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目的 探讨肝细胞癌 (hepatocellularcarcinoma ,HCC)的血管形成情况以及双期螺旋CT (spiralcomputedtomography ,SCT)增强表现特征与HCC微血管形成、其它临床和病理特征之间的关系。方法 对 5 0例 (男 3 9例 ,女 11例 )共 5 4个经手术病理证实且行SCT动、静脉双期增强扫描的HCC病灶进行回顾性分析 ,用免疫组化SP法检测癌组织血管形成情况 ,将SCT的表现特征与免疫组化结果和其它的临床、病理特征进行对照分析。结果 第Ⅷ因子相关抗原 (FⅧRA)表达部位以间质内皮细胞为主的占2 4.1% ( 13 /5 4) ,以肝窦内皮为主的占 18.5 % ( 10 /5 4) ,混合型占 5 7.4% ( 3 1/5 4)。所有病灶平均微血管密度 (microvesseldensity ,MVD)为 5 2 .2 0± 13 .89,微血管的平均直径为 ( 15 .0 6± 7.76) μm。MVD与Edmondson分级有关 (F =3 .488,Ρ =0 .0 2 3 ) ;微血管直径与AFP值有关 (t =3 .3 0 3 ,Ρ =0 .0 0 2 )。与SCT显示的包膜类型有关的是MVD和病理分级 ;与增强类型有关的是肿瘤的大小和瘤内有无坏死 ;与SCT显示的侵袭转移性有关的是MVD、FⅧRA的表达部位和肿瘤的大小 ;与SCT显示的病灶的大小有关的是AFP值 ;与SCT显示的肝硬化有关的是HBsAg和病灶的大小。 结论 微血管形成决定HCC的某些生物学行为 ,SCT图像表现特?
Objective To investigate the angiogenesis of hepatocellular carcinoma (HCC) and the relationship between enhanced features of spiral computed tomography (SCT) and the development of HCC microvessel and other clinical and pathological features. Methods A total of 54 HCC foci confirmed by surgery and pathology and double scans enhanced by SCT were retrospectively analyzed in 50 cases (39 males and 11 females), and immunohistochemical SP method was used to detect the vascularity of the cancer tissue The formation of SCT performance characteristics and immunohistochemistry results and other clinical and pathological features were analyzed. Results FⅧRA expression accounted for 21.4% (13/54) in the stromal endothelial cells and 18.5% (10/54) in the liver sinusoid. The mixed type 5 7.4% (3 1/5 4). The mean microvessel density (MVD) of all lesions was 52.2 ± 13.89 and the mean diameter of microvessels was (15.0 ± 7.76) μm. MVD was related to Edmondson classification (F = 3.488, P = 0. 023); microvessel diameter was related to AFP (t = 3.303, P = .0102). MVD and pathological grade are related to the type of envelope displayed by SCT; the size of the tumor and whether there is necrosis in the tumor related to the type of enhancement; the expression of MVD, FⅧRA and tumor Size; AFP values related to the size of the lesions shown on the SCT; and the size of the HBsAg and lesions on the cirrhosis shown by the SCT. Conclusions Some of the biological behaviors of HCC are decided by microvessel formation, and SCT images have special characteristics.