食管癌淋巴结转移的CT表现及其与VEGF、p53蛋白表达之间的关系

Correlation between CT findings and expression of VEGF,p53 protein of lymph node metastases from esophageal carcinomas

目的探讨食管癌淋巴结转移的CT表现及其与血管内皮生长因子(vascularendothelialgrowthfactor,VEGF)、p53蛋白表达之间的关系。方法 66例经手术病理证实的食管癌患者术前均经胸部CT平扫与增强扫描,以判定转移淋巴结(MLN)的存在情况与影像表现,并经免疫组织化学法(SP)检验,以探测癌组织内VEGF与p53蛋白的表达。对所有患者MLN的CT表现与VEGF、p53蛋白表达的相关性,进行了统计学分析。结果 CT对食管癌MLNs诊断的准确率为83.33%(55/66)。在CT像上,MLNs表现为肿大、圆球形、强化不均匀或伴坏死、融合。食管癌组织中VEGF的阳性表达率为62.12%(41/66),p53蛋白的阳性表达率为51.52%(34/66)。VEGF、p53蛋白在食管癌MLN阳性组中的表达率明显高于阴性组(P<0.05)。MLNs的短径小于等于2cm组与短径大于2cm组的VEGF、p53蛋白阳性表达率差异无统计学意义(P>0.05)。结论 CT对食管癌MLN的诊断有较高的准确性,而食管癌中较高的VEGF、p53蛋白表达与淋巴结转移相关。

Objective To study the correlation between CT findings and expression of vascular endothelial growth factor（VEGF）,p53 protein of metastatic lymph nodes（MLNs） from esophageal carcinomas.Methods Sixty-six patients with surgically and pathologically proved esophageal carcinoma underwent precontrast and postcontrast CT scans of the chest before the operation to identify the presence of MLNs and their imaging findings,subsequently,underwent immunohistochemical（streptavidin peroxidase,SP） tests to detect the expression of VEGF and p53 protein in carcinous tissues.The correlation between CT findings and expression of VEGF and p53 protein in all the patients were statistically analyzed.Results The accuracy of CT scans in diagnosing MLNs from esophageal carcinomas was 83.33%（55/66）.On CT images,MLNs appeared as enlargement,ball shape and nonhomogeneous enhancement or associated with necrosis and confluence.The positive expression rate of VEGF and p53 protein in the group patients was 62.12%（41/66） and 51.52%（34/66）,respectively.The expression rate of VEGF and p53 protein in positive MLN group was significantly higher than that in negalive MLN group（P 0.05）.The positive expression rate of VEGF and p53 protein in two group patients with different MLN diameters which comprised short diameters of MLNs to be equal to or less than 2.0 cm and those to be more than 2.0 cm was not statistic difference（P 0.05）.Conclusion CT scan in diagnosing MLNs from esophageal carcinomas have higher accuracy,while the expression of VEGF and p53 protein was positively correlated with the detection rate of MLNs.