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目的研究原发性肝细胞肝癌(HCC)SCT平扫和增强扫描的各种影像学表现与VEGF和MVD的相关性。方法对手术病理证实的50例原发性肝细胞肝癌患者的SCT资料进行回顾性全面分析,对患者术后病理组织进行免疫组化检测,测定肝癌组织的VEGF蛋白表达,进行MVD定量测定。将肝癌病人的14个SCT表现指标(平扫密度与均匀度、动脉期强化程度与均匀度、门脉期强化程度与均匀度、病灶大小、形态、境界、轮廓、包膜有无与完整性、动静脉短路有无、血供类型)与VEGF蛋白表达和MVD进行统计学相关性分析。结果平扫密度的高低与均匀度、动脉期和门脉期强化程度、肿瘤大小、形态类型与VEGF表达相关,其中平扫密度的高低、肿瘤大小与VEGF呈负相关;平扫密度的均匀度、动脉期和门脉期强化程度、肿瘤形态类型与VEGF表达呈正相关;动脉期和门脉期强化程度、肿瘤形态类型与MVD均呈正相关;动脉期和门脉期强化均匀度、肿瘤境界、轮廓、包膜情况(有无及类型)、动静脉短路有无、血供类型与VEGF和MVD均无相关性。结论 SCT可以反映HCC的微循环状态,其某些表现特征和VEGF和MVD之间有相关性,可以从影像学角度来推测肿瘤的血管增生情况,评估肿瘤生物学行为及预后。
Objective To study the correlation between various imaging features of primary hepatocellular carcinoma (HCC) SCT plain scans and enhanced scans with VEGF and MVD. Methods A retrospective and comprehensive analysis of SCT data of 50 patients with hepatocellular carcinoma confirmed by pathology was performed. Immunohistochemistry was used to detect the pathological tissues of patients with hepatocellular carcinoma. The expression of VEGF protein in hepatocellular carcinoma was detected and the MVD was determined. Fourteen indicators of SCT (average density and evenness of flattening, degree and uniformity of arterial phase enhancement, degree and uniformity of portal venous phase, size, shape, boundary, contour, , Arteriovenous short circuit, blood supply type) and VEGF protein expression and MVD were statistically analyzed. Results The level and uniformity of plaque density, the degree of arterial phase and portal venous enhancement, tumor size and morphology were correlated with the expression of VEGF. The level of plaque density and tumor size were negatively correlated with VEGF. The evenness of plaque density , The degree of arterial phase and portal phase enhancement, the type of tumor and the expression of VEGF were positively correlated; the degree of arterial phase and portal phase enhancement, the type of tumor morphology and MVD were positively correlated; arterial phase and portal phase enhancement of homogeneity, Contour, envelope (with or without type), arteriovenous short circuit, blood type and VEGF and MVD were not related. Conclusions SCT can reflect the microcirculation status of HCC. Some of its features are related to VEGF and MVD. The tumor angiogenesis can be inferred from the imaging point of view and the biological behavior and prognosis of the tumor can be assessed.