肝细胞癌实时超声造影灌注参数与肿瘤微血管的相关性

Correlation between real-time contrast-enhanced ultrasound perfusion parameters of hepatocellular carcinoma and tumor microvessel density

目的探讨肝细胞癌(HCC)实时超声造影灌注参数与肿瘤微血管(MVD)的相关性。方法选择2017年6月至2018年10月在东莞市人民医院进行诊治的40例肝细胞癌病人作为研究对象,术前对所有病人进行实时超声造影检查。造影后定量分析峰值时间增强图像的平均血流密度(MFD),用时间-强度曲线(TIC)声学定量分析软件绘制TIC进行定量分析,得出病灶绝对增强强度(AEI)并对达峰时间(TTP)和峰值强度(PI)进行记录,将以上记录数据与术后病理免疫组织化学染色计数的微血管密度进行相关性分析。结果 MFD为(0.78±0.15)、AEI为(7.43±3.54)dB、TTP为(14.24±5.11)s、PI值为(43.11±10.25)dB。Pearson相关分析显示,MFD、PI与MVD呈显著正相关(r=0.846;0.732,P=0.013;0.005),TTP值与MVD呈显著负相关(r=-0.561,P=0.000),AEI与MVD之间不具备相关性(P>0.05)。结论实时超声造影灌注参数PI、TTP及MFD与MVD的表达具有良好的相关性,可以作为定量评价肿瘤血流生成状况的可靠指标。

Objective To investigate the correlation between real-time contrast-enhanced ultrasound perfusion parameters of hepatocellular carcinoma(HCC)and tumor microvessel density(MVD). Methods Forty patients with hepatocellular carcinoma who were treated in Dongguan People’s Hospital from June 2017 to October 2018 were enrolled in the study.All patients underwent real-time contrast-enhanced ultrasonography before surgery.After angiography,the mean blood flow density(MFD)of the peak time-enhanced image was quantitatively analyzed with the time-intensity curve(TIC)drawn by TIC acoustic quantitative analysis software to obtain the absolute enhancement of lesions(AEI)and time to progress(TTP)and peak intensity(PI)were recorded.Correlation analysis was made of the above recorded data and the microvessel densityof postoperative pathological immunohistochemical staining.Results The mean MFD,AEI,TTP,and PI of all patients were(0.78±0.15),(7.43±3.54)dB,(14.24±5.11)s,and(43.11±10.25)dB,respectively.Pearson correlation analysis showed that MFD,PI and MVD were significantly positively correlated(r=0.846;0.732,P=0.013;0.005),TTP value was significantly negatively correlated with MVD(r=-0.561,P=0.000),and there was no correlation between AEI and MVD(P>0.05).Conclusion The real-time contrast-enhanced ultrasound perfusion parameters PI,TTP and MFD have a good correlation with the expression of MVD,which can be used as a reliable indicator for quantitative evaluation of tumor blood flow.