子宫颈癌CT灌注与肿瘤血管生成相关性研究

Study on Correlations Between CT Perfusion Parameters and Tumor Angiogenesis of Cervical Cancer

通过对子宫颈癌CT灌注与肿瘤微血管密度(MVD)关系的分析,研究其与肿瘤血管生成的相关性。对31例子宫颈癌行术前CT灌注扫描。测量宫颈癌组织及癌旁正常组织的灌注量(PF)、血流量(BV)、强化峰值(PEI)、强化峰值时间(TTP),切取与CT灌注靶层面相对应的31例宫颈癌组织及15例癌旁正常组织石蜡切片,采用免疫组化CD34染色,显微镜下Weidener方法计数阳性MVD。分析宫颈癌CT灌注参数与MVD值之间的关系。31例宫颈癌肿瘤组MVD值(27.87±14.72)高于对照组MVD值(7.01±1.71),且有随临床分期逐渐上升趋势;宫颈癌CT灌注参数PF、PEI值分别与MVD表达及计数存在相关性(r值分别为0.47和0.45);鳞癌组PF值与MVD值相关(r值为0.42);低分化组PF、PEI值与MVD值相关(r值分别为0.46和0.45);Ⅱ～Ⅲ期组PF、PEI、BV值与MVD值相关(r值分别为0.43、0.49和0.53);有无淋巴结转移组PF值与MVD值均有相关性(r值分别为0.94和0.42)。表明子宫颈癌癌灶CT灌注参数与癌灶MVD表达存在相关性,可以一定程度上反映癌灶血管生成状况、肿瘤组织恶性程度、浸润情况和临床分期,有助于判断肿瘤的分级及预后,在宫颈癌的诊断中有一定的临床应用价值。

This study was aimed to analyze the correlation between CT perfusion parameters, e.g. perfusion （PF）, blood volume （BV）, peak enhancement image （PEI）, time to peak （TTP）, and the microvessel density （MVD） of cervical cancer. CT perfusion scans were carried out in 31 patients with cervical cancer. After their surgical resec- tions, we obtained 31 cases of cervical cancer specimens, and 15 cases of adjacent normal cervical specimens as con- trol group, then these 46 specimens were used in MVD detection through immunohistochemical CD34 staining. The MVDs of the tumor group were significantly higher than those in the control group, and the former seems to increase with the clinical stages with a positive correlation. The PF and PEI values have positive correlations with correspond- ing MVD values. The PF value of squamous carcinoma group has correlation with corresponding MVD value. The PF and PEI values of poorly differentiated group have correlations with corresponding MVD values. The PF, PEI and BV values of Ⅱ-Ⅲ stage group are positively correlated with corresponding MVD values. The PF value of lymph metastasis or non-lymph metastasis group both have correlations with corresponding MVD values. We found that CT perfusion parameters were positively correlated with corresponding MVD values in cervical cancer. Our results sug- gest that CT perfusion is a new method which could reflect tumor angiogenesis, histological malignant grade, inva- sion, and clinical stage. It will help us determine the tumor staging and prognosis.