周围型肺癌CT征象和动态CT增强与肿瘤微血管密度相关性研究

目的探讨周围型肺癌CT征象和动态CT增强表现与肿瘤微血管密度的关系。方法30例经手术病理证实为周围型肺癌,术前行螺旋CT平扫和动态增强扫描,并观察其征象并测量感兴趣区CT值。病理标本采用免疫组织化学染色SP法表达抗体CD34,并进行病理学观察。结果肿瘤微血管密度与周围型肺癌组织学类型无关(P>0.05),与肿瘤的分化程度、CT影像上肿瘤直径、分叶征、棘状突起、血管集束征、胸膜凹陷征、纵隔淋巴结转移均有密切相关(P<0.05),而与毛刺征无关(P>0.05);肺腺癌的强化幅度略高于鳞癌,但没有统计学意义(P>0.05),肺腺癌与鳞癌的强化幅度均与其MVD值呈正相关(r=0.619,P<0.05;r=0.586,P<0.05)。结论周围型肺癌CT征象和动态CT增强有助于对肺癌的血管密度和预后的评价。

The Relationship of CT Features and Dynamic Enhanced Appearances and Tumor Microvessel Density in Peripheral Lung Cancer

Objective To investigate the relationship of CT features,dynamic enhanced appearances and tumor microvessel density(MVD)in peripheral lung cancer.Methods 30 cases of peripheral lung cancer proved by operation and pathology were collected in this study.All cases were undergone plain and dynamic enhanced CT scan before surgery,the imaging features of tumors were observed and the CT attenuations of the region of interest(ROI)were measured.The pathologic specimens of tumor were immunostatined by using CD34 mono-antibody in SP methods,then MVD was measured to show tumor vascularization.Results The MVD of tumors was no relation with the histological type of tumor in peripheral lung cancer(P>0.05);while it was positively correlated with the degree of tumor cell differentiation,tumor size,lobulation sign,spinous protuberance,vessel convergence sign,pleural retraction sign and lymph node metastasis(P<0.05);but the speculation sign(P>0.05).The enhanced degree in adenocarcinomas was obviously than that in squamous cell carcinomas,but there was no statistical meaning(P>0.05).Both the adenocarcinomas and squamous cell carcinomas were all positively correlated to MVD(P<0.05).Conclusion CT features in peripheral lung cancer can help to assess MVD and the prognoses.