肝细胞癌双期螺旋CT表现特征与VEGF、bFGF表达以及临床、病理的关系研究

目的 探讨肝细胞癌(HCC)双期螺旋CT(SCT)增强表现特征与血管内皮生长因子(VEGF)、碱性成纤维细胞生长因子(bFGF)的表达以及临床、病理特征之间的关系。资料与方法 对50例共54个经手术病理证实且行SCT动、静脉双期增强扫描的HCC病灶进行回顾性分析，记录其临床和病理特征，用免疫组织化学SP法检测癌组织中VEGF、bFGF的表达情况，将SCT表现特征与上述指标进行对照分析。结果 HCC中VEGF和bFGF的阳性表达率分别为81.5％(44／54)和75．9％(41／54)。Logistic回归分析表明与SCT显示的包膜类型有关的因素是病理分级；与强化类型有关的因素有病灶的大小和瘤内有无坏死；与SCT显示侵袭转移性有关的因素是病灶的大小；与SCT显示的病灶大小有关的因素有AFP水平、VEGF和病理分级。结论 HCC的SCT表现特征受多种不同因素的共同影响，SCT表现特征可在一定程度上反映VEGF的表达情况。

Correlation between Bi-phase Spiral CT Findings and the Expression of VEGF and bFGF in HCC

Objective To study the correlation of bi-phase spiral CT (SCT) findings with the expression of vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF), also with the clinical and pathological features, in hepatocellular carcinoma (HCC).Materials and Methods Bi-phase SCT scanning was performed in 50 patients, including 39 males and 11 females, with pathologically proved HCC. A total of 54 lesions was found. SCT features were retrospectively analyzed. The expressions of VEGF and bFGF were estimated with immunohistochemical SP method. Clinical manifestations and pathological results were recorded.Results Positive expression of VEGF and bFGF was 81.5%(44/54) and 75.9% (41/54), respectively. Pseudocapsular patterns seen on SCT scans were related to Edmondson's grade, and enhancement patterns were associated with tumor's diameter and intratumoral necrosis. Significant correlation existed between the high infiltration and SCT image severity, such as intrahepatic daughter foci, tumor-emboli in portal veins and lymphatic metastasis. The expression of VEGF, AFP level and Edmondson's grade were correlated with lesion's diameter on SCT scans. Conclusion SCT features of HCC are influenced by a combination of different factors. SCT can reflect the expression of VEGF in a certain degree.