肝细胞癌弥散加权成像与肿瘤血管生成的相关性

Correlation between Diffusion-Weighted Imaging and Hepatocellular Carcinomas Angiogenesis

目的探讨肝细胞癌(Hepatocellular carcinoma,HCC)血管内皮生长因子(Vascular endothelial growth factor,VEGF)、微血管密度(Microvessel density,MVD)与表观弥散系数(Apparent diffusion coefficient,ADC)值的相关性。方法采用免疫组织化学Elivison二步法检测38例HCC组织VEGF、MVD表达,运用Edmondson-Steiner分级法对细胞分化程度进行分级,并分析VEGF、MVD、细胞分化与ADC值的相关性。结果 1.VEGF表达1级、2级和3级对应的ADC值分别为1.17±0.49×10-3mm2/s、1.46±0.45×10-3mm2/s和0.91±0.47×10-3mm2/s,HCC组织VEGF表达2级ADC值明显高于VEGF表达3级(p=0.003);VEGF与ADC值呈显著负相关(r=-0.321,p=0.05)。2.HCC组织MVD与ADC值无显著相关(p=0.345)。3.高、中、低分化HCC对应的ADC值分别为0.92±0.51×10-3mm2/s、1.33±0.34×10-3mm2/s、1.52±0.46×10-3mm2/s,高分化组ADC值明显低于中、低分化HCC(p=0.028;p=0.004);病理分级与ADC显著正相关(r=0.530,p=0.001)。结论肝细胞癌ADC值与肿瘤血管生成具有相关性;MRI DWI可以用于评价HCC肿瘤血管生成。

The purpose of this study was to evaluate the correlation between the ADC values on diffusion-weighted images and the expression of vascular endothelial growth factor （VEGF） and microvessel density （MVD） in HCCs. Methods MVD and VEGF expression were detected in HCC tissue samples using the Etivison method. HCCs were histologically classified using the Edmondson-Steiner classification system. The correlation between the ADC values and VEGF expression and MVD and the cell differentiation of HCCs was analyzed. esults The mean ADC values of the HCCs with 1 grade VEGF expression, 2 grade and 3 grade were 1.17±0.49× 10^（-3）mm2/s, 1.46±0.45× 10^（-3）mm2/s, respecuvely. The ADC values of HCCs =0.45× 10^（-3）mm2/s and 0.91±0.47×10^（-3）ith 2 grade VEGF expression were higher than those in HCCs with 3 grade VEGF expression. In HCCs. there was a negative correlation between VEGF expression and the ADC value （r=-0.321, p=0.05）, but there was no obvious correlation between MVD and the ADC value （p=0.345）. The mean ADC values of the well-differentiated HCCs, the moderately differentiated HCCs and the poorly differentiated HCCs were 0.92 ± 0.51× 10^（-3）mm/s. 1.33 ＋ 0.34 × 10^（-3）mm/s and 1.52 ± 0.46× 10^（-3）mm/s. respectively. The ADC values of the we/l-differentiated HCCs were lower than those of the moderately and the poorly differentiated HCCs. The HCC pathological grades showed a positively correlated with the ADC values （r=0.530, p=0.001）. Conclusion The HCC ADC values were related to tumor anglogenesis, indicating that diffusion-weighted imaging can be used to evaluate HCC angtogenesis.