宫颈癌CT灌注成像与VEGF、MVD的相关性研究

Study on correlations between CT perfusion imagimg and changes of VEGF and MVD expressions of cervical cancer

目的探讨宫颈癌CT灌注成像参数与血管内皮生长因子(VEGF)、微血管密度(MVD)的相关性及其临床应用价值。方法分析临床拟诊为宫颈癌的患者35例行宫颈CT灌注扫描,并与11例宫颈良性病变作对照。根据灌注所得图像得到时间-密度曲线,分析CT灌注参数并结合病理、免疫组化结果进行分析。结果宫颈癌灌注时间-密度曲线特点为速升缓降或中高位强化型,短时间达峰值,峰值高于宫颈良性对照组。宫颈癌组的灌注参数BF、BV、PEI、PMB、MTT、TTP与宫颈良性病变各组间差异有统计学意义(P<0.05)。MVD与宫颈癌灌注参数BF、BV、PEI、PMB呈正相关,与MTT、TTP呈负相关。宫颈癌Ⅰ期与Ⅱ期MVD值之间差异有统计学意义(P<0.05);良恶性病变组之间、不同的肿瘤临床分期之间及不同病理类型之间,VEGF阳性表达率差异有统计学意义(P<0.05);良恶性病变组之间、不同的肿瘤临床分期之间,MVD计数具有统计学意义(P<0.05)。三组不同分化程度的宫颈癌之间VEGF表达及MVD计数有差异(P<0.05),但组间不具有统计学意义。结论宫颈癌为富血供、高灌注肿瘤,CT灌注成像参数结合VEGF、MVD分析,对宫颈癌的诊断、分期及指导临床治疗具有较高的参考价值。

Objective To analyze the correlation between CT perfusion parameters and changes of VEGF and MVD expressions of cervical cancer and to evaluate its value in clinical use.Methods CT perfusion imaging was performed in 35 patients with cervical cancer diagnosed pathologically,and 11 patients with cervical benign diseases were considered as control group.Time-density curve was obtained by CT perfusion images.CT perfusion parameters were analyzed with pathological and immunohistochemical observations.Results Time-density curve in cervical cancer group showed rapid rise with gradual decline,short time to peak and higher peak than control group.The values of BF,BV,PEI,PMB,MTT,TTP for cervical cancer group and the values in control group showed statistical significance（P〈0.05）.MVD was positively correlated with CT perfusion parameters including BF,BV,PEI,PMB,but MVD was negatively correlated with MTT and TTP.MVD value in stage I and stage II showed difference statistically（P〈0.05）;There were statistical significant in VEGF expressions between benign and malignant groups,different clinical stages and different pathological types;there were statistical significant in MVD account between benign and malignant groups,and different clinical stages（P〈0.05）.Three groups of different differentiation degree of cervical cancer between VEGF expression and MVD counts had difference（P〈0.05）,but not statistically significant between groups.Conclusion Cervical cancer is one type of rich blood supply and high perfusion cancer,CT perfusion imaging with VEGF and MVD expressions analysis provides a referential value for early diagnosis,differentiation,clinical treatment and prognosis.