摘要
目的探讨多层螺旋CT（MSCT）灌注成像评价非小细胞肺癌（NSCLC）分化程度的价值及机制。方法应用MSCT对44例NSCLC行灌注成像，其中22例构建微血管构筑二维表型（2D—TMAP）。用Spearman相关分析和趋势检验，探讨不同区域血流量（BF）、血容量（BV）、强化峰值（PEI）、平均通过时间（MTT）、达峰时间（TTP）与NSCLC分化程度、2D—TMAP指标的关系。结果趋势检验和相关分析结果均显示，总BF、总BV和总PEI随NSCLC分化程度降低而减低，r分别为-0．613（P=0．000）、-0．309（P=0．042）和-0．350（P=0．020）。总PEI与总微血管密度（MVD）呈正相关（r=0．441，P=0．046），周围区BF、总BF、总BV、总PEI与未形成完整管腔的MVD、鼠抗人增殖细胞核抗原（PCNA）的表达强度均呈负相关（均P〈0．05）。NSCLC的分化程度与未形成完整管腔的周围区MVD、PCNA和血管内皮生长因子（VEGF）的表达强度均呈正相关，r分别为0．477（P=0．034）、0．656（P=0．002）和0．430（P=0．048），而与总MVD无关。未形成完整管腔的周围区MVD与VEGF、PCNA、ephrinB2和EphB4表达强度均呈正相关，r分别为0．586（P：0．005）、0．430（P=0．048）、0．634（P=0．002）和0．634（P=0．002）。结论灌注成像能有效评价NSCLC的分化程度，其机制在于通过检测微血管的管腔化程度来评价NSCLC的血流模式。
Objective To determine the significance of MSCT perfusion scan on differentiation of NSCLC and to investigate its possible mechanisms. Methods Forty four NSCLC patients underwent CT perfusion scan by MSCT. Among them, 22 cases were selected to detected the two-dimensional tumor microvascular architecture phenotype （2D-TMAP） , the relationships between CT perfusion parameters （BF, BV, PEI, TTP） , and the differentiation of NSCLC were analysed by using the correlation analysis and trend test. Spearman correlation analysis was used to study the relationships between CT perfusion parameters, differentiation, and 2D-TMAP. Results The total BF, BV and PEI decreased with decreasing differentiation of NSCLC （ P 〈 0.05 ）. The total PEI showed a positive correlation with the total MVD （ P 〈 0.05）. There were negative correlations between the surrounding area BF, the total BF, BV, and PEI, the uncomplete lumen of the surrounding area MVD, and expression of PCNA, respectively （P 〈 0.05）. There were positive correlations between degree of differentiation and the uncomplete lumen of the surrounding area MVD （P 〈 0. 05）. It was the same as degree of differentiation and expression of PCNA, VEGF, respectively. There were positive correlations between the uncomplete lumen of the surrounding area MVD and expression of VEGF, ephrinB2, EphB4, and PCNA, respectively （P〈0.05）. Conclusion Perfusion parameters reflect the difference of density of vassels with mature functional lumen. Careful evaluation of the differences of blood flow pattern in pulmonary space-occupying lesions by MSCT perfusion scan can be used to identify the degree of NSCLC differentiation.
出处
《中华肿瘤杂志》
CAS
CSCD
北大核心
2009年第6期460-464,共5页
Chinese Journal of Oncology
基金
基金项目：湖南省自然科学基金（07JJ5010）
关键词
癌
非小细胞肺
多层螺旋CT
血液灌注
肿瘤分期
病理学
Carcinoma, non-small cell lung
Multi-slice spiral CT
Blood flow perfusion
Neoplasm staging
Pathology
