肝细胞癌和胆管细胞癌螺旋CT增强差异的分子生物学基础

The Biomolecular Mechanism of the Enhancement Difference on Spiral CT in Hepatocellular Carcinoma and Intrahepatic Cholangiocellular Carcinoma

目的探讨肿瘤血管生成及血管内皮生长因子(VEGF)的表达对肝细胞癌(HCC)和胆管细胞癌(CCC)螺旋CT增强表现特征的影响。资料与方法对经手术病理证实且术前行CT增强检查的50例HCC(54个病灶)和24例CCC(28个病灶)患者的资料进行分析。观察其CT增强表现类型及两者动脉期的强化程度;用免疫组织化学SP法检测肿瘤VEGF的表达水平,用CD34标记微血管并进行微血管密度(MVD)计数。将免疫组织化学的结果与两种肿瘤的CT增强表现特征进行对照分析。结果HCC与CCC肿瘤组织VEGF的阳性表达率差异具有统计学意义(χ2=5.50,P<0.05),HCC和CCC的MVD差异也有统计学意义(t=2.03,P<0.05);HCC动脉期强化类型与VEGF和MVD未显示出相关性(χ2=0.10,t=0.63,P>0.05),CCC不同延迟强化类型的MVD值的差异具有统计学意义(t=2.09,P<0.05),HCC和CCC动脉期强化程度差异有统计学意义(χ2=46.6,P<0.01)。结论HCC和CCC组织的VEGF蛋白表达率及MVD值的差异在一定程度上影响了二者CT增强表现。

Objective To evaluate the correlation between multiple-phase enhanced spiral computed tomography （CT） features and the expression of vascular endothelial growth factor （VEGF） , mierovessel density （MVD） in hepatocellular carcinoma （HCC） and intrahepatic cholangiocellular carcinoma （CCC）. Materials and Methods 50 cases （ 54 lesions） of HCC and 24 cases （28 lesions） of CCC proved by pathology were retrospectively analyzed with multiple-phase enhanced CT scanning. Immunohistochemical analysis was carried out to examine the expression of VEGF and account of MVD by using antibodies against CD34 in HCC and CCC. The types of enhanced CT were compared with the results of VEGF expression,the MVD in HCC and CCC respectively. Results There were significant differences between HCC and CCC in VEGF positive expression and MVD （X^2 = 5.50 ,t = 2.03 ,P 〈 0.05 ）. There were no correlations between the types of arte- rial-phase enhanced CT and VEGF, MVD in HCC （X^2 = 0.10 ,t = 0.63 ,P 〉 0.05 ） ;while the MVD was correlated with the type of delayed-phase enhanced CT in CCC （ t = 2.09,P 〈 0.05）. There was a significant difference in arterial-phase enhanced degree between HCC and CCC （ X^2 = 46.6,P 〈 0.01 ）. Conclusion The significant difference of VEGF expression and MVD in HCC and CCC may influence their enhanced CT features.