胸部SFT的多层螺旋CT影像学表现与组织标本CerbB-2表达的相关性

Correlation Between the Multi-slice Spiral CT Imaging Findings of Chest Solitary Fibrous Tumor and CerbB-2 Expression in Tissue Specimens

目的探讨胸部孤立性纤维性肿瘤(SFT)的多层螺旋CT影像学表现与组织标本人表皮生长因子受体2(CerbB-2)表达的相关性。方法收集手术治疗的SFT的34例患者临床资料,术前均行多层螺旋CT检查,切除肿瘤组织标本采用免疫组织化学SP法对CerbB-2表达进行检测,分析结果。结果在多层螺旋CT下肿瘤形态13例(38.24%)为圆形或椭圆形、18例(52.94%)为不规则形、3例(8.82%)为分叶状,30例(88.24%)肿瘤组织边缘清晰、4例(11.76%)边缘不清,12例(35.29%)CT平扫及强化扫描肿瘤密度均均匀,22例(64.71%)平扫和强化扫描不均匀有不规则钙化或病灶坏死。肿瘤最大直径4.72~22 cm,平均为(13.34±4.36)cm,肿瘤实质平扫CT值(35.79±8.33)HU,肿瘤实质增强CT值(66.47±21.56)HU,静脉期最大强化率(vCER)(155.24±45.72)%。26患者切除肿瘤组织中CerbB-2表达阳性,阳性率为76.47%,其中弱阳性7例、中等阳性11例、强阳性8例。瘤细胞密度(438.95±103.47)个,肿瘤实质血管数(2.41±0.74)条。患者多层螺旋CT检查所示的肿瘤直径、肿瘤平扫及增强扫描CT值、静脉期vCER不同时CerbB-2表达阳性率明显不同,比较差异有统计学意义(P<0.05)。Spearman相关分析显示患者多层螺旋CT检查所示肿瘤直径、肿瘤平扫及增强扫描CT值、静脉期vCER值与肿瘤组织中CerbB-2表达阳性率之间有正相关性(P<0.05)。结论胸部SFT在多层螺旋CT下主要表现为边缘清晰、不均匀强化的圆形或椭圆形包块,组织CerbB-2表达阳性率高。多层螺旋CT影像学指标与肿瘤组织CerbB-2蛋白有密切相关性。

Objective To discuss correlation between the Multi-slice spiral CT(MSCT)imaging findings of chest solitary fibrous tumor(SFT)and human epidermal growth factor receptor 2(CerbB-2)expression in tissue specimens.Methods Clinical data of 34 patients with SFT treated by surgery were collected,MSCT was performed before operation,the expression of CerbB-2 was detected by immunohistochemical SP method in resected tumor tissue specimens,and analyzed the results.Results MSCT showed that 13(38.24%)of the tumors were round or oval in shape,18 cases(52.94%)were irregular,3 cases(8.82%)were lobulated,tumor margins were clear in 30 cases(88.24%),4 cases(11.76%)had indistinct edges.The tumor density was uniform in 12 cases(35.29%)with CT plain scan and enhanced scan,22 patients(64.71%)had irregular calcification or lesion necrosis on plain and enhanced scans.The maximum diameter of the tumor was 4.72-22cm,and with an average diameter of(13.34±4.36)cm.The CT value of tumor parenchyma plain scan was(35.79±8.33)HU,and the CT value of tumor parenchyma enhanced scan was(66.47±21.56)HU,VCER(155.24±45.72)%in venous phase.CerbB-2 expression was positive in the resected tumor tissues with 26 patients,and the positive rate was 76.47%,there were 7 cases were weakly positive,11 cases were moderately positive and 8 cases were strongly positive,the tumor cell density was(438.95±103.47)and the number of parenchymal vessels was(2.41±0.74).Tumor diameter,CT value of plain scan and enhanced scan and vCER of venous phase were different,and CerbB-2 expression positive rate was significantly different,the difference was statistically significant(P<0.05).Spearman correlation analysis showed tumor diameter,CT value of plain scan and enhanced scan,vCER value of venous phase and positive rate of CerbB-2 expression in tumor tissues were positively correlated(P<0.05).Conclusion The SFT of the chest under multislice spiral CT is mainly manifested as round or elliptic mass with clear edge and non-uniform enhancement,CerbB-2 expression rate in tumor tissues was high,and MSCT imaging indexes were closely correlated with CerbB-2 protein in tumor tissues.