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目的研究肾肿瘤的动态CT与微血管密度和血管内皮生长因子表达之间的关系。方法①对肾肿瘤进行多期CT扫描,包括平扫和注射造影剂后40、90、180 s共4期,选择合适兴趣区,测得肿瘤各期的强化值(分别为E40、E90、E180)和各期CT值之间的变化值(分别为△1、△2、△3)。对比剂注射流量3 m l/s,对比剂总量75 m l。②利用免疫组化法对肿瘤标本行抗CD34、VEGF染色。结果①共计18例符合纳入标准病例,共18个肿瘤,右6例,左12例,肾恶性肿瘤17例;肾良性肿瘤1例。②恶性肿瘤VEGF表达与E40、E90、E180、△1、△2、△3之间有相关性(相关系数分别为r=0.785,P=0.000;r=0.699,P=0.002;r=0.513,P=0.035;r=0.769,P=0.000;r=-0.764,P=0.000;r=-0.493,P=0.044)。③恶性肿瘤MVD与E40、E90、E180、△1、△2、△3之间有相关性(相关系数分别为r=0.880,P=0.000;r=0.855,P=0.000;r=0.791,P=0.000;r=0.836,P=0.000;r=-0.875,P=0.000;r=-0.433,P=0.075)。结论动态CT参数与肾肿瘤血管生成之间有良好的相关性,动态CT能较准确地反映肾肿瘤的血管生成。
Objective To study the relationship between dynamic CT and microvessel density and vascular endothelial growth factor (VEGF) expression in renal tumors. Methods ① The multi-phase CT scan of renal tumors was performed, including 40,90,180 s after plain scan and contrast medium injection. The appropriate region of interest was selected to determine the enhancement values of the tumor stages (E40, E90, E180 ) And the changes between the CT values (Δ1, Δ2, Δ3, respectively). Contrast injection flow 3 m l / s, contrast agent total 75 m l. ② using immunohistochemical staining of anti-CD34, VEGF in tumor specimens. Results ① A total of 18 cases met the standard criteria, 18 tumors in total, 6 in the right, 12 in the left, 17 in the kidney and 1 in the kidney. ② There was a correlation between VEGF expression and E40, E90, E180, △ 1, △ 2 and △ 3 in malignant tumors (r = 0.785, P = 0.000, r = 0.699, P = 0.035; r = 0.769, P = 0.000; r = -0.764, P = 0.000; r = -0.493, P = 0.044). (3) The correlation between MVD and E40, E90, E180, △ 1, △ 2 and △ 3 in malignant tumors was significant (r = 0.880, P = 0.000, r = 0.855, P = 0.000; = 0.000; r = 0.836, P = 0.000; r = -0.875, P = 0.000; r = -0.433, P = 0.075). Conclusion There is a good correlation between dynamic CT parameters and renal tumor angiogenesis. Dynamic CT can reflect the angiogenesis of renal tumors more accurately.