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目的初步评价肺腺癌血管生成与容积灌注成像定量CT参数的相关性。资料与方法30例肺腺癌(直径≤3cm)患者,行多层螺旋CT(MSCT)容积灌注成像(经肘前静脉注入非离子型对比剂)。用免疫组织化学染色方法测定微血管密度(MVD)并标定血管内皮生长因子(VEGF),评价肺腺癌容积灌注成像定量CT参数(强化值、灌注值、结节-主动脉强化值比及平均通过时间)与MVD的相关性。结果肺腺癌强化值(34.25±12.80)HU、结节-主动脉强化值比(14.59±4.72)%及灌注值(29.02±6.91)ml.min-1.100g-1与MVD(68.18±19.84)均呈正相关(r=0.728,P<0.0001;r=0.689,P<0.0001;r=0.894,P<0.0001)。17例(56.7%)肺腺癌VEGF表达阳性,其强化值(38.16±13.88)HU、结节-主动脉强化值比(15.96±5.41)%、灌注值(30.91±7.25)ml.min-1.100g-1及MVD(74.36±20.45)均高于VEGF表达阴性的肺腺癌[(28.13±9.71)HU、(13.01±2.97)%、(26.36±5.71)ml.min-1.100g-1、60.10±11.84](t=2.10,P=0.045<0.05;t=2.30,P=0.030<0.05;t=2.51,P=0.025<0.05;t=2.78,P=0.033<0.05)。VEGF表达阳性的肺腺癌强化值、结节-主动脉强化值比及灌注值与MVD均呈正相关(r=0.681,P=0.005<0.05;r=0.713,P=0.003<0.05;r=0.904,P<0.0001)。结论肺腺癌强化值、结节-主动脉强化值比及灌注值反映了肺腺癌的MVD。强化值、结节-主动脉强化值比及灌注值可能是VEGF相关的肺腺癌血管生成的指标。
Objective To evaluate the correlation of quantitative CT parameters of angiogenesis and volume perfusion imaging in lung adenocarcinoma. Materials and Methods Thirty patients with lung adenocarcinoma (diameter≤3cm) underwent multi-slice spiral CT (MSCT) volumetric perfusion imaging (non-ionic contrast agent was injected through the antecubital vein). The microvessel density (MVD) was measured by immunohistochemistry and the expression of vascular endothelial growth factor (VEGF) was assayed to evaluate the quantitative CT parameters of lung adenocarcinoma perfusion imaging (intensification, perfusion, nodule-aortic enhancement ratio and mean passage Time) and MVD. Results Compared with the MVD (68.18 ± 19.84), the values of HU (34.25 ± 12.80), nodular aorta enhancement (14.59 ± 4.72)% and perfusion (29.02 ± 6.91) ml.min-1.100g- (R = 0.728, P <0.0001; r = 0.689, P <0.0001; r = 0.894, P <0.0001). The expression of VEGF in 17 cases (56.7%) of lung adenocarcinomas was positive, with the enhancement value of 38.16 ± 13.88 HU, the nodule-aorta enhancement ratio of 15.96 ± 5.41% and the perfusion value of 30.91 ± 7.25 ml.min-1.100 g-1 and MVD (74.36 ± 20.45) were higher than that of VEGF-negative lung adenocarcinoma [(28.13 ± 9.71) HU, (13.01 ± 2.97)%, (26.36 ± 5.71) ml.min-1.100g- ± 11.84] (t = 2.10, P = 0.045 <0.05; t = 2.30, P = 0.030 <0.05; t = 2.51, P = 0.025 <0.05; t = 2.78, P = 0.033 <0.05). There was a positive correlation between VEGF-positive lung adenocarcinoma, nodular-aortic enhancement ratio and perfusion and MVD (r = 0.681, P = 0.005 <0.05; r = 0.713, P = 0.003 <0.05; , P <0.0001). Conclusions Enhanced lung adenocarcinoma, nodular aorta enhancement ratio and perfusion reflect the MVD of lung adenocarcinoma. Intensive values, nodular-aortic enhancement ratio and perfusion values may be indicators of VEGF-related angiogenesis in lung adenocarcinoma.