MVD和VEGF蛋白的表达及16层CT动态增强与脑膜瘤复发的关系

目的探讨脑膜瘤中微血管密度（microvessel density，MVD）和血管内皮生长因子（vascular endothelial growth factor，VEGF）蛋白的表达以及16层CT动态增强扫描与脑膜瘤复发的关系及其l临床应用价值。方法（1）采用MaxVison^TM法分别检测复发组脑膜瘤33例和非复发组脑膜瘤26例的MVD平均值和VEGF蛋白的表达情况；（2）16层超高速螺旋CT机动态增强扫描，测定CT值及到达峰值持续的时间，分析三者与肿瘤复发的相关性。结果（1）非复发组与复发组脑膜瘤的MVD平均值分别为34．2923±17．2422、71．4100±39．4750，复发组明显高于非复发组（P=0．000〈0．05）；其中复发组脑膜瘤Ⅰ级与Ⅱ、Ⅲ级的MVD平均值分别为54．7304±25．3080、109．7800±39．6420，Ⅱ、Ⅲ级的MVD平均值明显高于Ⅰ级者（P=0．000〈0.05）。（2）VEGF蛋白表达在复发组脑膜瘤Ⅰ级的阳性率39．13％（9／23）高于非复发组的阳性率11．54％（3／26）（P=0．044〈0．05）。（3）38例VEGF蛋白表达阴性的脑膜瘤中MVD平均值为37．9263±15．2300，21例VEGF蛋白表达阳性的脑膜瘤中MVD平均值为86．0286±28．7464，VEGF蛋白的表达与MVD平均值呈正相关（r=0．7888，P〈0.001）。（4）16层CT动态增强扫描D-T曲线斜率与MVD平均值呈正相关（r=0．33，P〈0.01）；峰值持续时间与MVD平均值呈负相关（r=-0．42，P〈0.005）。结论16层CT动态增强扫描与VEGF蛋白和MVD联合检测可作为脑膜瘤手术前、后客观反映其生物学特性的一组重要指标，为脑膜瘤手术后的进一步治疗提供依据。

The Relationship between Recurrence and MVD、Expression of VEGF、16-slice Helical Computed Tomography Dynamic Enhancement in Meningiomas

Objective To investigate the relationship between recurrence and expression of VEGF,MVD and multislice helical computered tomography （MSCT） dynamic enhancement in meningiomas, and evaluate its clinical usefulness. Methods Thirty-three recurrence and 26 primary meni-Ngiomas were observed the expression of MVD and VEGF by immunohistochemistry MaxVisionTM. The finding of CT dynamic enhancement were reviewed, measuring the slope rate of time dentisy curves（SR-DTC） and time on peak. Results （1）the general average of MVD in the primary and recurrent meningiomas was respectively 34. 292 3±17. 242 2.71. 410 0±39. 475 0.It was significantly higher in the recurrent group（P= 0. 000〈0.05） ;The general average of MVD was respectively 54. 730 4±25. 308 0,109. 780 0±39. 642 0 in the recurrent meningiomas of grade Ⅰand grade Ⅱ, Ⅲ, and it was significantly higher in the recurrent meningiomas of gradeⅡ, Ⅲ （P= 0. 000%0.05）. （2） The expression of VEGF was respectively 39.13 % （9/23） and 11.54 % （3/26）in the recurrent meningiomas of gradeⅠand primary meningiomas. The former was higher than the latter（P=0. 044〈0. 05）. （3） The general average of MVD was 37. 926 3±15.230 0 in 38 meningiomas which was negative expression of VEGF, while it was 86.028 6±28. 746 4 in 21 meningiomas which was positive expression of VEGF. Expression of VEGF was positively correlated with general average of MVD （r=0. 788 8, P〈0. 001）. （4） The slope rate of time dentisy curves （SR-DTC） in 16-slice CT dynamic enhancement of meningiomas was positively correlated with general average of MVD（r=0.33,P〈0.01） ; MVD was negatively correlated with time on peak（r= -0.42 ,P〈0. 005）. Conclusion Expression of VEGF,MVD and 16-slice CT dynamic enhancement in meningiomas were examined combined, and they may be an important prediction marker for detecting the clinical pathological characteristics of meningiomas.