肝细胞癌螺旋CT扫描与血管内皮生长因子表达的相关性研究

Correlation between expression of vascular endothelial growth factor and the spiral CT manifestations of hepatocellular carcinoma

目的探讨肝细胞癌(HCC)组织中血管内皮生长因子(VEGF)的表达水平与螺旋CT增强扫描表现关系,从影像学角度评价VEGF在HCC表达的意义与特点。方法50例外科手术切除、病理证实的HCC患者,术前均作肝脏的平扫与双期增强扫描,依据肿瘤的强化方式分为四型:动脉期强化型、门静脉期强化型、双期强化型及双期不强化型。采用流式细胞技术测定手术标本肿瘤边缘区、肿瘤中央区及肿瘤临界区的VEGF表达水平。结果①HCC肿块边缘区VEGF的表达水平高于肿瘤中央区和临界区(P<0.01)。②VEGF的表达水平与HCC分级存在正相关性(P<0.01)。③HCC分型与VEGF表达水平相关(P<0.05)。4、HCC动脉期肿块强化CT值与VEGF表达水平正相关(P<0.01)。5、HCC肿块的大小与VEGF表达水平无关(P>0.05)。有淋巴结转移及门静脉癌栓形成的病例其VEGF表达水平高于无淋巴结转移、无门静脉癌栓形成的病例。(P<0.01,P<0.05)。结论HCC肿瘤动脉期强化值与VEGF表达水平均值呈线性相关(r=0.713),且VEGF表达水平与HCC分型、分级、肿瘤的强化方式及肿瘤是否转移密切相关。

Objective To study the relationships between the vascular endothelial growth factor （VEGF） level and enhanced spiral CT manifestations of hepatocellular carcinoma（HCC） and to evaluate the significance of the VEGF expression from the point of medical imaging. Methods Fifty patients with, surgically and pathologically proved HCC underwent spiral CT scanning （plain and dual - phase）. According to tumor contrast and signals shown on spiral CT, the HCC was divided into four types ：arterial blood supplying, portal blood supplying, both arterial and portal blood supplying, and poorly blood supplying. VEGF expression levels of tumor samples were analyzed quantitatively by flow cytometry.Results ①Expression level of VEGF in the border of tumor was higher than those in the center and periphery of tumor （ P 〈 0.01）. ②Expression level of VEGF was correlated with HCC stage. （ P 〈 0.01）.③Expression level of VEGF was correlated with the type of HCC（ P 〈0.05）. ④Positive correlation was found between SCT enhancement value in arterial phase and expression levels of VEGF in HCC（ P 〈 0.01）. ⑤The size of tumor was not con＇elated with the VEGF expression level （ P 〉 0.05）. In lymphatic metastasis group and portal venous tumor thrombus group, the expression level of VEGF was higher than that in the group without lymphatic metastasis or portal venous tumor thrombus（ P 〈0.01, P 〈0.05）. Conclusion Positive correlation was found between SCT enhancement value in arterial phase and expression levels of VEGF in HCC （ r = 0. 713）. The expression levels of VEGF were also correlated with the type, stage, contrast enhancement model, and metastasis of HCC.