原发性肝癌320排容积CT全肿瘤灌注参数值与微血管密度及其与病理分级的相关性研究

发布时间：2018-01-04 12:21

本文关键词：原发性肝癌320排容积CT全肿瘤灌注参数值与微血管密度及其与病理分级的相关性研究　出处：《临床放射学杂志》2017年04期 　论文类型：期刊论文

【摘要】：目的探讨原发性肝癌320排容积CT全肿瘤灌注参数值与微血管密度(MVD)值的关系,并分析不同分化程度肝癌与MVD值的相关性。方法前瞻性搜集47例行320排容积CT灌注成像的原发性肝癌患者,采用全肿瘤测量法计算瘤体的肝动脉灌注量(HAP)、门静脉灌注量(PVP)及肝动脉灌注指数(HAPI)。根据EdmondsonSteiner分级法行病理分级。不同分化程度原发性肝癌各灌注参数值相比采用单因素方差分析或非参数检验分析。采用Spearman等级相关的分析方法对不同分化程度原发性肝癌的各灌注参数值、肿瘤MVD以及病理分级间的相关性进行分析。结果 47例患者中,高分化肝癌13例,中分化肝癌24例,低分化肝癌10例。MVD值分别为49.59个/mm~2、64.26个/mm~2、85.27个/mm~2。不同分化程度的原发性肝癌全肿瘤灌注参数值存在差异,高分化肝癌的HAP和HAPI最低,PVP最高,低分化肝癌的HAP和HAPI最高,PVP最低,中分化肝癌介于两者之间。不同分化程度原发性肝癌与肿瘤的MVD值呈正相关关系(r=0.815,P0.05)。低MVD计数组原发性肝癌的HAP、HAPI均低于高MVD计数组,差异有统计学意义(P=0.000)。低MVD计数组原发性肝癌的PVP大于高MVD计数组,差异有统计学意义(P=0.000)。结论全肿瘤灌注参数值能够定量反映不同分化程度原发性肝癌的血流动力学特点及肿瘤新生血管状况,可作为活体无创性评估肿瘤恶性程度及肿瘤血管生成的测量方法。原发性肝癌的分化程度与肿瘤MVD间存在一定的相关性,提示MVD与原发性肝癌的恶性程度有关,可在全肿瘤灌注参数值的变化中得到反映。
[Abstract]:Objective to investigate the primary hepatocellular carcinoma 320 slice volume CT tumor perfusion parameters and microvessel density (MVD) value of the relationship, and analyze the correlation of different degree of differentiation of HCC and MVD. Methods a prospective collection of 47 patients underwent 320 slice volume CT perfusion imaging in patients with primary liver cancer, hepatic artery perfusion of the tumor the whole tumor measurement method (HAP), portal venous perfusion (PVP) and hepatic perfusion index (HAPI). According to EdmondsonSteiner classification method for pathological grading. Different degree of differentiation of primary hepatocellular carcinoma perfusion values compared by one-way ANOVA or nonparametric test analysis. The perfusion parameters of different degree of differentiation primary liver cancer by using the method of Spearman correlation analysis of the value of MVD and the correlation between tumor pathological grade were analyzed. Results of the 47 patients, 13 cases of liver cancer in high differentiation, differentiation of hepatocellular carcinoma in 24 cases, 10 cases of poorly differentiated hepatocellular carcinoma.M The VD values were different degree of differentiation of 49.59 /mm~2,64.26 /mm~2,85.27 /mm~2. hepatocellular carcinoma tumor perfusion parameters between high differentiation of hepatocellular carcinoma HAP and HAPI is the lowest, the highest PVP, low differentiation of hepatocellular carcinoma HAP and HAPI is the highest, the lowest PVP, between the differentiation of hepatocellular carcinoma between the two different differentiation of the primary. Hepatocellular carcinoma and tumor MVD value was positively correlated (r=0.815, P0.05). The low MVD counts in patients with primary liver cancer HAP, HAPI were lower than that of MVD group, the difference was statistically significant (P=0.000). The low MVD counts in patients with primary liver cancer PVP was higher than MVD group, the difference was statistically significant (P=0.000). Conclusion the tumor perfusion parameters can reflect the different degree of differentiation of primary hepatocellular carcinoma and tumor blood flow dynamics characteristics of neovascularization, measurement method can be used for in vivo noninvasive assessment of tumor malignancy and tumor angiogenesis. There is a certain correlation between the degree of differentiation of primary hepatocellular carcinoma and tumor MVD, suggesting that MVD is related to the malignancy of primary liver cancer, and can be reflected in the change of tumor perfusion parameter values.

【作者单位】：新乡医学院第一附属医院放射科;郑州大学第一附属医院放射科;
【分类号】：R735.7;R730.44
【正文快照】： 原发性肝癌作为一种典型的血管富集的实体肿瘤,其中肿瘤内新生的血管在肿瘤的生长和扩散中起重要作用[1,2]。有研究证实,肿瘤血管生成状态对肿瘤病理分级、疗效评估及预后判断有重要价值[3~5]。迄今,微血管密度(microvessel density,MVD)已成为评估肿瘤血管生成的常用检查指标

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