原发性肝癌肿瘤微血管形态特征与其生物学特性的关系

Relationship between morphological characteristics of tumor microvessel and biological features of primary hepatocellular carcinoma

目的:探讨HCC肿瘤微血管特征与其大小、细胞分化程度、DSA血供分型等生物学特性的关系. 方法:选取手术切除前做过血管造影且未做栓塞治疗的HCC标本32例.对不同分化程度、大小、DSA血供分型肝癌的MVD、肿瘤微血管直径、肿瘤梁索直径、肿瘤微血管梁索直径比进行相关统计学分析. 结果:随HCC生长,肿瘤微血管分型有增高的趋势(rs=0.55,P=0.001):肝癌DSA血供分型随肿瘤微血管分型增加呈增加的趋势(rs=0.56,P=0.001);不同大小肝癌MVD不同,3-5 cm组肝癌的MVD最大,与≤3 cm及>5 cm组比P=0.005及P:0.016:随HCC 生长,微血管直径有增高的趋势;肿瘤MVD在乏血供、中等血供、富血供HCC中分别为45.34±21.18、69.50±54.18和61.56±38.94,乏血供组MVD明显小于中等血供和富血供组(P=0.014,P=0.031).肿瘤微血管直径、微血管梁索直径比有随HCC血供分级由乏血供至富血供有明显的增加趋势,乏血供HCC肿瘤微血管直径明显低于富血供HCC(P=0.044),其血管梁索直径比明显低于中等血供和富血供组(P=0.017, P=0.008);富血供HCC与中等血供相比,MVD基本相似,而富血供HCC的微血管直径有大于中等血供HCC的趋势;MVD与肝癌分化程度无关(P>0.05). 结论:HCC在生长的不同阶段,其肿瘤微血管特征是不同的,并有一定的发展规律;HCC的DSA不同血供类型之间有明显的肿瘤微血管特征差异.

AIM: To investigate the relationship between the tumor microvascular characteristics and biological features of primary hepatocellular carcinoma (HCC). METHODS: Thirty-two tumor specimens were resected from patients with HCC. The tumor microvessel density (MVD), microvessel diameter (MD), trabecular diameter (TD) and diameter ratio of tumor microvessel to trabecular (D-TM/T) of HCC with different differentiated degree, sizes, and blood supply in DSA were analyzed statistically. RESULTS: The grades of tumor microvessel type tended to go up with the growth of HCC (rs= 0.55,P= 0.001). With the increase of tumor microvessel grades, DSA blood supply tended to be higher types (rs= 0.56, P= 0.001). MVD was different between different sizes of HCC, and the highest value, which was significantly higher than that of HCC with the diameters of≤3 cm (P= 0.005) and >5 cm (P= 0.016), appeared in tumors with the diameters of 3- 5 cm. MD was increased with the increase of HCC diameter. MVDs in low, moderate and high blood supply HCC were 45.34±21.18, 69.50±54.18 and 61.56±38.94 respectively, and MVD in low blood supply HCC was much markedly lower than that in moderate and high one (P= 0.014, P=0.031). Tumor MD and D-TM/T was increased from low to high blood supply HCC accordingly. Tumor MD of low blood supply HCC was significantly smaller than that in high one (P= 0.044), and D-TM/T obviously lower than moderate and high one (P= 0.017, P= 0.008). MVD showed no significant difference between high and moderate blood supply HCC.MVD was not significantly related to the differentiated degree of HCC (P>0.05). CONCLUSION: The characteristics of tumor microvessels are regularly different during the progress of HCC. HCC with different blood supply shows significant differences in features of tumor microvessels.