肝细胞癌肿瘤血管生成与螺旋CT增强特征探讨

Correlation between Angiogenesis and Enhanced Spiral CT Features in Hepatocellular Carcinoma

目的 探讨肝细胞癌 (HCC)肿瘤血管生成的调控因子血管内皮生长因子 (VEGF)及血管内皮生长因子受体 (VEGFR)表达及其与螺旋CT(SCT)增强表现和特征之间的相关性。资料与方法 对经手术病理证实的 39例共4 1个HCC病灶 ,观察其SCT表现和特征。用免疫组织化学SP法检测HCC中VEGF、VEGFR 1/Flt 1和VEGFR 2 /KDR/Flk 1蛋白的表达 ,并与SCT增强表现和特征对照。结果 VEGF、Flt 1、KDR/Flk 1阳性率分别为 6 1.0 %、6 8.3%和 70 .7% ;在侵袭高危组、包膜欠完整和 /或无包膜组、小肝癌组中VEGF和KDR/Flk 1的表达均高于侵袭低危组、包膜完整组和大肝癌组 ,差异有显著性 (P <0 .0 5 ) ;但VEGF和KDR/Flk 1的表达与动脉期强化类型之间无相关性。Flt 1的表达在各组间无显著性差异。χ2 检验提示VEGF表达与KDR/Flk 1表达相关 (P <0 .0 0 1) ,而未显示VEGF表达与Flt 1表达、KDR/Flk 1表达与Flt 1表达之间的相关性 (P >0 .0 5 )。结论 VEGF通过结合其特异性酪氨酸激酶受体KDR/Flk 1促进HCC肿瘤血管生成因而促进HCC的生长、浸润和转移 ;且可通过SCT增强表现在一定程度上推测VEGF及其受体KDR/Flk 1和Flt 1的表达情况。

Objective To investigate the expression and modulation of vascular endothelial growth factor (VEGF) and vascular endothelial growth factor receptor (VEGFR) in the angiogenesis of hepatocellular carcinoma (HCC), to correlate the expression with spiral CT (SCT) features.Materials and Methods Dual phase SCT scanning during arterial and portal phase was performed in 39 patients with 41 pathologically confirmed HCC lesions. CT signs and enhancement patterns were observed. The expression of VEGF, VEGFR 1/Flt 1 and VEGFR-2/KDR/Flk 1 were estimated with immunohistochemical SP method. CT findings were compared with the expressions.Results The positive expression rate of VEGF, Flt 1 and KDR/Flk 1 was 61.0% (25/41), 68.3% (28/41) and 70.7% (29/41), respectively. The expression of VEGR and KDR/Flk 1 were statistically higher in the group with high invasion risk, incomplete pseudo capsule and small lesions (≤5cm) than that in the group with low invasion risk, intact pseudo capsule and large lesions (P<0.05). No correlation existed between the VEGF and KDR/Flk 1 expression and enhancement patterns during arterial phase. The results with χ 2 test suggested that a correlation existed between VEGF expression and KDR/Flk 1 (P<0.001), while no correlation was found between VEGF and Flt 1, neither between KDR/Flk 1 and Flt 1 (P>0.05). Conclusion VEGF and KDR/Flk 1 seem to play a potentially important role in the angiogenesis, growth and metastasis of HCC, and SCT scanning is an effective means for predicting the expression of VEGF, Flt 1 and KDR/Flk 1 in HCC.