肝癌发生后全肝微循环的变化规律及与血清AFP、CA199、GGT的相关性研究

Study on the variation of whole liver microcirculation and its correlation with serum AFP,CA199 and GGT after hepatocellular carcinoma

目的:了解肝癌发生后全肝微循环的变化规律和肝癌CT灌注参数与血清甲胎蛋白(AFP)、糖类抗原199(CA199)谷氨酸氨基转移酶(GGT)的相关性。方法:肝癌病人行上腹部增强扫描获得原始图像,经后处理灌注软件分析得到CT灌注伪彩图及参数,比较20例病人肝癌病灶(A组)、邻近肝组织(B组)、较远肝组织(C组)的血容量(BV)、血流速(BF)、平均通过时间(MTT)、肝动脉分数(HAF)、表面通透性(PS)灌注参数数值。检测病人血液中的AFP、CA199及GGT含量,与癌组织灌注参数作相关性分析。结果:HAF、BV、BF、PS值:A组>B组>C组(P<0.01),MTT值:A组<B组<C组,差异有统计学意义(P<0.01)。GGT与PS呈正相关关系(r=0.639,P<0.05),与MTT呈负相关关系(r=-0.577,P<0.05)。结论:CT灌注能够反映肝癌及周围肝组织的血流灌注状态,一定程度上可以提示肝癌的进展程度,为临床治疗及评价预后提供了一定的参考依据。GGT与肝癌的异常微循环关系密切,在肝癌发生、发展中发挥重要作用。

Objective:To investigate the changes of liver microcirculation and correlation between CT perfusion parameters,and serum alpha-fetoprotein(AFP),carbohydrate antigen 199(CA199)and glutamate aminotransferase(GGT).Methods:The original images of enhanced scan of upper abdomen in liver cancer patients were collected,and the pseudo-color CT perfusion images and parameters were obtained by post-processing perfusion software analysis.The blood volume(BV),blood flow(BF),mean passage time(MTT),hepatic artery fraction(HAF)and surface permeability(PS)perfusion parameters were compared among group A(liver cancer lesion),group B(adjacent liver tissue)and group C(distant liver tissue).The serum levels of AFP,CA199 and GGT in three groups were tested,and their correlation with perfusion parameters of cancer tissue were analyzed.Results:The value of HAF,BV,BF and PS in group A,group B and group C gradually decreased,the MTT value in group A,group B and group C gradually increased,and the differences of whose among three groups were statistically significant(P<0.01).The GGT was positively correlated with PS(r=0.639,P<0.05),and negatively correlated with MTT(r=-0.577,P<0.05).Conclusions:CT perfusion can reflect the status of blood perfusion in liver cancer and surrounding liver tissues,indicate the progression of liver cancer to a certain extent,and provide a certain reference for clinical treatment and prognosis evaluation.GGT is closely related to the abnormal microcirculation of liver cancer,and plays an important role in the occurrence and development of liver cancer.