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目的回顾分析胸部孤立性纤维性肿瘤(SFT)的多层螺旋CT静脉期的最大强化率(vCER)与Vimentin、CD34、Bcl-2、CD99、SMA、瘤细胞密度、胶原束、血管数、细胞异型性的相关性,并进行多因素分析,探讨以MSCT多期扫描评价SFT的生物学特性。方法回顾性分析经病理证实的28例胸部SFT的CT表现,其中手术切除26例,2例穿刺活检,术前均进行MSCT多期扫描,并计算肿瘤实质vCER。术后肿瘤行大体病理及HE染色、免疫组织化学染色分析。结果肿瘤实质静脉期强化率与Bcl-2表达呈正相关。肿瘤最大直径值与CD99表达呈正相关,肿瘤实质平扫CT值及肿瘤的最大直径值与SMA表达呈负相关,肿瘤最大直径值与肿瘤内胶原束呈负相关。影响SFT实质静脉期强化率相关的因素为Bcl-2和胶原束,均为正相关因素,即肿瘤实质静脉期强化率高的肿瘤,胶原束较多,Bcl-2高表达。结论胸部SFT的MSCT多期增强扫描可比较全面观察肿瘤,肿瘤实质静脉期强化率能反映SFT一定的生物学特性,根据SFT的MSCT多期扫描征象,可间接评价其相关基因的表达及部分生物学特性,为SFT的治疗和预后判断提供新的有价值的依据。
Objective To retrospectively analyze the relationship between vCER and Vimentin, CD34, Bcl-2, CD99, SMA, tumor cell density, collagen bundles, number of blood vessels and number of cells in multiphase spiral CT of thoracic solitary fibrous tumor (SFT) Atherosclerosis and multivariate analysis were performed to evaluate the biological characteristics of SFT by multi-period MSCT scanning. Methods The CT manifestations of 28 cases of thoracic SFT confirmed by pathology were analyzed retrospectively. Among them, 26 cases were removed surgically and 2 cases were performed biopsy. MSCT multi-phase scanning was performed before operation and vCER was calculated. Postoperative tumor line gross pathology and HE staining, immunohistochemical staining. Results The enhancement rate of tumor parenchymal venous phase was positively correlated with the expression of Bcl-2. The maximum diameter of tumor was positively correlated with the expression of CD99. The CT value of the tumor and the maximum diameter of the tumor were negatively correlated with the expression of SMA. The maximum diameter of the tumor was negatively correlated with the collagen bundles in the tumor. The factors influencing the enhancement rate of SFT in venous phase were Bcl-2 and collagen bundles, which were both positive correlation factors, that is, tumors with high enhancement rate of parenchymal veins, more collagen bundles and higher Bcl-2 expression. Conclusions Multi-phase enhanced scan of chest SFT can be used to observe tumor comprehensively. The enhancement rate of real venous phase of tumor can reflect certain biological characteristics of SFT. According to the multi-period MSCT scanning sign of SFT, the expression of related genes and some biological Learn characteristics, provide new valuable basis for SFT treatment and prognosis.