摘要
目的探讨肾细胞癌与肾盂移行细胞癌螺旋CT同层动态扫描参数与瘤组织微血管密度、癌细胞血管内皮生长因子蛋白表达之间的相关关系。方法对18例肾细胞癌及12例肾盂移行细胞癌患者行同层动态CT扫描,计算动态CT参数,增强后组织的CT增值(ΔHu),时间密度曲线升段斜率(S)、组织血管增强比值(TBR)、TDC类型及相应TD曲线下面积(AR)值。组织切片经CD34单克隆抗体及VEGF多克隆抗体免疫组化染色,计数“热点”(hotspot)MVD、VEGF蛋白表达量,并观察肾细胞癌及肾盂移行细胞癌微血管分布。结果①癌组织MVD与动态CT参数S、ΔHu、TBR、AR及TDC类型之间呈显著正相关,相关系数分别为0.512、0.562、0.515、0.53及0.568。VEGF蛋白表达量与MVD及动态CT各参数间均无明显相关性。②三型TD曲线对应的RCC癌组织MVD分别为128.6、147.5、161.8。三型间有统计学意义。VEGF分别为11442.6、12288.8、12539.2,无统计学意义。③RCC、TCC的斜率S与各型间均有显著性差异。ΔHu在RCC曲线三型间有显著性差异,TCC除A与C型有显著性差异外,余型间均无统计学意义。AR值,A与B型间无统计学意义,余型间有显著性差异。TCC三型间AR值均无统计学意义。RCC、TCC的TBR无统计学差异。④RCC与TCC增强CT表现存在着差异,这种差异反映了不同类型肿瘤间血管生成的不同。结论螺旋CT动态参数与肿瘤血管生成的相关关系有助于评价肿瘤血供、血管生成情况及其分布,有助于选择治疗方案、评估疗效和预测预后。
Objective To investigate the correlation of certain parameters of spiral CT （SCT） with tumor microvascular density （MVD） and vascular endothelial growth factor （VEGF） in renal cell carcinoma （RCC） and renal transitional cell carcinoma （TCC）. Methods For each of 18 cases RCC and 12 cases TCC proved by histopathology, and preformed by dynamic CT, enhancement parameters were derived as follows. The slope of the contrast media uptake curve （S）, area under the curve （AR）, AHu and tissue blood ratio （TBR） were calculated for all lesions. Pathologic slides of each case underwent CD34 monoclonal antibody and VEGF polyclonal antibody immunohistochemical staining, then ＂hot spots＂ of MVD and VEGF protein expression were evaluated. The distributions of microvessels on slides were also observed. Pearson correlation test was used to determine the strength of the relationship between enhancement parameters and MVD determinations. Resuits ①Tumor MVD had significant correlation with S, △Hu, TBR, AR and T-DC types with correlation coefficient of 0. 512, 0. 562, 0. 515, 0. 53 and 0. 568, respectively. All correlation of VEGF protein expression with MVD and each of enhancement parameters were not statistically significant.②For these 3 curve types, tumor MVD of RCC were 128.6, 147.5, 161.8, and VEGF protein expression were 7965. 5, 8879. 4, 7994, respectively. Meanwhile, tumor MVD of TCC were 105.7, 132.6, 152. 4, and VEGF protein expression were 11442.6, 12288.8, 12539.2, respectively. ③Different enhancement parameters of dynamic SCT such as S, AHu, TBR and AR, had different statistical significant among 3 types of RCC and TCC. ④Differenees of CT features between RCC and TCC were shown as well as that of tumor angiogenesis did. Conclusion Correlations between parameter of dynamic helical CT scan and the vascular genesis is helpful to assess the tumor vascularity and angiogenesis, thus is useful for clinical evaluation and prediction of its prognosis.
出处
《中国医学影像技术》
CSCD
北大核心
2006年第6期933-937,共5页
Chinese Journal of Medical Imaging Technology
关键词
肾细胞癌
移行细胞癌
肿瘤血管生成
体层摄影术
X线计算机
Renal cell eareinoma
Transitional cell carcinoma
Tumor angiogenesis
Tomography, X-ray computed
