肝细胞癌边缘CT征象与肿块周围部VEGF表达相关性研究

 目的 研究肝细胞癌(hepatocellular carcinoma,HCC)边缘组织中血管内皮生长因子(vascular endothelial growth factor,VEGF)的表达水平与螺旋CT增强扫描表现,探讨癌灶边缘强化程度与VEGF表达之间的关系.方法 经外科手术切除、病理证实的HCC患者48例,术前进行全肝平扫与双期增强扫描,观察肿块边缘CT表现与病理特征,分析包膜有无、包膜完整性及肿瘤的强化程度与VEGF表达之间的关系.采用VEGF免疫组织化学检测手术标本肿瘤边缘区不同方位点VEGF表达阳性细胞百分比.结果 CT显示包膜的有无及完整性与手术病理一致,包膜完整、境界清楚10例(10/48,20.83%),肿块无明确包膜17例(17/48,35.42%),境界均显示不清,包膜不完整、境界部分不清楚21例(21/48,43.75%);肿块周边不同方位点VEGF表达阳性率完全一致14例(14/48,29.2%),平均阳性率为(53.09±11.72)%,动脉期肿块周边组织CT强化程度(28.13±10.20) Hu;肿块周边不同方位点VEGF表达阳性率不一致34例(34/48,70.8%),平均阳性率为(78.24±14.73)%,动脉期肿块周边组织CT强化程度(57.25±12.83) Hu.结论 CT扫描能较好的反映肿瘤包膜的完整程度,肿瘤边缘区有包膜与无包膜其VEGF表达水平有明显差异(P<0.05);肿块边缘强化程度与肿瘤边缘区VEGF表达水平呈正相关关系(P<0.01).HCC肿瘤边缘区VEGF表达水平与HCC的边缘CT表现有关,一定程度上反映了肿瘤的病理特征和生物学行为.

A study on the relationship between the expression of vascular endothelial growth factors and the spiral CT manifestations on the periphery of hepatocellular carcinoma

Objective To study the relationship between the level of vascular endothelial growth factors （VEGF） level and enhancement spiral CT features of hepatocellular carcinoma （ HCC ）, and that between the enhancement degree of SCT and the level of VEGF expression on the periphery of the mass. Methods 48 cases （48 lesions） of HCC that had been proved surgically and pathologically were collected. Enhancement dual -phase （plain and dual -phase） SCT scanning of the whole liver was included in this study. All the features of SCT were compared with clinieopathological characteristics on the periphery of the mass. The correlation between the enhancement degree of the SCT scanning （arterial phase） and the level of VEGF expression on the periphery of the mass was analyzed. The expression of VEGF was determined by immunohistoebemical method on different sites of the periphery of the mass. Results Among the 48 eases, there were 10 cases （ 10/48,20.83% ） with marked pseudocapsule, 17 cases （ 17/48,35.42% ） without marked pseudoeapsule, and 21 cases （21/48,43.75%） with imperfect pseudocapsule. The number of patients with constant VEGF expression levels was 14 （ 14/48,29.2% ）, the expression percentage averaged （53.09 ± 11.72 ） %, the enhancement degree on SCT averaged （ 28.13 ± 10.20） Hu. The number of patients with different VEGF expression levels was 34 （34/48,70.8%） , the average of its expression percentage was （78.24±14.73 ） %, and the average of the enhancement degree on SCT was （ 57.25 ± 12.83 ） Hu. Conclusions （ 1 ） The integrity of tumor capsule could be well reflected by the CT scanning of the tumor border in HCC. Between the pseudocapsule group and non - pseudocapsule group, the expression levels of VEGF in the tumor border of HCC was significantly different （ P 〈 0.05 ）. （2） The positive eorre-lation was found between the SCT enhancement value in the arterial phase and the expression levels of VEGF in the border of the mass （P 〈0.01 ）. The peripheral enhancement features of HCC in the border of the mass on spiral CT scanning could reflect the expression levels of VEGF and the histopathologic characteristics, and predict the biologic behavior to a certain degree.