直肠癌血管生成参数及临床病理参数与动态增强磁共振血流灌注参数的相关性

Correlation of dynamic contrast-enhanced MRI perfusion parameters with rectal cancer angiogenesis and pathological parameters

目的:分析动态增强磁共振血流灌注成像(dynamic contrast-enhanced magnetic resonance image,DCE-MRI)参数与直肠癌血管生成参数及临床病理参数的相关性。方法:随机选取2016年2月至2019年1月在我院手术后病理确诊的直肠癌患者58例,术前行DCE-MRI,对肿瘤横断面兴趣区定量检测Ktrans、Ke、Ve和iAUC,术后病理采用Western blot检测血管内皮细胞生长因子(vasular endothelial growth factor,VEGF)表达,免疫组化法检测微血管密度(microvascular density,MVD),评价Ktrans、Ke、Ve和iAUC在直肠癌临床病理参数[病理分期(T1、T2、T3、T4)、淋巴结转移(阴性vs阳性)、远处转移(阴性vs阳性)、血管浸润(阴性vs阳性)、神经浸润(阴性vs阳性)]中的差异。Pearson Rank相关性方法分析Ktrans、Ke、Ve和i AUC与直肠癌血管生成相关参数VEGF及MVD的相关性。结果:Ktrans及Kep在不同T分期直肠癌中差异有统计学意义(P <0. 001、P <0. 001),组间比较,Ktrans在T4期高于T3、T2及T1期(P <0. 001、P <0. 001、P <0. 001),Kep在T4期高于T3、T2及T1期(P <0. 01、P <0. 001、P <0. 001)。Ktrans及Kep在淋巴结转移(阴性vs阳性)、远处转移(阴性vs阳性)、血管浸润(阴性vs阳性)、神经浸润(阴性vs阳性)差异无统计学意义(P均> 0. 05)。Pearson Rank相关性分析显示,Ktrans及Kep随着VEGF、MVD水平升高而升高,二者为正相关(P <0. 000 1、P <0. 000 1);Ve和i AUC与VEGF、MVD水平无相关性(P> 0. 05、P> 0. 05)。结论:DCE-MRI参数Ktrans及Kep可对直肠癌血管生成参数及临床病理T分期进行评估,可以作为术前肿瘤生物学行为的预测参数。

Objective:To evaluate the correlation of dynamic contrast-enhanced MRI perfusion in rectal cancer with angiogenesis and pathological parameters.Methods:Fifty-eight patients diagnosed as rectal cancer by post-operation pathology was randomly collected from February 2016 to January 2019.DCE-MRI was applied,and K trans,K e,V e,and iAUC of tumor transverse interested region was measured.VEGF and MVD were detected by Western blot assay or immunohistochemistry assay.The differences of K trans,K e,V e and iAUC in rectal cancer pathological stage(T 1,T 2,T 3,T 4),lymph node metastasis(negative vs positive),distant metastasis(negative vs positive),blood vessel invasion(negative vs positive),nerve invasion(negative vs positive)were evaluated.Pearson Rank correlation method was used to analyze the correlation of K trans,K e,V e and iAUC with rectal cancer angiogenesis parameters VEGF and MVD.Results:K trans or K ep were significant differences in different rectal cancer stage(P<0.001,P<0.001).K trans in T 4 stage was higher than in T 3,T 2 and T 1 stage(P<0.001,P<0.001,P<0.001),K ep in T 4 stage was higher than in T 3,T 2 and T 1 stage(P<0.01,P<0.001,P<0.001).K trans or K ep in lymph node metastasis(negative vs positive),distant metastasis(negative vs positive),blood vessel invasion(negative vs positive),nerve invasion(negative vs positive)were not different(all P>0.05).Pearson Rank correlation analysis showed that K trans or K ep was increased with VEGF and MVD expression,that was positive correlation(P<0.0001,P<0.0001),V e and iAUC were not correlated with VEGF and MVD expression(P>0.05,P>0.05).Conclusion:DCE-MRI perfusion parameters K trans or K ep can used to evaluate the rectal cancer angiogenesis and pathological T stage and used as predictive parameters of the pre-operation tumor biological behavior.