摘要
背景准确评估肿瘤组织的微循环血流灌注情况,对于临床治疗以及预后评估有着重要意义.超声造影(contrast-enhanced ultrasonography,CEUS)是一种敏感度极高的微循环血流监测手段,能客观反映肿瘤组织的微循环血流灌注状态,可为临床诊治提供可靠的血流动力学信息.目的运用CEUS评估胃癌(gastric cancer,GC)血流灌注状态,并探讨其与血管新生指标的相关性.方法选取在浙江医院行手术切除的66例GC患者作为研究对象(GC组).所有患者术前三天内行CEUS检查,运用时间-强度曲线测定GC组织、癌旁正常组织的增强强度、达峰时间,并采用酶联免疫吸附法(enzymelinked immunosorbent assay,ELISA)测定患者血清血管内皮生长因子(vascular endothelial growth factor,VEGF)、血管生成素-2(Angiopoietin-2,Ang-2)水平,术后测定组织标本微血管密度(microvessel density,MVD).同期选取72例健康志愿者作为对照组进行比较分析.结果GC组织的增强强度明显高于癌旁正常组织,差异有统计学意义(P<0.05);GC组织的达峰时间明显短于癌旁正常组织,差异有统计学意义(P<0.05);GC组织的MVD明显高于癌旁正常组织,差异有统计学意义(P<0.05);GC组的VEGF、Ang-2明显高于对照组,差异有统计学意义(P<0.05);GC组织的增强强度分别与VEGF、Ang-2、MVD呈正相关(r=0.85,r=0.81,r=0.88,P<0.05);GC组织的达峰时间分别与VEGF、Ang-2、MVD呈负相关(r=-0.72,r=-0.73,r=-0.86,P<0.05).结论CEUS能动态评估GC血流灌注状态,其血流参数与VEGF、Ang-2、MVD相关性良好,能为临床评估GC血管新生状态提供无创性影像学手段.
BACKGROUND Accurate evaluation of microcirculation perfusion in tumor tissue is of great significance for clinical treatment and prognosis evaluation.Contrast-enhanced ultrasonography(CEUS)is a highly sensitive means of monitoring microcirculation perfusion,which can objectively reflect the microcirculation perfusion state of tumor tissue and provide reliable hemodynamic information for clinical diagnosis and treatment.AIM To evaluate the perfusion status of gastric cancer(GC)by CEUS,and to explore the correlation between the perfusion status and the indexes of angiogenesis.METHODS Sixty-six patients with GC were selected as study subjects(GC group).All patients were examined by CEUS 3 d before operation.The enhanced intensity(EI)and time to peak(TTP)of GC and tumor-adjacent normal tissues were measured by time-intensity curve analysis.The levels of vascular endothelial growth factor(VEGF)and angiopoietin-2(Ang-2)were measured by enzyme-linked immunosorbent assay(ELISA),and the microvessel density(MVD)was measured after operation.Seventytwo healthy volunteers were selected as a control group for comparative analysis.RESULTS The EI and MVD were significantly higher and the TTP was significantly shorter in GC tissue than in normal tissue(P<0.05).VEGF and Ang-2 levels were significantly higher in the GC group than in the control group(P<0.05).EI had a positive correlation with VEGF,Ang-2,and MVD(r=0.85,0.81,and 0.88,respectively;P<0.05),and TTP had a negative correlation with VEGF,Ang-2,and MVD(r=-0.72,-0.73,and-0.86,respectively;P<0.05).CONCLUSION CEUS can dynamically evaluate the perfusion status of GC,and CEUS blood flow parameters have a good correlation with VEGF,Ang-2,and MVD.CEUS can provide a noninvasive imaging method for clinical evaluation of the angiogenesis status of GC.
作者
方苑仲
刘志红
张荣
Yuan-Zhong Fang;Zhi-Hong Liu;Rong Zhang(Department of Laboratory Medicine,Hangzhou Yuhang Maternal and Child Health Hospital,Hangzhou 311100,Zhejiang Province,China;Department of Medicine,Deqing People’s Hospital,Huzhou 313200,Zhejiang Province,China;Department of Ultrasonography,Zhejiang Hospital,Hangzhou 310013,Zhejiang Province,China)
出处
《世界华人消化杂志》
CAS
2020年第9期347-351,共5页
World Chinese Journal of Digestology
关键词
超声造影
胃癌
增强强度
达峰时间
血管内皮生长因子
血管生成素-2
微血管密度
Contrast-enhanced ultrasound
Gastric cancer
Enhanced intensity
Time to peak
Vascular endothelial growth factor
Angiopoietin-2
Microvessel density
