T3~T4期结肠癌伴淋巴结转移的多层螺旋CT影像表现及其与Glut-1、VEGF的相关性研究  

Multi spiral CT imaging findings of T3-T4 stage colon cancer with lymph node metastasis and their correlations with Glut-1 and VEGF

作　　者：李齐勇 杨慧 曹劲松 林国成 LI Qiyong;YANG Hui;CAO Jinsong;LIN Guocheng(Department of Medical Imaging,Yichang Second People’s Hospital,Yichang,Hubei Province 443000,China;Intensive Care Unit,Yichang Second People’s Hospital,Yichang,Hubei Province 443000,China)

机构地区：[1]宜昌市第二人民医院医学影像科,湖北宜昌443000 [2]宜昌市第二人民医院重症监护室,湖北宜昌443000

出　　处：《实用放射学杂志》2022年第12期2007-2010,共4页Journal of Practical Radiology

摘　　要：目的探讨T3~T4期结肠癌伴淋巴结转移的多层螺旋CT(MSCT)影像表现及其与葡萄糖转运蛋白1(Glut-1)、血管内皮生长因子(VEGF)的相关性。方法选取经手术病理证实为T3~T4期结肠癌的患者107例,根据其有无淋巴结转移分为淋巴结转移组(68例),无淋巴结转移组(39例),回顾性分析其CT征象,并通过免疫组化染色方法检测Glut-1、VEGF的表达,分析CT征象与Glut-1、VEGF的相关性。结果结肠癌伴淋巴结转移MSCT主要表现为肠壁不规则增厚并肠腔不规则狭窄,部分呈肿块型改变,浆膜面受累,可见结节状、分叶状改变,周围脂肪间隙模糊呈云絮状、辐轮状改变,增强病灶多以中度以上强化为主,可合并肠梗阻、肝转移、肺转移、骨转移等远处转移。T3~T4期结肠癌伴淋巴结转移组Glut-1和VEGF阳性表达率明显高于无淋巴结转移组,差异有统计学意义(P<0.05)。T3~T4期结肠癌伴淋巴结转移有无远处转移与Glut-1和VEGF阳性表达有关,差异有统计学意义(P<0.05),T3~T4期结肠癌伴淋巴结转移病变部位、病变形态、病变强化程度、有无肠梗阻、淋巴结短径、淋巴结强化差值与Glut-1和VEGF阳性表达无关,差异无统计学意义(P>0.05)。将MSCT影像表现有意义的征象与Glut-1和VEGF进行相关性分析显示,有淋巴结转移和远处转移T3~T4期结肠癌的患者与Glut-1和VEGF的表达呈正相关性(P<0.05)。结论结肠癌组织中Glut-1和VEGF的高表达与淋巴结转移密切相关,可通过Glut-1和VEGF的表达判断结肠癌患者淋巴结转移情况以及为患者预后提供参考。Objective To investigate the multi spiral CT(MSCT)imaging findings of T3-T4 stage colon cancer with lymph node metastasis and their correlations with glucose transporter 1(Glut-1)and vascular endothelial growth factor(VEGF).Methods A total of 107 patients with T3-T4 stage colon cancer confirmed by surgery and pathology were collected and divided into lymph node metastasis group(n=68)and non-lymph node metastasis group(n=39)according to the presence of lymph node metastasis.Their CT features were analyzed retrospectively,and expressions of Glut-1 and VEGF were detected by immunohistochemical staining.The correlations between CT features and Glut-1 and VEGF were analyzed.Results The MSCT of colon cancer with lymph node metastasis was manifested mainly as irregular bowel wall thickening with narrow lumen and some mass change,serosal surface involvement with visible nodular or lobulated appearances,neighbouring fuzzy and wheel-shape fat,moderately enhanced lesions,and accompanying intestinal obstruction and distant metastasis in liver,lung and bone.The positive expression rates of Glut-1 and VEGF in the T3-T4 stage colon cancer with lymph node metastasis group were significantly higher than those in the non-lymph node metastasis group,with statistical significances(P<0.05).Both the positive expression of Glut-1 and VEGF were correlated with the presence of distant metastasis in T3-T4 stage colon cancer with lymph node metastasis(P<0.05).There were no significant differences between lesion site,lesion morphology,lesion enhancement degree,presence of intestinal obstruction,lymph node short diameter,lymph node enhancement difference in T3-T4 stage colon cancer with lymph node metastasis and the positive expressions of Glut-1 and VEGF(P>0.05).The correlation analysis of MSCT imaging signs with Glut-1 and VEGF showed that patients with lymph node metastasis and distant metastasis of T3-T4 stage colon cancer were positively correlated with the expression of Glut-1 and VEGF(P<0.05).Conclusion The high expressions of Glut-1

关 键 词：结肠癌 淋巴结转移 葡萄糖转运蛋白1 血管内皮生长因子 多层螺旋CT 

分 类 号：R735.35[医药卫生—肿瘤] R446.8[医药卫生—临床医学] R814.42