原发性肝细胞癌的超声造影表现与血管内皮生长因子表达的相关性

目的探讨原发性肝细胞癌(HCC)的CEUS增强时间-强度曲线各参数与血管内皮生长因子(VEGF)表达的相关性。方法选择经手术病理证实的27例原发性HCC作为研究对象,其中中低分化癌16例,高分化癌11例,取其中13例患者的癌周组织作为对照。分析术前CEUS图像,绘制时间-强度曲线,计算增强时间、上升斜率、相对峰值强度、峰值增强率、下降斜率。应用S-P免疫组化法对VEGF进行定位,应用蛋白印迹法对VEGF进行定量,分析CEUS曲线参数与VEGF表达的相关性。结果 VEGF蛋白主要分布于胞浆中,蛋白定量分析显示中低分化HCC、高分化HCC、对照组织的VEGF蛋白相对含量分别为(46.63±9.70)%、(32.36±8.56)%、(8.85±5.05)%,两两比较差异均有统计学意义(P均<0.05)。HCC曲线的相对峰值强度与VEGF蛋白相对含量呈正相关(r=0.56,P<0.05),而增强时间、上升斜率、峰值增强率及下降斜率与VEGF蛋白相对含量均无相关性(P均>0.05)。结论 HCC造影增强时间-强度曲线的相对峰值强度可反映VEGF蛋白表达,不同分化程度HCC的VEGF蛋白相对含量差异显著。

Correlation between contrast-enhanced ultrasonographic appearances and the expression of vascular endothelial growth factor of primary hepatocellular carcinoma

Objective To investigate the relationship between the parameters of CEUS time-intensity curve and vascular endothelial growth factor (VEGF) of primary hepatocellular carcinoma (HCC). Methods Twenty-seven patients with pathologically confirmed primary HCC were enrolled, including 16 with poorly to moderately differentiated HCC and 11 with well differentiated HCC. The hepatic tissues around HCC in 13 patients were selected as control. CEUS images before operation were analyzed. Time-intensity curve was drawn and the parameters such as intensity time, rising slope, relative peak intensity, peak enhancement rate, descending slope were calculated. VEGF was located with immunohistochemistry method and quantitatively analyzed with Western-blot method. The correlation between the parameters of enhancement time-intensity curve and VEGF expression was analyzed. Results VEGF was mainly distributed in cytoplasm. The quantitative analysis showed that the relative value of VEGF was (46.63±9.70)% in moderately to poorly differentiated HCC, (32.36±8.56)% in well differentiated HCC, and (8.85±5.05)% in control group, statistical differences were found between each two groups (all P<0.05). The relative peak intensity of HCC was positively correlated to VEGF expression(r=0.56, P<0.05), while no correlation was found with intensity time, rising slope, peak enhancement rate nor descending slope (all P>0.05). Conclusion The relative peak intensity of HCC may indicate VEGF expression, and the relative value of VEGF in different differentiated HCC is obviously different.