计算机断层扫描仿真内镜下微血管特征与结肠息肉样病变患者血管内皮生长因子的关系

Correlation of microvascular characteristics under computed tomography virtual endoscopy with vascular endothelial growth factor in patients with colonic polypoid lesions

目的 探讨计算机断层扫描仿真内镜(CTVE)下微血管特征与结肠息肉样病变患者血管内皮生长因子(VEGF)的关系。方法 收集2020年7月至2021年12月于张家口市第一医院就诊的215例结肠息肉样病变患者的临床资料,根据同期病理检查结果将其分为结肠息肉组(n=103)、结肠腺瘤组(n=63)、早期结肠癌组(n=49)。比较不同病变性质CTVE、病理检查下的微血管密度(MVD),分析结肠息肉样病变患者CTVE检查下不同MVD、不同病变性质的VEGF水平。结果 结肠息肉组、结肠腺瘤组、早期结肠癌组患者病理检查下的MVD略高于CTVE,但差异均无统计学意义(P>0.05)。早期结肠癌组患者CTVE、病理检查下的MVD均明显高于结肠息肉组、结肠腺瘤组患者,结肠腺瘤组患者CTVE、病理检查下的MVD均明显高于结肠息肉组患者,差异均有统计学意义(P<0.01)。早期结肠癌组患者血清VEGF水平最高,结肠息肉组患者血清VEGF水平最低,差异均有统计学意义(P<0.05)。MVD<10组患者的VEGF水平最低,>15组患者的VEGF水平最高,差异均有统计学意义(P<0.05)。结论 CTVE与病理检查下的MVD结果相似,MVD与结肠息肉样病变患者VEGF水平有密切关系,两者对结肠息肉样病变的良恶性判断均有参考价值。

Objective To analyze the correlation of microvascular characteristics under computed tomography virtual endoscopy(CTVE) with vascular endothelial growth factor(VEGF) in patients with colonic polypoid lesions. Method A total of 215 patients with colon polypoid lesions treated in Zhangjiakou First Hospital from July 2020 to December 2021were selected, they were divided into colon polyp group(n=103), colon adenoma group(n=63), and early colon cancer group(n=49) according to the pathological results of the same period. The CTVE of different nature of lesions, microvascular density(MVD) under pathological examination were compared. The VEGF of patients with different MVD and different nature of lesions were analyzed in patients with colonic polypoid lesions under CTVE. Result The MVD of pathological examination in colon polyp group, colon adenoma group and early colon cancer group were slightly higher than those of CTVE, but the differences were not statistically significant(P>0.05). The MVD by pathological examination and CTVE in early colon cancer group was significantly higher than that in colon polyp group and colon adenoma group, the MVD by pathological examination and CTVE in colon adenoma group was significantly higher than that in the colon polyp group, the differences were statistically significant(P<0.01). The VEGF was highest in the early colon cancer group, and lowest in colon polyp group, the differences were statistically significant(P<0.05). The VEGF was lowest in patients with MVD<10, and highest in patients with MVD>15, the differences were statistically significant(P<0.05). Conclusion The MVD under CTVE is similar to that by pathological examination, the MVD is closely related to the VEGF in patients with colonic polypoid lesions, and both have reference significance for the benign and malignant of colonic polypoid lesions.