摘要
目的探讨多层螺旋CT灌注成像与周围型肺癌血管生成及细胞周期蛋白D1（cyclinDl）表达的相关性。方法73例周围型肺癌行16层螺旋CT灌注成像，分析周围型肺癌的时间密度曲线（TDC）、灌注参数图像和各灌注参数[血流量（BF）、血容量（BV）、平均通过时间（MTT）、表面通透性（PS）、强化峰值（PH）、肿块-动脉强化峰值比（PHpm／PHa）]。利用免疫组织化学测定微血管密度（MVD）并标定cyclinD1，评价周围型肺癌各CT灌注参数与MVD计数及cyclinD1表达的相关性。统计学方法采用单因素方差分析及Pearson相关分析方法。结果3组周围型肺癌（腺癌、鳞癌、其他类型癌）的TDC曲线相似，都有明显的上升支，CT值明显增加[TDC曲线的峰值分别为（44．87±6．83）、（34．91±8．05）、（40、66±5．87）HU]，达峰值后变化较小，较平坦，有一个平台期；cyclinD1阳性表达44例，周围型肺癌cyclinD1阳性表达患者的MVD值明显高于阴性表达者[分别为（33．88±14．81）、（23．17±11．66）条／高倍视野，P〈0．01]；周围型肺癌cyclinD1阳性表达者的PH、PHpm／PHa、BF、BV、PS值[分别为（60．56±6．27）HU、（20．71±2．54）、（245．54±69．73）ml·100mg^-1·min^-1、（12．17±3．50）ml／100mg、（20、11±7．34）ml·100mg^-1·min^-1]明显高于阴性表达者[（56．39±6．87）HU、（19．02±3．27）、（194．23±80．89）ml·100mg^-1·min^-1、（9．67±3．00）ml／100mg、（14．10±7．45）ml·100mg^-1·min^-1]，差异有统计学意义（P值均〈0．05）；3组周围型肺癌中，cyclinD1阳性表达的PH、PHpm／PHa、BF、BV、PS值与MVD均呈正相关，其中，BV、PS、BF值的r值分别为0．409、0．517、0．503，呈显著性相关（P值均〈0．01）；PH、PHpm／PHa的r值分别为0．319、0．324，呈低度相关（P值均〈0．05）。cyclinD1阴性表达者PH、PHpm／PHa、BF、BV、PS值与MVD均无相关性。结论多层螺旋CT灌注成像与肿瘤血管生成具有较好的相关性，能够反映肿瘤的血管生成及cyclinD1表达，提供了一种定量评价周围型肺癌血流模式的非创伤性方法，有利于周围型肺癌的诊断。
Objective To investigate the relationship between multi-slice spiral CT perfusion imaging and tumor angiogenesis and cell cycle protein D1 （ cyclinD1 ） expression in patients with peripheral lung cancer. Methods Seventy-three patients with peripheral lung cancer underwent 16-slice spiral CT perfusion imaging. The CT perfusion imaging were analyzed for time density curve （TDC）, perfusion parametric maps and the respective perfusion parameters （BF, BV, PS, PH, and PHpm/PHa）. Correlation between the respective perfusion parameters and immunohistochemical findings of MVD measurement and cyclinD1 expression were evaluated. Statistical method used one factor analysis of variance （One-way ANOVA） and Pearson correlation analysis. Results The shape of TDC of three groups of peripheral lung cancers （ adenocareinoma, squamous cell carcinoma, and other type of cancer） was similar. They showed a steeper slope, was obvious increase of nodular HU value [ peak height of TDC is respectively （ 44. 87 ± 6. 83）, （34. 91 ± 8.05 ）, （40. 66 ± 5. 87 ） HU ], changed little after reaching peak height, became flat at peak, had a platform. Forty-four patients were eyelinD1 positive expression, the peripheral lung cancers with eyelinD1 positive expression showed significantly higher MVD value than that of the peripheral lung cancers with eyelinD1 negative expression [ respectively （ 33.88 ± 14.81 ） , （ 23.17 ± 11.66 ） band/high magnification, P 〈 0.01 ]. The cancers with eyelinD1 positive expression showed significantly higher PH, PHpm/PHa, BF,BV, PS value than those of the cancers with eyelinD1 negative expression [ respectively （60.56±6.27）HU,（20.71±2.54）,（245.54±69.73）ml·100mg^-1·min^-1,（12.17 ±3.50）ml/ 100 mg, （20. 11 ± 7.34 ） ml·100mg^-1·min^-1 vs. （ 56. 39 ± 6. 87 ） HU, （ 19.02 ± 3. 27 ）, （ 194. 23 ± 80.89）ml·100mg^-1·min^-1 ,（9.67 ± 3.00） ml/100 mg,（14. 10 ±7.45） ml·100mg^-1·min^-1, all P 〈0.05]. MVD was positively correlated with PH, PHpm/PHa, BF, BV, and PS of the three groups of cancers with eyelinD1 positive expression. Among, the correlation coefficient （r value） of BV, PS, BF was 0. 409, 0. 517,0. 503 respectively（ all P 〈 0. 01 ）. MVD was significantly correlated with them. The r value of PH, PHpm/PHa is 0. 319,0. 324 respectively（all P 〈0. 05）. MVD was less correlated with them. MVD was not correlated with PH, PHpm/PHa, BF, BV, and PS of the three groups of cancers with eyelinD1 negative expression. Conclusions Multi-slice spiral CT perfusion imaging moderately correlated with tumor angiogenesis and reflected MVD measurement and eyelinD1 expression. It provided not only a noninvasive method of quantitative assessment for blood flow patterns of peripheral lung cancer but also an applicable diagnostic method for peripheral lung cancer.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2008年第7期734-739,共6页
Chinese Journal of Radiology
