食管癌CT灌注参数与MVD相关性分析

Esophageal carcinoma: MSCT perfusion parameters and microvessel density

目的:分析食管癌多层螺旋CT(MSCT)灌注成像参数与肿瘤微血管密度(MVD)间的相关性,探讨MSCT灌注成像在评价肿瘤血管生成中的应用价值。方法:79例经手术病理证实的食管癌患者行MSCT灌注成像,绘制兴趣区(ROI)的时间-密度曲线(TDC),计算血流量(BF)、血容量(BV)、平均通过时间(MTT)、毛细血管通透性(PS);切取同层肿瘤组织切片,测定微血管密度,分析不同分化程度、组织学分型及浸润深度的肿瘤组织的CT灌注参数差异及各参数与MVD之间的相关性。结果:79例食管癌BF、BV、MTT、PS平均值分别为(93.07±54.31)ml/(min.100g)、(6.35±1.77)ml/100g、(9.17±7.07)s、(12.71±7.79)ml/(min.100g);MVD计数为(24.69±8.61)条/高倍视野。BF、BV值与MVD呈正相关(P<0.05,r值分别为0.445、0.341),不同侵及深度的肿瘤组织的BF值的差异有统计学意义(P=0.034)。结论:MSCT灌注成像可间接反映活体食管癌血管生成情况,为治疗方案的制定、疗效判定及预后评估提供依据。

Objective To correlate multi-slice computed tomography （MSCT） perfusion parameters with micro-vessel density （MVD） and to explore the value of MSCT perfusion in the evaluation of tumor angiogenesis of esophageal carcinoma. Methods：Seventy-nine patients with pathologically confirmed esophageal carcinoma underwent perfusion MSCT exami- nation, tumor blood flow （BF）, blood volume （BV）,mean transit time （MTT） and permeability surface-area product （PS） were determined. After surgery, resected specimens were sectioned and stained immunohistochemically t for quantification of microvessel density （MVD）. Perfusion MSCT measurements were correlated with MVD. Results.. Mean BF, BV, MTT and PS were （93.07±54.31）ml/（min· 100g） ,（6.35±1.77）ml/100g, （9.17±7.07）s and （12.71±7.79）ml/（min · 100g） ,re- spectively. The mean value of MVD was （24.69±8.61）item/hpf in 79 patients with esophageal carcinoma. BF （r：0. 445, P〈0. 05） and BV （r：O. 341, P〈0.05） correlated positively with MVD. Conclusion： MSCT perfusion is a feasible tech- nique for quantifying tumor microvascularity and angiogenesis in esophageal carcinoma and facilitates the diagnostic workup of esophageal carcinoma for treatment plan,monitoring to antitumor therapy and prognosis.