原发性肝癌超声血运分级与血管生成的相关性探讨

Relationship between classification of Doppler ultrasound blood flow signals and angiogenesis in primary hepatocellular carcinoma

目的探讨超声血运分级与基质金属蛋白酶(MMP)9在原发性肝癌(PHC)血管生成中的相关性。方法选取大连医科大学第二附属医院2008年4月-2013年4月行PHC手术的60例患者,且术前均行超声检查,记录所有患者经超声检查病灶内血流信号分级情况。取所有患者的肿瘤组织,运用免疫组化法检测MMP-9和CD31的表达,并计算微血管密度(MVD)。相关性采用Spearman相关分析。结果肝癌超声血运分级:0级15例、1级20例、2级15例、3级10例。MMP-9在肝癌的表达率为72.3%,MVD为43.2±5.4。肝癌病灶内超声血运分级与MMP-9的表达和MVD呈正相关(r=0.56,P<0.05)。结论肝癌超声血运分级情况能较好地显示病灶内血管的变化,对肝癌的诊治及临床评估血管生成指标有一定的意义。

Objective To investigate the relationship of the classification of Doppler ultrasound blood flow signals with matrix metalloproteinase- 9（ MMP- 9） expression and microvessel density（ MVD） in primary hepatocellular carcinoma（ PHC）. Methods Sixty patients with PHC,who underwent surgical resection in the Second Affiliated Hospital of Dalian Medical University from April 2008 to April 2013,were included in the study. These patients underwent ultrasound examination before operation. The classification of Doppler ultrasound blood flow signals in the focus was recorded. The expression of MMP- 9 and CD31 in carcinoma tissues was detected by immunohistochemistry,and MVD was calculated. Continuous data were analyzed by t test,while categorical data by chi- square test; the relationship was evaluated by Spearman correlation analysis. Results The classification of Doppler ultrasound blood flow signals was as follows： grade 0（ 15 cases）;grade 1（ 20 cases）; grade 2（ 15 cases）; grade 3（ 10 cases）. The positive rate of MMP- 9 expression was 72. 3%. The MVD was 43. 2 ±5. 4. The classification of Doppler ultrasound blood flow signals in the focus was positively correlated with MMP- 9 expression and MVD（ r =0.56,P〈0.05）. Conclusion The classification of Doppler ultrasound blood flow signals can reveal vascular changes in the focus,and it can be used in the clinical evaluation of angiogenesis in tumor tissues and the clinical diagnosis and treatment of PHC.