膀胱移行上皮癌螺旋CT增强扫描与肿瘤血管生成的相关性研究

目的　分析膀胱癌螺旋CT增强早期的表现 ,探讨癌灶的强化程度与肿瘤血管生成的关系。方法　 53例膀胱癌患者术前行盆腔CT平扫与螺旋CT(SCT)增强扫描 (在对比剂开始注射后40～ 45s进行扫描 ) ,测得肿瘤灶的CT强化值。术后对每一个病灶行病理分级、血管内皮生长因子(VEGF)、微血管密度 (MVD)的研究 ,用统计学分析癌灶的CT强化值与病理分级、VEGF、MVD等的相关性。结果　 73个膀胱癌灶出现不同程度的强化。不同病理分级癌灶的CT强化均值、MVD均值差异有显著性 (P <0 .0 0 1)。CT强化均值与MVD呈高度相关 (r =0 .93 6,P <0 .0 0 1) ,与病理分级相关(r =0 .75,P <0 .0 0 1) ,与VEGF表达不相关。VEGF与MVD、病理分级不相关。结论　膀胱癌在SCT增强早期的CT强化值与MVD、病理分级呈正相关 ,此期膀胱癌的CT强化值可反映癌灶内的微血管生成情况与血供情况

Relationship between early enhanced helical CT and tumor angiogenesis in bladder cancer

OBJECTIVE: To study the relationship between enhanced degree in the cancer lesion and angiogenesis in the tumor through early manifestations in enhanced helical CT in patients with bladder cancer. METHODS: Fifty-three patients with bladder carcinoma were examined by pelvic plain CT and helical CT scan at peak enhancement of cancer lesion. Histologic grade, vascular endothelial growth factor (VEGF) and micro-vascular density (MVD) were analyzed for each resected cancer lesion. Pearson and Spearman correlation tests were used to assess the relationship between CT enhancement and histologic grade, VEGF or MVD. RESULTS: In early enhancing phase of helical CT, different degrees of enhancement were observed in 73 bladder cancer lesions. The difference between average CT attenuation and MVD in different histologic grade cancer lesions was statistically significant (P < 0.001). A positive correlation was found between the CT enhancement and MVD (gamma = 0.936, P < 0.001), histologic grade (gamma = 0.75, P < 0.001), but VEGF of bladder cancer did not correlate with the CT enhancement or MVD. CONCLUSION: The early enhancement of helical CT enhancement of bladder cancer, showing a positive relation to MVD and histologic grade, can reflect the tumor angiogenesis and blood supply.