结直肠癌64层螺旋CT灌注成像与微血管密度及血管内皮生长因子的相关性

Evaluation of microvessel density and vascular endothelial growth factor in colorectal carcinoma with 64-multidetector-row CT perfusion imaging

目的探讨结直肠癌64层螺旋CT（64MDCT）灌注成像与微血管密度（MVD）和血管内皮生长因子（VEGF）相关性。方法对33例结直肠癌患者进行64层螺旋CT灌注成像检查．绘制所选层面靶动脉、靶静脉及肿瘤的感兴趣区（ROI）的时间-密度曲线（TDC）。64层螺旋C灌注的参数包括血流量（BF）、血容量（BV）、平均通过时间（MTT）和表面通透性（PS）。测定癌组织的MVD和VEGF的表达。对不同类型TDC间的MVD和VEGF进行比较：并对cT灌注参数与癌组织的MVD和VEGF表达进行相关性分析。结果结直肠癌组织MVD值为22．61±9．01．VEGF阳性表达率为86．2％（19／25）。结直肠癌的TDC分为5种类型．不同TDC类型的MVD和VEGF差异无统计学意义（F值分别为2．59和1．11，P〉0．05）。CT灌注诸参数与MVD与VEGF均无相关（P〉0．05）。结论多层螺旋CT灌注成像与MVD和VEGF均能反映结直肠癌的血管生成状况．但它们之间无相关。

Objective To evaluate the correlation of 64-muhidetector-row CT （64MDCT） perfusion imaging with microvessel density（MVD）and vascular endothelial growth factor（VEGF）in colorectal carcinoma. Methods 64MDCT perfusion imaging was performed in 33 patients with pathologically verified colorectal carcinoma. Time-density curves （TDC） were created from the region of interest （ROI） drawn over the tumor, target artery and vein by 64MDCT with perfusion functional software. The individual perfusion maps generated were for blood flow（BF）, blood volume （BV）, mean transit time （MTT） and permeability-surface area product（PS）. MVD and VEGF expression of surgical specimens were examined by immunohistochemical staining with anti-CD34, anti-VEGF monoclonal antibody. MVD and VEGF were compared among the different types of TDC in colorectal carcinoma. The correlation of CT perfusion parameters with MVD and VEGF was also examined. Results TDC of colorectal carcinoma was divided into five types according to their shapes. MVD in the colorectal carcinoma was 22.61＋9.01. VEGF staining was found in 25 of 29 tumors （86.2%）. The score of VEGF expression was 4.15_＋1.09. No significant differences of MVD and VEGF expression among TDC types were found （F=2.59, 1.11, P〉0.05）. There were also no correlations of MVD and VEGF expression with any dynamic CT parameters （P〉0.05）. Conclusion 64MDCT perfusion imaging, MVD and VEGF may reflect angiogenic activity, but no significant correlations are found among them.