目的:探讨肝癌患者二维超声、彩色多普勒血流显像(color Doppler flow imaging,CDFI)、彩色能量血流显像(color power Dopper imagi n g a n g l o,C PA)与免疫组织化学指标的相关性.方法:选择62例肝癌(hepatocellular carcinoma,H C C...目的:探讨肝癌患者二维超声、彩色多普勒血流显像(color Doppler flow imaging,CDFI)、彩色能量血流显像(color power Dopper imagi n g a n g l o,C PA)与免疫组织化学指标的相关性.方法:选择62例肝癌(hepatocellular carcinoma,H C C)患者为研究对象,应用二维超声观察肝脏内肿块的形态、大小、边界、回声强度及内部回声情况,应用CDFI、CPA观察肿瘤区域及周边血供情况,并采用免疫组织化学SABC法观察p53及增殖细胞核抗原(proliferating cell nuclear antigen,PCNA)的表达情况,并且测定微血管密度(microvessel density,MVD),分析影像学参数与免疫组织化学指标的相关性.结果:二维超声结果显示,MVD均值在形态、个数、回声、边界、均匀值、坏死程度分组中差异均有统计学意义(P<0.05).瘤体多发、瘤体边界不清、回声不均、内部伴坏死、伴门静脉癌栓者的p53蛋白及PCNA阳性表达均高于瘤体单发、边界清、内部回声均匀者(P<0.05).有转移组的MVD值、p53蛋白及PCNA阳性表达率均显著高于无转移组(P<0.05).不同CDFI分型中,Ⅲ型与Ⅰ型相比,MVD值、p53蛋白及PCNA表达均较高(MVD:55.26±18.47 vs 34.59±11.18,p53蛋白:9/9 vs 6/18,PCNA:9/9 vs 12/18),差异有统计学意义(P<0.05).不同CPA分型中,与Ⅲ型的MVD值相比,Ⅰ型的MVD值与Ⅱ型的MVD值均低于Ⅲ型(Ⅰ型,MVD:26.58±8.42vs 51.52±16.36,Ⅱ型:35.43±13.04 vs 51.52±16.36)(P<0.05).与Ⅰ型的p53、PCNA表达相比,Ⅱ型和Ⅲ型的p53蛋白、PCNA表达均高于Ⅰ型(Ⅱ型,p53蛋白:21/32 vs 3/18,Ⅲ型:12/12 vs 3/18)(Ⅱ型,PCNA:29/32 vs 6/18,Ⅲ型:12/12 vs 6/18)(均P<0.05).CDFI、CPA与MVD值、p53蛋白及PCNA表达间呈正相关,差异均有统计学意义(P<0.01).结论:二维超声、CDFI、CPA及与MVD、p53蛋白及PCNA有密切关系,在一定程度上可作为肝癌初筛方法,对临床肝癌的诊断具有重要价值.展开更多
AIM:To evaluate the sensitivity and specificity of abdominal ultrasound (US) for the diagnosis of hepatic steatosis in severe obese subjects and its relation to histological grade of steatosis. METHODS: A consecutive ...AIM:To evaluate the sensitivity and specificity of abdominal ultrasound (US) for the diagnosis of hepatic steatosis in severe obese subjects and its relation to histological grade of steatosis. METHODS: A consecutive series of obese patients, who underwent bariatric surgery from October 2004 to May 2005, was selected. Ultrasonography was performed in all patients as part of routine preoperative time and an intraoperative wedge biopsy was obtained at the beginning of the bariatric surgery. The US and histological findings of steatosis were compared, considering histology as the gold standard. RESULTS: The study included 105 patients. The mean age was 37.2 ± 10.6 years and 75.2% were female. The histological prevalence of steatosis was 89.5%. The sensitivity and specificity of US in the diagnosis of hepatic steatosis were, respectively, 64.9% (95% CI: 54.9-74.3) and 90.9% (95% CI: 57.1-99.5). The positive predictive value and negative predictive value were, respectively, 98.4% (95% CI: 90.2-99.9) and 23.3% (95% CI: 12.3-39.0). The presence of steatosis onUS was associated to advanced grades of steatosis on histology (P = 0.016). CONCLUSION: Preoperative abdominal US in our series has not shown to be an accurate method for the diagnosis of hepatic steatosis in severe obese patients. Until another non-invasive method demonstrates better sensitivity and specificity values, histological evaluation may be recommended to these patients undergoing bariatric surgery.展开更多
文摘目的:探讨肝癌患者二维超声、彩色多普勒血流显像(color Doppler flow imaging,CDFI)、彩色能量血流显像(color power Dopper imagi n g a n g l o,C PA)与免疫组织化学指标的相关性.方法:选择62例肝癌(hepatocellular carcinoma,H C C)患者为研究对象,应用二维超声观察肝脏内肿块的形态、大小、边界、回声强度及内部回声情况,应用CDFI、CPA观察肿瘤区域及周边血供情况,并采用免疫组织化学SABC法观察p53及增殖细胞核抗原(proliferating cell nuclear antigen,PCNA)的表达情况,并且测定微血管密度(microvessel density,MVD),分析影像学参数与免疫组织化学指标的相关性.结果:二维超声结果显示,MVD均值在形态、个数、回声、边界、均匀值、坏死程度分组中差异均有统计学意义(P<0.05).瘤体多发、瘤体边界不清、回声不均、内部伴坏死、伴门静脉癌栓者的p53蛋白及PCNA阳性表达均高于瘤体单发、边界清、内部回声均匀者(P<0.05).有转移组的MVD值、p53蛋白及PCNA阳性表达率均显著高于无转移组(P<0.05).不同CDFI分型中,Ⅲ型与Ⅰ型相比,MVD值、p53蛋白及PCNA表达均较高(MVD:55.26±18.47 vs 34.59±11.18,p53蛋白:9/9 vs 6/18,PCNA:9/9 vs 12/18),差异有统计学意义(P<0.05).不同CPA分型中,与Ⅲ型的MVD值相比,Ⅰ型的MVD值与Ⅱ型的MVD值均低于Ⅲ型(Ⅰ型,MVD:26.58±8.42vs 51.52±16.36,Ⅱ型:35.43±13.04 vs 51.52±16.36)(P<0.05).与Ⅰ型的p53、PCNA表达相比,Ⅱ型和Ⅲ型的p53蛋白、PCNA表达均高于Ⅰ型(Ⅱ型,p53蛋白:21/32 vs 3/18,Ⅲ型:12/12 vs 3/18)(Ⅱ型,PCNA:29/32 vs 6/18,Ⅲ型:12/12 vs 6/18)(均P<0.05).CDFI、CPA与MVD值、p53蛋白及PCNA表达间呈正相关,差异均有统计学意义(P<0.01).结论:二维超声、CDFI、CPA及与MVD、p53蛋白及PCNA有密切关系,在一定程度上可作为肝癌初筛方法,对临床肝癌的诊断具有重要价值.
文摘AIM:To evaluate the sensitivity and specificity of abdominal ultrasound (US) for the diagnosis of hepatic steatosis in severe obese subjects and its relation to histological grade of steatosis. METHODS: A consecutive series of obese patients, who underwent bariatric surgery from October 2004 to May 2005, was selected. Ultrasonography was performed in all patients as part of routine preoperative time and an intraoperative wedge biopsy was obtained at the beginning of the bariatric surgery. The US and histological findings of steatosis were compared, considering histology as the gold standard. RESULTS: The study included 105 patients. The mean age was 37.2 ± 10.6 years and 75.2% were female. The histological prevalence of steatosis was 89.5%. The sensitivity and specificity of US in the diagnosis of hepatic steatosis were, respectively, 64.9% (95% CI: 54.9-74.3) and 90.9% (95% CI: 57.1-99.5). The positive predictive value and negative predictive value were, respectively, 98.4% (95% CI: 90.2-99.9) and 23.3% (95% CI: 12.3-39.0). The presence of steatosis onUS was associated to advanced grades of steatosis on histology (P = 0.016). CONCLUSION: Preoperative abdominal US in our series has not shown to be an accurate method for the diagnosis of hepatic steatosis in severe obese patients. Until another non-invasive method demonstrates better sensitivity and specificity values, histological evaluation may be recommended to these patients undergoing bariatric surgery.
