肝癌边缘CT强化特征与肿瘤新生血管的相关性研究

The correlation between CT enhancement patterns and tumor angiogenesis in the edge of hepatocellular carcinoma

目的探讨多层螺旋CT双期扫描判断HCC边缘部强化特征与肿瘤新生血管的相关性。方法 38例经手术证实的HCC患者术前行全肝CT平扫及双期增强扫描,观察其边缘部CT强化特点;采用常规病理学检查和免疫组化检测CD34表达。结果 CT平扫发现病灶边缘清楚者,肿瘤以膨胀性生长为主,病理学上肿瘤多有或薄或厚的包膜,而边缘不清肿瘤在病理学上表现为肿瘤浸润性生长;动态增强后发现肿瘤边缘不清或呈高密度者,癌细胞浸润率高,边缘新生血管丰富,转移的危险性大,而呈低密度者癌细胞浸润率低,新生血管较少,转移的可能性小。结论动态CT增强扫描能很好地显示肿瘤边缘的CT强化特点,进而反映肿瘤组织的病理学改变,对临床有较大的诊治指导意义。

Objective To investigate the correlation between the enhancement characteristics and tumor angiogenesis in the edge of hepatocellular carcinoma.Methods The characteristics of CT enhancement confirmed by preoperative CT scan and contrast CT of hepatic arterial and portal phase were studied in 38 patients with hepatocellular carcinoma.CD34 was detected by immunohistochemistry in the tumor tissues.Results The tumors with clear edge shown on plain CT with thin or thick envelope were in the manner of expansive growth,while the tumors with unclear edge were in invasive growth;there was a higher probability of invasion for tumors with unclear and high-density,and a probable transfer for tumors with rich edge angiogenesis;relatively,there was lower transfer for tumors with low-density and fewer new blood vessels.Conclusion Dynamic enhanced CT scan can show the CT enhancement characteristics of the tumor,which might reflect the pathological changes and have great significance for clinical guidance.