大肠癌腹腔内转移SCT征象与MVD、nm23表达的关系

Correlation between spiral CT features of metastasis in abdominal cavity and expression of MVD and nm23 in colorectal carcinoma

目的探讨大肠癌腹腔内转移螺旋CT征象与MVD、nm23表达的关系。方法40例大肠癌患者,行螺旋CT扫描,并用免疫组化SP法,检测MVD和nm23表达。结果SCT判断大肠癌腹腔内淋巴结转移准确率为77.5%,腹膜转移准确率为90%,肝、肾上腺、卵巢的转移准确率为100%。大肠癌腹腔内转移与无转移组间的CT强化程度、MVD和nm23表达的比较,差异具有统计学意义(P<0.05)。SCT强化程度与MVD之间正相关(r=0.963,P<0.001),两者均与nm23的表达负相关(r_1=-0.971,P<0.001;r_2=0.958,P<0.001)。结论SCT扫描可准确反映大肠癌腹腔内转移情况。nm23的失活可能是大肠癌转移的因素,肿瘤血管生成可能是大肠癌转移的促进因素。CT强化程度可作为一定量指标初步判断肿瘤血管生成,来帮助我们对大肠癌的转移进行推断。

Objective To investigate the correlation between spiral CT features of metastasis in abdominal cavity and expressions of nm23 and MVD in colorectal carcinoma. Methods Forty patients with colorectal carcinoma were examined by SCT before the operation. Expressions of nm23 and MVD in 40 patients with colorectal carcinoma diagnosed by pathology were examined immunohistochemically using SP techniques. Results The accuracy of SCT features for lymph node metastasis in abdominal cavity was 77.5 %. The accuracy of peritoneum metastasis in colorectal carcinoma was 90.0 % and the accuracy of liver, adrenal gland, ovaries of metastasis by SCT was 100%. CT enhancement and expressions of nm23 and MVD between metastasis and no metastasis in abdominal cavity were statistically significant in each of groups （P〈0. 05）. The CT extent of enhancement positively correlated with MVD （r=0. 963, P〈0. 001）. The CT extent of enhancement and MVD negatively correlated with nm23 （r1 = -0. 971, P〈0. 001; r2 =-0. 958, P〈0. 001）. Conclusion SCT scan for the metastasis of abdominal cavity were reliable techniques in colorectal carcinoma. The inactivation of nm23 may be a factor in the metastasis of colorectal carcinoma. And tumor angiogenesis may be a stimulative factor in the metastasis of colorectal carcinoma. CT extent of enhancement might be a quantitative index for tumor angiogenesis. And it may help us to predict the metastasis of colorectal carcinoma.