超声造影联合血管生成相关因子对乳腺病变微血管生成的评价

Microvascular of breast lesions evaluated by contrast enhancement ultrasound imaging combined with pathologic basis of angiogenesis

目的应用超声造影剂及微血管密度(MVD)、血管内皮生长因子(VEGF)联合评价乳腺良恶性病变微血管生成。方法对69例乳腺病变患者(28～72岁)进行超声造影检查,分析超声造影模式、造影时间-强度曲线、微血管密度指数(MDI)等相关参数。免疫组化方法检测VEGF表达、MVD,并与超声造影模式及时间-强度曲线相关参数进行对比,取得它们之间的相关性。结果病理诊断证实69例乳腺病变中,19例良性病变,50例恶性病变。超声造影增强模式、分布模式及灌注模式与MVD相关性均具有统计学意义。乳腺恶性肿瘤造影剂平均强度及达峰强度高于良性肿瘤(P<0.05)。超声造影剂平均强度、达峰强度及曲线下面积与MVD具有正相关性(P<0.01)。MDI与MVD、VEGF表达均为正相关(P<0.01),而超声造影其他相关参数与VEGF表达无相关性(P>0.05)。结论与VEGF相比,超声造影部分相关参数与MVD的相关性更为密切,可作为评价乳腺微血管生成的有效工具,对良恶性病变的鉴别有一定意义。

Objective To determine the correlation of real-time gray scale contrast-enhanced ultrasonographic （CEUS） patterns and parameters with microvessel density （MVD） and vascular endothelial growth factor （VEGF） expression for assessment of angiogenesis in breast lesions.Methods Real-time gray scale CEUS was performed in 69 women with breast lesions.CEUS patterns and quantitative parameters were analyzed.Mean MVD counts and VEGF expression in breast lesions were measured by immunohistochemical analysis.Results Pathologic analysis showed 19 benign and 50 malignant lesions.CEUS enhanced patterns,distribution patterns and perfusion patterns associated with the MVD counts were statistically significant.The mean intensity and peak intensity of the malignant lesions were higher than benign lesions （P0.05）. The microvessel density index （MDI） and MVD counts,VEGF expression were significant correlation （P0.01）,but CEUS other quantitative parameters and VEGF expression were not correlated （P0.05）.Conclusions CEUS parameters are more closely correlated with MVD than VEGF expression;CEUS can become an effective tool for angiogenesis of breast lesions to identify malignancy or benign of breast mass.