肝细胞癌CT强化类型与病理、MVD、VEGF的相关性研究

目的 探讨肝细胞癌(HCC)CT动态增强表现的强化类型与瘤内MVD及VEGF表达之间的关系.方法 运用免疫组化SP法,检测45例经手术切除并病理证实的肝细胞癌瘤内MVD及VEGF的表达,所有病例术前均行CT平扫及增强扫描.结果 (1)病理分级、MVD及VEGF间的关系:Ⅰ、Ⅱ、Ⅲ级和Ⅳ级的MVD分别为22.9±12.6、36.7±16.2、51.1±17.3和67.8±21.4,VEGF阳性表达率分别为28.6%(2/7)、53.3%(8/15)、90.9%(10/11)和100.0%(12/12),Ⅰ级与Ⅲ/Ⅳ级和Ⅱ级与Ⅳ级之间的MVD、VEGF阳性表达率差异显著(P＜0.05),Ⅰ级与Ⅱ级、Ⅱ级与Ⅲ级和Ⅲ级与Ⅳ级之间的MVD,VEGF阳性表达率无显著性差异(P＞0.05).(2)动脉供血型、双重供血型及少血供型肝细胞癌的MVD分别为70.6±22.9、65.7±21.6和25.1±13.5,VEGF阳性表达率分别为85.1%(23/27)、63.6%(7/11)和28.6%(2/7).动脉供血型和双重供血型、双重供血型和少供血型之间VEGF阳性表达率差异均无显著性(P＞0.05),动脉供血型或动脉供血型和双重供血型合并组与少供血型之间VEGF阳性表达率差异有显著性(P＜0.05);动脉供血型和双重供血型的肝细胞癌,其MVD计数均高于少血供型,组间有显著性差异(P＜0.01),动脉供血型与双重供血型MVD计数无显著性差异(P＞0.1).结论 MVD及VEGF表达可在一定程度上反映HCC的分化程度及血供分型.

Study on the Correlation between Blood Supply Types and Pathology, MVD and VEGF Expression in Hepatocellular Carcinoma

Objective To evaluate the correlation between the dynamic enhanced CT signs of hepatocellual carcinoma(HCC),MVD and VEGF expressions in hepatocellular carcinoma.Methods The MVD and VEGF expression were examined by means of SP immunohistochemical technique in 45 cases of HCC proved by pathology.All patients were examined by plain and contrast-enhanced CT.Results(1)The relation of pathologic grade,MVD and VEGF:the MVD in HCC of grade Ⅰ,Ⅱ,Ⅲ,Ⅳ were 22.9 ± 12.6,36.7 ±16.2,51.1±17.3,67.8±21.4,VEGF positive rates in HCC of grade Ⅰ,Ⅱ,Ⅲ and Ⅳ were 28.6%(2/7),53.3%(8/15),90.9%(10/11)and 100.0%(12/12).The pathologic grading of HCC was positively correlated with MVD and VEGF expression,in grade Ⅰ and grade Ⅲ～Ⅳ,Ⅱ and grade Ⅳ(P＜0.05).There were no statistical correlation between Ⅰ and Ⅱ,Ⅱ and Ⅲ or between Ⅲ and Ⅳ(P＞0.05).(2)There were three blood supply types in HCC at contrast-enhanced CT,the MVD ad VEGF positive rates were 70.6±22.9 and 85.l%(23/27)in tumors with arterial blood,65.7±21.6 and 63.6%(7/11)in those with double blood supply,and 25.1±13.5 and 28.6%(2/7)in those with poor blood supply.There was statistical difference(P＞0.05)in VEGF expression between the tumors with arterial blood,arterial combining with double blood supply and poorly blood supply.In HCC with arterial and double blood supply,MVD expression level was higher than that with poor blood supplies(P＜0.01).Conclusion MVD and VEGF expression can reflect the tumor's cell differentiation of HCC in a certain degree.