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目的研究多层CT灌注与缺氧诱导因子-1α(HIF-1α)介导肝癌血管生成的相关性及临床意义。方法手术、病理证实的34例肝癌、11例肝血管瘤行多层CT灌注成像,获取参数。免疫组化SP法检测34例肝癌、11例肝血管瘤及周围正常肝中缺氧诱导因子-1α、血管内皮生长因子(VEGF)的表达,CD34单克隆抗体标记微血管密度,将两者对比研究。结果肝癌的肝动脉灌注量(HAP)、肝动脉灌注指数(HAI)均高于肝血管瘤及周围正常肝(P<0.01)。肝癌缺氧诱导因子-1α与VEGF及CD34的表达呈正相关(P<0.01)。肝癌HAP和HPI与HIF-1α、VEGF及CD34的表达呈正相关(P<0.05)。肝癌的Edmondson-Steiner组织学分级从Ⅰ级、Ⅱ~Ⅲ级、Ⅳ级间HAP、HAI、MVD的差异有统计学意义(P<0.05)。结论多层CT灌注在一定程度上反映HIF-1α介导的缺氧条件下的肝癌血管生成。
Objective To investigate the correlation between multi-slice CT perfusion and hypoxia-inducible factor-1α (HIF-1α) -mediated angiogenesis in hepatocellular carcinoma and its clinical significance. Methods 34 cases of hepatocellular carcinoma confirmed by pathology and 11 cases of hepatic hemangiomas underwent multi-slice CT perfusion imaging. Immunohistochemical SP method was used to detect the expression of hypoxia inducible factor-1α and vascular endothelial growth factor (VEGF) in 34 cases of hepatocellular carcinoma, 11 cases of hepatic hemangioma and surrounding normal liver tissues, and the microvessel density of CD34 monoclonal antibody was compared with each other . Results The hepatic artery perfusion (HAP) and hepatic artery perfusion index (HAI) of HCC were higher than those of hepatic hemangioma and surrounding normal liver (P <0.01). The expression of HIF-1α and VEGF and CD34 in HCC were positively correlated (P <0.01). There was a positive correlation between HAP, HPI and the expression of HIF-1α, VEGF and CD34 in HCC (P <0.05). The Edmondson-Steiner histological grade of HCC was statistically different from that of HAP, HAI and MVD in grades Ⅰ, Ⅱ ~ Ⅲ, and Ⅳ (P <0.05). Conclusion Multi-slice CT perfusion reflects HIF-1α-mediated hepatic angiogenesis under hypoxic conditions to a certain extent.