良性前列腺增生、前列腺癌的CT多期强化特征与血管生成关系的研究

Correlative study of angiogenesis with the CT multi-phase scan features of benign prostatic hyperplasia and prostate cancer

目的:探讨MVD、微血管相关指标及bFGF在BPH和PCa中的表达情况、与临床病理特征的关系及其相互之间的关系,以及和MSCT多期扫描强化特征的相关性。方法:对经病理证实的35例BPH和27例PCa患者术前均行MSCT扫描,绘制BPH和PCa时间-密度曲线(T-DC),并计算曲线升段的斜率(S);所有标本行CD34、bFGF的免疫组化染色。结果:时间-密度曲线分三种类型,在两组病例分布的差异有统计学意义(P<0.01)。BPH和PCa组织中MVD分别为11.00±4.14和32.11±13.19,BPH微血管平均直径等指标比PCa的相应指标要大(P<0.01)。bFGF在PCa中的表达高于在BPH中的表达(P<0.01)。斜率(S)与MVD、bFGF及MVD与bFGF有相关性(P<0.05);在前列腺癌中,斜率(S)与PCa的Gleason分级、肿瘤分化程度有相关性(P<0.05)。MVD与Gleason分级、肿瘤分化程度分级之间有相关性(P<0.01)。结论:bFGF及MVD在PCa中的表达水平高于在BPH中的表达。MSCT多期扫描强化特征能够显示BPH、PCa的血供情况,在一定程度上反映增生及癌组织中血管生成因子的表达及微血管的生成。

Objective：Based on investigating the relationship between microvascular density（MVD）, related indexes of micmvaseular, basic fibroblast growth factor（bFGF） and the clinicopathologic characters in benign prostatic hyperplasia（BPH） and prostate cancer （PCa）, to explore the eorrelation between the features of multi-slice spiral computed tomography（MSCT） and the level of MVD, bFGF and related indexs of microvascular in BPH and PCa. Methods： Thirty-five BPH and twenty-seven PCa cases proved by histopathology were examined with multi-phase contrast-enhanced MSCT scanning. The time-density curve （T-DC） and slope（S） of the contrast media uptake curve were recorded. Immunohistochemieal technique of all specimens was performed. Results： Time-density curves were classi- fied to three groups, the difference between BPH and PCa in the type of the curves was observed （ P 〈 0.01）. The number of MVD in BPH and PCa were 11.00 ＋ 4.14 and 32.11 ＋ 13.19, respectively. The related indexes of microvascular of BPH such as diameter were bigger than those of PCa （ P 〈 0.01）. The level of bFGF in PCa was higher than in BPH （ P 〈 0.01）. There were significant positive correlation between bFGF and MVD （ P 〈 0.01）, and between the slope （S） and MVD, bFGF （ P 〈 0.05）. The slope（S） was correlated positively with Gleason grade and differentiation of PCa （ P 〈 0.05）. There was positive correlation between MVD and Gleason grade, differentiation of the tumor （ P 〈 0.01）. Conclusion： The level of bFGF and MVD in PCa was higher than that of in BPH. MSCT can display the blood supply and enhancement characters of BPH and PCa. The MSCT imaging of BPH and PCa can reflect the expression of angiogenesis factor and angiogenesis.