微小肝癌的动态超声监测及其生物学特征

Dynamic US scanning and their biological study of micro hepatocellular carcinoma(MHCC)

目的研究微小肝癌超声诊断特征及与血管内皮生长因子(VEGF)表达的关系。方法实验组由12只肝脏内含直径≤10 mm单一肿瘤结节的新西兰大白兔组成。应用超声仪在不同时间对实验兔接种区进行监测,取出荷瘤肝脏进行病理学检查及VEGF的免疫组化检测。进行统计学卡方检验分析。结果超声检查:2只兔病灶中央发现血流信号,12只兔病灶的非中心区发现丰富血流信号。免疫组化检查:12只肿瘤病灶的周边组织VEGF皆为高表达,中央组织有8例为高表达,4例为低表达,瘤周正常肝组织皆为低表达。统计分析:肿瘤周边组织高表达率为100%(12/12),肿瘤中央组织高表达率83.33%(10/12),经采用卡方检验(确切概率法),P=0.4783,α=0.05,P>α,证明肿瘤周边组织与肿瘤中央组织的VEGF表达无统计学差异。结论超声可发现微小肝癌的异常表现,表现形式取决于肿瘤内部的组织成分、细胞排列方式。增强特点和血流动力学改变取决于肿瘤中心及周边的血管数目。微小肝癌的血流动力学变化与肿瘤组织VEGF的表达有一定相关性。

Objective To study the relationship between ultrasound features and vascular endothelial growth factor（VEGF） expression in micro hepatecellular carcinoma （MHCC）. Methods Experimental group： 12 rabbit models beating VX2 liver tumors with the diameter ≤ 10 mm. Uhrasonography（US） scanning was performed at different time after implantation of VX2 tumors. The liver tumors were collected after US monitoring. HE stain and immunohistechemieal examination were performed for pathology and VEGF expression observation. Statistical significance was analyzed by chi - square test. Results US scan： Color Doppler flow imaging（CDFI） showed that the 12 tumors were hypervascular in paracentre and in the centre of all the tumors, the blood flowing was only found in two of them. examination： High expression of VEGF was found in marginal tissue of the 12 tumors and in center tissue of 8 tumors, low expression of VEGF was found in enter tissues of 4 tumors and in all of the normal liver tissues. Statistics： The high expression of VEGF was 100 % in marginal tissues, and 83.33 % in center tissues. In the chi - square test （ P = 0. 4783,α = 0.05, P 〉α）. There was no statistical difference. Conclusion MHCC can be detected by fellow- up US. The features of US were depended on inside tissue - component. The change of blood kinetics and enhanced patterns had relationship with the number of small blood vessels in the center and. peripheral tissues of the tumors. Blood kinetics of MHCC is related with VEGF expression.