CT灌注成像与结直肠癌微血管密度的相关性研究

Correlation between CT perfusion imaging parameters and microvessel density in colorectal cancer

目的探讨结直肠癌64排螺旋CT(64MDCT)灌注成像结果与微血管密度(MVD)的相关性。方法纳入2015年1月至2016年1月本院收治的32例结直肠癌患者为对象,术前开展64MDCT诊断,获取血流量(BF)、血容量(BV)、灌注起始时间(TTS)、灌注峰值时间(TTP)、表面通透性(PS)参数值;术后应用免疫组化染色方案获取MVD。测评上述指标与肿瘤Dukes分期和分化程度的关系,分析64MDCT检测指标与MVD相关性。患者随访至2017年6月,将因癌症死亡、复发及转移患者纳为预后不良组,将其它患者纳为预后良好组,对比两组BF、BV、TTS、TTP、PS、MVD差异。结果 32例患者BF值为(56.0±27.4)m L·100g^(-1)·min^(-1),BV值为(44.5±24.2)m L·100g^(-1),TTS值为(27.0±10.2)s,TTP值为(95.0±30.0)s,PS值为(5.4±2.6)×10^(-1)·m L·100g^(-1)·min^(-1),MVD值为(32.7±11.1)条/高倍视野,且BF、TTS、TTP、PS及MVD均与肿瘤Dukes分期及分化程度无关(P>0.05),BV与肿瘤Dukes分期有关(P<0.05)。预后不良组BF、BV、TTS、TTP、PS、MVD均较预后良好组明显更高(P<0.05)。BF、BV、TTS、PS与MVD呈明显正相关(r=0.645、0.493、0.504、0.632;均P<0.01)。结论 CT灌注成像参数能够反映结直肠癌微血管密度,可能有助于评估肿瘤侵袭转移能力,但其与肿瘤分期及分化程度无明显关系。

Objective To investigate the correlation between 64-multidetector-row CT（64MDCT） perfusion imaging parameters and the microvessel density（MVD） in colorectal cancer. Methods 32 cases with colorectal cancer treated in our hospital from January2016 to January 2017 were selected. The blood flow（BF）, blood volume（BV）, time to start（TTS）, time to peak（TTP） and permeability surface area product（PS） were obtained by 64 MDCT perfusion imaging, the MVD were observed by postoperative immunohistochemical staining. The relationship between the above indexes and Dukers staging and differentiation were evaluated, the correlation between 64 MDCT indexes and MVD were analyzed. The patients were followed up until June 2017. Patients with cancer death, recurrence and metastasis were assigned to the poor prognosis group, the rest were the good prognosis group. BF, BV, TTS, TTP, PS and MVD between the two groups were compared. Results BF was（56.0±27.4） m L·100g（-1）·min（-1）, BV was（44.5±24.2） m L·100g（-1）, TTS was（27.0±10.2） s, TTP was（95.0±30.0） s, PS was（5.4±2.6） ×10（-1）·m L·100g（-1）·min（-1）, MVD was（32.7±11.1）/high power field in the patients. BF, TTS, TTP, PS and MVD were not significantly correlated with Dukes staging and differentiation（all P 0.05）, while BV were significantly correlated with Dukes stage of the tumor（P 0.05）. BF, BV, TTS, TTP, PS and MVD in the poor prognosis group were significantly higher（P 0.05）. BF, BV, TTS and PS were positively correlated with MVD（r = 0.645, 0.493, 0.504, and 0.632; all P 0.01）. Conclusion CT perfusion imaging parameters can reflect the microvessel density of colorectal cancer, which may be helpful to evaluate the invasion and metastasis of tumor, while the parameters rarely has correlations with tumor stages and differentiation.