| 乳腺肿瘤血管生成功能性变化特征及其机制 |
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| 引用本文： | 李颖嘉,杨莉,夏琼,文戈. 乳腺肿瘤血管生成功能性变化特征及其机制[J]. 南方医科大学学报, 2009, 29(8): 1557 |
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| 作者姓名： | 李颖嘉 杨莉 夏琼 文戈 |
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| 作者单位： | 南方医科大学南方医院超声科,广东,广州,510515;南方医科大学南方医院药材科,广东,广州,510515;南方医科大学南方医院影像中心,广东,广州,510515 |
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| 摘 要： | ![]()
目的 探讨乳腺良恶性不同肿瘤、同种肿瘤不同灌注区域血流灌注特征以及血管生成表型的差异.方法 应用超声造影时间-强度曲线(TIC)定量分析技术检测30例乳腺恶性肿瘤、30例乳腺纤维腺瘤瘤灶边缘及中心部区域灌注参数及平均灌注参数峰值强度(PI)、曲线下面积(AUC)、达峰时间(TTP)、廓清时间(WOT),免疫组化技术检测CD34、血管内皮生长因子(VEGF)、Flk-1/KDR在两组肿瘤中的表达.结果 恶性组TIC形态多数(87.88%,29/33)呈速升缓降型,良性组多数(80.00%,12/15)呈缓升速降型.恶性组平均AUC、WOT大于良性组(P<0.05),平均PI、TTP两组间无统计学差异(P>0.05).恶性组病灶边缘的PI、AUC、WOT、TTP与中心相比有统计学差异(P＜0.05),良性组病灶边缘的各灌注参数与中心相比无统计学差异(P>0.05).恶性组微血管密度显著高于良性组(P<0.05),尤其富集于癌巢边缘.VEGF及Flk-1/KDR在恶性组血管内皮细胞尤其癌巢边缘呈强阳性表达,在良性组血管内皮细胞几乎不表达(P<0.05).结论 实时超声造影TIC形态、各平均灌注参数及区域灌注参数的差异为乳腺良恶性肿瘤的鉴别诊断提供了重要依据.针对VEGF或Flk-1/KDR为靶点进行乳腺癌特异性分子显像可能为乳腺癌的准确诊断提供新的思路.Abstract：Objective To compare the histological morphology, hemodynamics and angiogenesis-related molecules between benign and malignant breast tumor and investigate their variation in different perfusion regions in the same type of tumors.Methods Thirty patients with malignant breast carcinoma and 30 with breast fibroadenoma underwent contrast-enhanced ultrasound examination with time-intensity quantitative analysis. The perfusion indices including peak intensity (PI), area under the curve (AUC), time to peak (TTP) and wash-out time (WOT) were measured both inside and on the margin of the foci. The expressions of CD34, vascular endothelial growth factor (VEGF), and Flk-1/KDR in both groups were measured immuhistochemically. Results The time-intensity curve (TIC) of malignant tumor group was characterized by rapid ascent and slow descent, while that of the benign group presented with slow ascent and rapid descent. The AUC and WOT of the malignant tumor group were significantly higher than those of the benign group, while the PI and TTP showed no significant difference. In malignant tumor group, PI, AUC and WOT on the margin of the foci were significantly higher those of the inside region, while TTP showed a reverse pattern. No significant differences were found in the perfusion parameters between the inside and outside of the foci in the benign group. The distribution of CD34 was heterogeneous in breast carcinoma, and the micro-vessels were densely distributed especially on the margin of the cancer nest. The microvessel density of the malignant group (34.48±8.34) was significantly higher than that of the benign group (18.65±4.69). Diffuse or focal high VEGF expression was found on the margin of the cancer nest and necrotic tissue, but hardly detected in the benign group. Flk-1/KDR expressed diffusely or fiscally in breast carcinoma with especial high expression on the margin of the cancer nest and necrotic tissue, but was virtually undetectable in the benign group. Conclusion The perfusion pattern, TIC, mean perfusion parameter and variation of the regional perfusion parameters provide valuable evidence for differential diagnoses between benign and malignant breast tumors. Molecular imaging targeting VEGF and Flk-1/KD shed light on new approaches to early diagnosis of breast carcinoma.
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| 关 键 词： | 乳腺肿瘤 血管生成 灌注参数 CD34 VEGF Flk-1/KDR |
Hemodynamic changes in benign and malignant breast tumors and the mechanism |
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| LI Ying-jia,YANG Li,XIA Qiong,WEN GE. Hemodynamic changes in benign and malignant breast tumors and the mechanism[J]. Journal of Southern Medical University, 2009, 29(8): 1557 |
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| Authors: | LI Ying-jia YANG Li XIA Qiong WEN GE |
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| Affiliation: | LI Ying-jia1,YANG Li2,XIA Qiong3,WEN GE3 Department of Ultrasound Diagnosis1,Department of Pharmacy2,Imaging Centre3,Nanfang Hospital,Southern Medical University,Guangzhou 510515,China |
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| Abstract: | ![]()
Objective To compare the histological morphology, hemodynamics and angiogenesis-related molecules between benign and malignant breast tumor and investigate their variation in different perfusion regions in the same type of tumors. Methods Thirty patients with malignant breast carcinoma and 30 with breast fibroadenoma underwent contrast-enhanced ultrasound examination with time-intensity quantitative analysis. The perfusion indices including peak intensity (PI), area under the curve (AUC), time to peak (TTP)... |
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| Keywords: | CD34 VEGF Flk-1/KDR |
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