胰腺癌的CT增强和瘤体微血管密度及病理分级的相关性研究

The correlation study of CT enhancement, intratumoral microvessel density and pathological grades in pancreatic carcinoma

目的 探讨胰腺癌的胰实质期CT增强、瘤体实质瘤细胞处的微血管密度和病理级别的相关性 ,评价胰腺癌CT强化程度、形式和其恶性度的关系。方法 选择经手术切除有病理大标本的胰腺患者 34例 ,手术前均行CT增强扫描 ,观察胰腺癌胰实质期强化程度和形式 ,并对胰腺癌的手术标本行HE染色和免疫组化标记 ,检测胰腺癌标本的微血管密度和组织学病理级别。对胰腺癌的CT强化状况、瘤体实质瘤细胞处微血管密度计数和病理级别作对照分析。结果 胰腺高分化腺癌 16例 ,中等分化腺癌 7例 ,低分化腺癌 11例。CT呈等密度强化者 13例 ,呈稍低密度强化者 9例 ,呈稍低密度强化伴小囊性变者 9例 ,呈稍低密度伴大片状低密度灶者 3例。瘤体标本免疫组化标记示瘤体实质瘤细胞处微血管密度计数少者 10例 ,微血管密度计数中等者 16例 ,微血管密度计数多者 8例。胰腺癌的病理亚型和瘤体CT胰期增强程度、形式进行Spearman秩相关检验的结果为r=0 785 7,t=7 185 1,P <0 0 0 1。胰腺癌的病理亚型和瘤体实质瘤细胞处微血管密度计数明显相关 (r=0 36 13,t=2 1917,P <0 0 5 )。肿瘤的CT胰实质期增强程度、形式和瘤体实质瘤细胞处微血管密度计数非常明显相关 (r=0 6 76 8,t=5 2 0 0 6 ,P <0 0 0 1)。结论 胰腺癌的CT胰实质期增强?

Objective The purpose of this work was to study the correlation of pancreatic phase CT enhancement, intratumoral microvessel density (MVD) and histopathological grades in pancreatic carcinoma and to evaluate the relationship between CT enhancement degree and the malignancy degree of pancreatic carcinoma. Methods 34 patients with pancreatic carcinoma underwent CT scanning before resection. The enhancement degrees and forms of tumor were observed in pancreatic-phase. The operational sample was stained with HE and CD34 marked by immunohistochemistry. MVD and histopathological grades of pancreatic carcinoma were examined. CT enhancement of the tumor, MVD counting in hot spots areas of neoplastic parenchymal cells and pathological grades of pancreatic carcinoma were comparatively analyzed. Results Highly differentiated pancreatic adenocarcinoma was identified in 16 patients, moderately differentiated tumor in 7 and poorly differentiated tumor in 11. Isodensity CT enhancement was demonstrated in 13 cases, slight low density enhancement in 9, slight low density enhancement along with small cyst lesion in 9 and slight low density enhancement along with large cyst lesion in 3. The counting of MVD with CD34 marked by immunohistochemistry in hot spot areas of neoplastic parenchyma cells were small in 10 cases, medium in 16 and large in 8. The pathological grades correlated with CT enhancement of tumor (r=0. 785 7, P<0.001). The pathological grade correlated with MVD counting of tumor (r=0.361 3, P<0.05). The CT enhancement of tumor correlated with MVD (r=0.676 8, P<0.001). Conclusion There was obvious and significant correlation between CT enhancement, pathological grades MVD numbers in the hot spot areas of tumor. The malignant degree of pancreatic carcinoma was inversely proportional to the extent of CT enhancement and inversely proportional to MVD numbers in the hot spot areas of tumor.