喉癌术后复发患者CT灌注参数与血管内皮生长因子表达的相关性研究

Correlation between CT perfusion parameters and VEGF in postoperative recurrence of laryngeal cancer

目的探讨喉癌术后复发患者CT灌注参数与血管内皮生长因子(VEGF)表达的相关性及其在喉癌术后复发临床诊治中的应用价值。方法回顾性分析2011年4月—2016年3月杭州师范大学附属医院喉癌术后半年内定期复查经临床明确诊断的喉癌复发病例40例,未复发病例20例,复查时均行CT灌注检查并计算各灌注参数(BF、BV、MTT、PS)值,同时抽取静脉血应用酶联免疫吸附法(enzyme-linked immune-sorbent assay,ELISA)定量检测血清中的VEGF含量。应用SPSS 13.0统计软件包分别对喉癌术后复发组织和未复发喉癌组织CT灌注参数和喉癌术后血清血管内皮生长因子含量进行统计学处理,统计分析各CT灌注参数值与VEGF表达的相关性。结果术后复发喉癌组织和术后未复发喉癌组织间各灌注参数BF值、BV值、MTT值及PS值差异均有统计学意义,术后复发喉癌组织的灌注参数明显高于未复发喉癌组织(P<0.05)。术后复发喉癌的灌注参数的BF值和BV值与其血清VEGF含量呈正相关(r=0.471、0.389,P<0.05),MTT值与其VEGF含量呈负相关(r=-0.427,P<0.05),而PS值与其VEGF含量无相关性(r=0.302,P>0.05)。结论喉癌术后复发组织CT灌注参数BV、BF值明显高于未复发组织,且与其血清VEGF含量具有明显的相关性,可以在一定程度上反映肿瘤的血供情况,喉癌术后复查通过CT灌注成像观察其参数值及血清VEGF含量可以明显提高早期发现及诊断喉癌术后复发的准确性以及指导临床抗肿瘤血管生成治疗有重要的意义,具有较高的临床应用价值。

Objective To observe the correlation between the CT perfusion parameters and the expression of vascular en- dothelial growth factor（VEGF） in postoperative recurrence of laryngeal cancer. Methods Forty postoperative recurrence of laryngeal cancer were scanned by spiral CT, and to calculate the perfusion parameters with perfusion functional soft- ware. The parameters included blood flow（ BF）, blood volume（BV） , mean transit time（MIT） and permeability surface （PS）. And the serum VEGF specimens were detected by sandwich enzyme-linked immunosorbent assay（ELISA） and 20 non-postoperative recurrence of laryngeal cancer as contrast. The correlation between the CT perfusion parameters and VEGF was studied. Results CT perfusion parameters（ BF, BV, MTT and PS） were difference between non-postopera- tive recurrence and postoperative recurrence lesions of laryngeal cancer. BF of postoperative recurrence group was higher than that of postoperative recurrence lesions group （ P 〈 0.05 ）. In postoperative recurrence, BF and BV was positively correlated with VEGF（ r = 0. 471,0.389, P 〈 0.05 ）, M3T and VEGF showed a negative correlation（ r = -0.427, P 〈 0. 05 ） , there was not correlative between PS and VEGF（ r = 0. 302, P 〉 0.05 ）. Conclusion CT perfusion parameters of postoperative recurrence of laryngeal cancer are correlated with VEGF, which may reflect the expression of VEGF. The CT perfusion should be helpful to diagnosis and treatment postoperative recurrence of laryngeal cancer.