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目的 应用彩色多谱勒能量图(CDE)在体外检测胆囊肿瘤血管生成,期望发展一种无创伤性评价肿瘤血管生成的方法.方法 36例胆囊癌和26例胆囊腺癌病人术前均行CDE探测胆囊肿瘤血流,术后切除标本行MVD和流式细胞计数检查,CDE检测结果与术后MVD和临床病理资料进行对照分析.结果 CDE显示的胆囊腺瘤血流信号以Ⅰ型、Ⅱ型为主,胆囊癌则以Ⅲ型、Ⅳ型为主(P<0.05),且胆囊癌内血流频谱的峰值速度(PS)及其大小显著高于胆囊腺瘤(P<0.05).CDE 检测到的肿瘤血管数目和分布与MVD测定结果呈正相关(P<0.05);CDE显示血流信号为Ⅲ血型、Ⅳ型者,发生淋巴转移者及 S+G2M期指数目明显高于Ⅰ型、Ⅱ型(P<0.05).结论 CDE能够在体外评价胆囊肿瘤血管生成,是鉴别胆囊良恶性肿瘤和判断肿瘤预后有用的参数.
Objective To detect the angiogenesis of gallbladder tumors by using color Doppler energy (CDE) in vitro and expect to develop a non-invasive method for evaluating tumor angiogenesis. Methods 36 patients with gallbladder carcinoma and 26 patients with gallbladder adenocarcinoma undergo CDE before surgery. The blood flow of gallbladder tumors was detected and the MVD and flow cytometry were examined after operation. The results of CDE were compared with postoperative MVD and clinicopathological data. The results showed that the signal of CDE showed gallbladder adenoma with type I and type II. Predominantly, gallbladder cancer was mainly type III and type IV (P<0.05), and the peak velocity (PS) and size of blood flow spectrum in gallbladder carcinoma were significantly higher than those of gallbladder adenoma (P<0.05). The number and distribution of tumor vessels were positively correlated with MVD measurement (P<0.05); CDE showed blood flow signals of type III and type IV. The number of lymph node metastasis and S+G2M index were significantly higher than that of type I and II. Type (P<0.05). Conclusion CDE can evaluate angiogenesis of gallbladder tumors in vitro. It is a useful parameter to identify benign and malignant gallbladder tumors and determine their prognosis.