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目的:研究MSCT影像表现及肿瘤血管生成对判断胰腺癌预后的价值。方法:回顾性分析36例经手术证实的胰腺癌患者的CT影像表现(肿瘤胰外侵犯,胰周血管侵犯)、临床病理因素,并采用免疫组化方法检测测量肿瘤微血管密度(MVD)、血管内皮生长因子(VEGF)和金属蛋白酶(MMP)表达水平,与患者的预后进行相关性分析。36例患者术前均行MSCT检查和CT血管成像、多平面重组(MPR)等图像后处理。结果:COX回归分析发现胰腺癌患者的临床分期、病理分级、CT影像表现(胰外侵犯,血管侵犯)、MMP-2表达水平与患者的预后有相关性(P<0.05),其中以CT图像上有胰外侵犯和血管侵犯的相对风险度最高(18.18,6.173)。结论:胰腺癌胰外侵犯、胰周血管侵犯的CT影像表现是预后的独立影响因素,而MVD、VEGF、MMP-9对胰腺癌预后评价无显著性意义。
Objective: To study the value of MSCT imaging and tumor angiogenesis in judging the prognosis of pancreatic cancer. Methods: Thirty-six surgically-confirmed pancreatic cancer patients were retrospectively analyzed for CT findings (extra-pancreatic invasion, peripancreatic vascular invasion) and clinicopathological factors. Immunohistochemical methods were used to detect the tumor microvessel density (MVD) The levels of VEGF and MMP were correlated with the prognosis of patients. Thirty-six patients underwent MSCT and CT angiography and multiplanar reconstruction (MPR) before operation. Results: There was a significant correlation between the expression of MMP-2 and the prognosis in patients with pancreatic cancer (P <0.05) by COX regression analysis. The clinical stage, pathological grade, CT imaging manifestations (extra-pancreatic invasion, vascular invasion) There is the highest relative risk of extra-pancreatic invasion and vascular invasion (18.18, 6.173). Conclusions: The CT findings of pancreatic carcinoma in peripancreatic invasion and peripancreatic vascular invasion are independent prognostic factors. However, MVD, VEGF and MMP-9 have no significant effect on the prognosis of pancreatic cancer.