肝细胞癌超声造影增强达峰时间与微血管密度相关性研究

Correlative study between the peak time of hepatocellular carcinoma on contrast-enhanced ultrasound and microvessel density

目的 探讨超声动态增强达峰时间（Tmax）与肝细胞癌（HCC）血管生成变化的关系。方法 对34例经手术或穿刺病理证实的HCC患者进行实时超声造影，通过绘制时间-强度曲线，记录Tmax；经HE染色进行肿瘤病理分级，应用CD34行免疫组化微血管密度（MVD）检测，分析Tmax与MVD的关系。结果 34例HCC中高分化6例，中分化15例，低分化13例，高分化组、中分化组、低分化组MVD分别为43．5±12．9、67．2±13．3、82．1±17．8，不同分化程度HCC间MVD差异有统计学意义（F=13．46，P=0．001）；Tmax分别为（33．0±5．1）s、（27．7±4．2）S、（22．7±3．3）S，不同分化程度HCC间Tmax差异有统计学意义（F=14．08，P〈0．001）；Tmax与MVD呈负相关（Y=-0．16X＋37．9，r=-0．605，P〈0．0001）。结论超声动态增强Tmax在一定程度上可以间接提示HCC的微血管密度，有助于判定HCC的分化程度。

Objective To study the correlation between the peak time（Tmax） on contrast-enhanced ultrasound and tumor microvessel density（MVD） of hepatocellular carcinoma（HCC）. Methods Thirty-four cases of HCC diagnosed pathologically in operation or puncturation underwent contrast-enhanced ultrasonography,and the Tmax of all the cases was recorded by drawing the time-intensity curves. All HCC tissue samples were graded pathologically by HE staining. The microvessels were counted by using immunostaining with anti-CD34 antibody,and the correlation between Tmax and MVD was analyzed. Results Of 34 patients,6 cases were diagnosed as well-differentiated, 15 cases as moderately differentiated,and the remaining 13 cases as poorly differentiated. MVD in the group of well-differentiated, moderately differentiated and poorly differentiated was 43.5 ± 12.9,67.2 ± 13.3, and 82. 1± 17.8, respectively. And Tmax in the three groups was （33.0±5.1）s,（27.7 ±4.2）s,and （22.7 ±3.3）s, respectively. MVD with differentiations was found to have statistic significance（ F = 13.46, P = 0. 001 ）, and the T± in the three groups was statistically significant （ F = 14.08 , P 〈0. 001 ）. Tmax was inversely correlated with MVD （Y = -0.16X ＋37.9, r = -0.605, P 〈0.0001）. Conclusions The Tmax of HCC on contrast-enhanced ultrasound can indirectly reflect the information of MVD in HCC lesion, which may be applicable to histological grading of HCC.