f-MSCT评价恩度抗兔门静脉VX2癌栓新生血管生成的研究

发布时间：2018-05-05 03:04

本文选题：计算机体层成像 + 灌注加权成像　；参考：《辽宁医学院》2013年硕士论文

【摘要】：目的通过多层螺旋CT灌注技术测得恩度治疗前后兔门静脉VX2癌栓CT各灌注参数值，与免疫组织化学方法获得恩度治疗前后兔门静脉VX2癌栓VEGF表达结果作相关性研究，评价恩度对兔门静脉VX2癌栓的抗血管生成作用。方法 1、将复苏后的VX2瘤株接种于1只日本大耳白兔腹股沟区肌肉内传代，14天后行MRI扫证实肿瘤传代成功。取出传代兔腹股沟区肌内肿瘤制成瘤条，开腹手术方式将瘤条种植在18只实验兔门静脉内，2周后分别行GE Light speed16螺旋CT增强扫描证实肿瘤种植成功，之后将18只荷瘤的日本大耳白兔随机分成恩度组、生理盐水组、空白组，每组6只，各组治疗前及治疗2周后分别行GE Light speed16螺旋CT灌注扫描，获得各组治疗前、后CT灌注图及灌注参数值：血流量（BF）、血容积（BV）、毛细血管表面通透性（PS）。 2、空白组实验兔于分组后即处死，恩度组及生理盐水组实验兔治疗2周后行CT灌注扫描后处死，留取移植瘤标本，尽量与灌注层面保持一致，所有移植瘤组织经10%Formalin固定，常规石蜡包埋，5μm连续切片，对移植瘤区域做：HE染色、免疫组化染色。免疫组化采用SP二步法，VEGF结果判定依据文献所述方法进行。最后将CT灌注参数与免疫组化VEGF表达结果进行统计学分析。结果各组均获得满意MSCT灌注图像、灌注参数及VEGF表达图像。 1、恩度组治疗后较治疗前门静脉癌栓CT各灌注参数： BF、BV、PS均值均明显降低(p 0.05)。恩度组治疗后较生理盐水组治疗后门静脉癌栓CT各灌注参数： BF、BV、PS均值均明显降低(p 0.05)。 2、免疫组织化学检测恩度治疗后门静脉癌栓VEGF表达结果较治疗前明显减低，差异有显著统计学意义（p0.01）。 3、空白组、恩度组治疗后、生理盐水组治疗后门静脉癌栓CT灌注参数BV与PS呈高度正相关，相关系数r分别为0.895、0.903、0.873（p0.01） 4、空白组门静脉癌栓各灌注参数与VEGF表达结果均呈高度正相关，r值分别为0.853、0.896、0.813（p0.01），生理盐水组治疗后门静脉癌栓各灌注参数与VEGF表达结果均呈高度正相关，r值分别为0.861、0.892、0.814（p0.01）。恩度组治疗后门静脉癌栓各灌注参数与VEGF表达结果均呈高度正相关，r值分别为0.863、0.828、0.837（p0.01）。结论 1、恩度作为一种靶向抗VEGF的药物，作用于门静脉癌栓组织后使门静脉癌栓组织中VEGF的表达程度降低。 2、MSCT灌注成像能获得并分析门静脉癌栓灌注参数（BF、BV、PS），可以间接了解门静脉癌栓的VEGF表达程度，进而明确肿瘤内血管生成情况，，对指导门静脉癌栓的治疗疗效的评价有一定的价值。
[Abstract]:Purpose The CT perfusion parameters of VX2 tumor thrombus in portal vein of rabbits were measured by multi-slice spiral CT perfusion technique before and after Endor treatment, and the correlation between CT perfusion parameters and VEGF expression of VX2 tumor thrombus in portal vein of rabbits before and after Endor therapy was studied by immunohistochemical method. To evaluate the anti-angiogenesis effect of Endor on portal vein VX2 tumor thrombus in rabbits. Method 1. The VX2 tumor strain after resuscitation was inoculated into the inguinal muscle of a Japanese white rabbit. The successful passage was confirmed by MRI scan 14 days later. The intramuscular tumors in the inguinal region of rabbits were taken out and made into tumor strips. The tumor strips were implanted in the portal vein of 18 rabbits by open surgery for 2 weeks. The tumor was successfully implanted by GE Light speed16 enhanced CT scan. After that, 18 Japanese large ear white rabbits were randomly divided into three groups: Endol group, normal saline group and blank group, 6 rabbits in each group. GE Light speed16 spiral CT perfusion scanning was performed before treatment and 2 weeks after treatment. Post CT perfusion imaging and perfusion parameters: blood flow volume, blood volume, capillary surface permeability. 2. The rabbits in the blank group were killed immediately after being divided into groups. The rabbits in the Endol group and the saline group were sacrificed after 2 weeks of CT perfusion scanning. The transplanted tumor specimens were collected and kept consistent with the perfusion level as far as possible. All the transplanted tumor tissues were fixed by 10%Formalin. Routine paraffin-embedded 5 渭 m serial sections were used to detect the transplanted tumor area with the use of w he staining and immunohistochemical staining. The SP two-step method was used to determine the VEGF results according to the method mentioned in the literature. Finally, CT perfusion parameters and immunohistochemical VEGF expression results were statistically analyzed. Result Satisfactory MSCT perfusion images, perfusion parameters and VEGF expression images were obtained in all groups. 1. The CT perfusion parameters of portal vein tumor thrombus after treatment in Endol group were significantly lower than those before treatment: the mean value of BVV / PS in BFU group was significantly lower than that in control group (P 0.05). The CT perfusion parameters of portal vein tumor thrombus after treatment in Endol group were significantly lower than those in saline group: the mean value of BFV / BV / PS was significantly lower than that in control group (P 0.05). 2. The expression of VEGF in portal vein tumor thrombus was significantly lower than that before treatment by immunohistochemistry, and the difference was statistically significant (P 0.01). (3) after treatment, the CT perfusion parameters (BV) of portal vein tumor thrombus were positively correlated with PS in normal saline group (r = 0.895). 4. There was a high positive correlation between the perfusion parameters of portal vein tumor thrombus and the expression of VEGF in the blank group. The values of the perfusion parameters and the expression of VEGF in the portal vein tumor thrombus were 0.853X 0.896U 0.813p0.01g, respectively. The positive correlation between the perfusion parameters of the portal vein tumor thrombus and the expression of VEGF in the saline group was 0.861U 0.8920.814p0.01a, respectively. There was a high positive correlation between the perfusion parameters of portal vein tumor thrombus and the expression of VEGF in the Endol group after treatment. Conclusion 1. Endol, as a targeted drug against VEGF, reduced the expression of VEGF in portal vein tumor thrombus after acting on portal vein tumor thrombus. 2MSCT perfusion imaging can obtain and analyze the perfusion parameters of portal vein tumor thrombus. It can indirectly understand the degree of VEGF expression in portal vein tumor thrombus, and then determine the angiogenesis in the tumor. It has certain value in guiding the evaluation of therapeutic effect of portal vein tumor thrombus.
【学位授予单位】：辽宁医学院
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R735.7;R816.5

【参考文献】