肾癌CT灌注成像和微血管密度及血管内皮生长因子相关性的研究

目的分析肾细胞癌(RCC)CT灌注参数强化峰值(PV)、血流量(BF)、血容积(BV)与肿瘤微血管密度(MVD)、血管内皮生长因子(VEGF)表达的相关性。方法对24例经手术病理证实的肾癌患者行多层螺旋CT灌注扫描,所得数据送入Advanced Workstation 4.2工作站,应用Perfusion 3软件分别测量肿瘤的灌注参数PV、BF、BV,用免疫组化过氧化物酶标记的链霉素卵白素法(SP法)检测RCC中MVD、VEGF的表达;研究VEGF阳性、阴性两组与灌注参数的关系及MVD与VEGF的关系。结果24例肾癌VEGF阳性率约54.2%(13/24),MVD平均值91.3±50.9。VEGF阳性肾癌与阴性肾癌的PV、BF、BV间有显著性差异,分别为74.32±32.49,53.38±29.43,P<0.05;938.58±89.63,907.29±112.59,P<0.05;89.73±9.37,62.14±11.23,P<0.05;VEGF阳性肾癌与阴性肾癌两组间的MVD值有显著性差异,分别为103.2±61.7,74.6±41.9,P<0.05;肾癌的VEGF与MVD间呈正相关(r=0.591,P<0.01);肾癌的CT灌注参数PV、BF、BV分别与MVD、VEGF表达存在正相关。结论肾癌CT灌注参数与MVD、VEGF表达存在正相关,灌注参数在一定程度上反映活体的肿瘤血管生成状况和恶性程度,有助于临床制定治疗方案,判断疗效及预后。

Correlation of CT perfusion parameters with MVD and VEGF in renal cell carcinoma

Objective To analyze the relationship of the CT perfusion parameters with MVD and VEGF in renal cell carcinoma (RCC). Methods CT perfusion scan were performed in 24 patients with RCC using multi-slice spiral computed tomography. All the data were sent to Advanced Workstation 4.2, and perfusion parameters (peak value, blood flow, blood volume) of tumor were obtained by Perfusion 3 software. MVD and expressions of VEGF were examined immunohistochemically using SP techniques. The correlation of VEGF-positive, VEGF-negative group and the perfusion parameters and the correlation of MVD and VEGF were studied respectively. Results VEGF positive rate of renal cell carcinoma was 54.2% (13/24). Average value of MVD was 91.3±50.9 in 24 patients. There was a significant difference in PV, BF, BV between VEGF-positive and VEGF-negative group (74.32±32.49, 53.38±29.43, P<0.05; 938.58±89.63, 907.29±112.59, P<0.05; 89.73±9.37,62.14±11.23, P<0.05). The mean MVD of VEGF-positive group were significantly higher than those of negative one (103.2±61.7, 74.6±41.9, P<0.05). The expression of VEGF had positive correlation to corresponding MVD values (r=0.591,P<0.01). The PV, BF, BV of renal cell carcinoma had positive correlation to MVD and VEGF correspondingly. Conclusion CT perfusion parameters of RCC was positively correlated with MVD and the expression of VEGF significantly. CT perfusion offers a new way to study the angiogenesis of RCC in vivo, which will be helpful to optimize the treatment protocol and to foretell the patient's prognosis.