相关性(P<0.05),与PCNA、Ki-67、P53阳�Objective:To investigate the correlation between the electronic computed tomography(CT)and magnetic resonance imaging(MRI)manifestations of invasive prostate cancer and the expression of biological factors and lymph node metastasis.Methods:Collected 117 cases of prostate cancer patients diagnosed in our hospital from February 2016 to February 2021.All patients underwent radical prostatectomy+pelvic lymph node dissction.CT and MRI imaging examinations were completed before the operation.According to postoperative pathological results and Gleason score,they were divided into invasive prostate cancer group(63 cases)and non invasive prostate cancer group(54 cases),and the CT and MRI features of the patients were analyzed.Immunohistochemical staining was used to analyze the positive expression of prostatc spccific antigcn(PSA),prolifcrating ccll nuclear antigen(PCNA),vascular endothelial growth factor(VEGF),nuclear proliferation-related antigen(Ki-67)and tumor suppressor protein(P53).Analyze the relationship between the CT and MRI manifestations of invasive prostate cancer and the expression of biological factors and lymph node metastasis.Results:CT and MRI in patients with invasive prostate cancer showed varying degrees of abnormal prostate changes,mainly manifested as nodules,wavy protrusions,fuzzy edges,and roughness.Prostate cancer broke through the capsule and involved adjacent seminal vesicle glands,bladder,rectum and peripheral fat tissue,pelvic enlarged lymph node metastasis can be seen.Measuring the apparent difusion cefficient(ADC)value and dynamic enhanced MRI quantitative parameters can roughly distinguish the benign,malignant and malignant degree of the lesion.The expression of PSA in the invasive prostate cancer group was lower than that in the non invasive prostate cancer group,while the expression of PCNA,VEGF,Ki-67,P53 and lymph node metastasis were higher than those in the non invasive prostate cancer group,and the differences were staistically signifcant(P<0.05).The positive expression rate of PSA a

关 键 词：侵袭性前列腺癌 CT MRI 生物因子 淋巴结转移 相关性 

分 类 号：R737.25[医药卫生—肿瘤] R445[医药卫生—临床医学]