CAJ | 학술논문

目的探讨原发性肾细胞癌(RCC)螺旋CT(SCT)征象与病理、肿瘤微血管密度(MVD)、血管内皮生长因子(VEGF)表达之间的关系.方法收集经手术及病理证实的RCC30例,术前行SCT平扫及三期增强扫描.标本用免疫组织化学生物索-过氧化物酶复合法(SABC法)染色,检测肿瘤MVD及VEGF的表达.结果 SCT多期增强扫描对30例RCC检出率100%,定性诊断正确率100%,术前分期正确率83.33%.MVD平均为(36±12.40)条/视野,VEGF阳性表达率73.33%.MVD与VEGF的表达无相关性(r=0.057,P>0.05).SCT征象:直径>3.0 cm组、瘤内有出血坏死组、无假包膜组、有静脉癌栓组,病理核分级、VEGF阳性表达及MVD均高于相对应组(P均<0.05).有淋巴结转移组的病理核分级及MVD均高于相对应组(P<0.05).CMP期RCC强化的CT值、强化程度分别与MVD呈正相关(r=0.784、P<0.05,r=0.789,P<0.05).结论 SCT多期增强扫描是RCC可靠的检查方法.能准确反映其病理学基础;RCC的部分征象与MVD及VEGF的表达有关,可预测RCC的侵袭和转移.
목적 탐토원발성신세포암(RCC)라선CT(SCT)정상여병리、종류미혈관밀도(MVD)、혈관내피생장인자(VEGF)표체지간적관계.방법 수집경수술급병리증실적RCC30례,술전행SCT평소급삼기증강소묘.표본용면역조직화학생물색-과양화물매복합법(SABC법)염색,검측종류MVD급VEGF적표체.결과 SCT다기증강소묘대30례RCC검출솔100%,정성진단정학솔100%,술전분기정학솔83.33%.MVD평균위(36±12.40)조/시야,VEGF양성표체솔73.33%.MVD여VEGF적표체무상관성(r=0.057,P>0.05).SCT정상:직경>3.0 cm조、류내유출혈배사조、무가포막조、유정맥암전조,병리핵분급、VEGF양성표체급MVD균고우상대응조(P균<0.05).유림파결전이조적병리핵분급급MVD균고우상대응조(P<0.05).CMP기RCC강화적CT치、강화정도분별여MVD정정상관(r=0.784、P<0.05,r=0.789,P<0.05).결론 SCT다기증강소묘시RCC가고적검사방법.능준학반영기병이학기출;RCC적부분정상여MVD급VEGF적표체유관,가예측RCC적침습화전이.
Objective To evaluate the correlation between imaging features of spiral computed tomography(SCT) and pathology, MVD, and the expression of VEGF in renal cell carcinoma(RCC). Methods Thirty patients with RCC diagnosed by pathology underwent SCT examinations.MVD and the expression of VEGF were examined immunohistochemically using SABC techniques. Results The detection and characterization rate as well as accuracy of staging before operation about 30 RCC of multiphasic SCT scans were 100 %, 100 % and 83.3 %, respectively. In 30 cases of RCC, the mean MVD was 36±12.4. The positive expression rate of VEGF were 73.33 %. There were no correlation between the MVD and the expression of VEGF in RCC (r =0.057, P >0.05). The features of SCT: on multiphasic SCT scans, the pathological nuclear grade, the MVD and positive expression of VEGF in groups of RCC with diameter larger than 3.0 cm, central necrosis, pseudocapsule and intravenous tumor emboli were obviously higher than those of the contrast group (P <0.05, P <0.05, P <0.05, respectively). The pathological nuclear grade and MVD in groups of RCC with lymph node metastasis were higher than the contrast group (P <0.05, P <0.05, respectively). There were the positive correlation between the enhanced Hounsfield' s units in the CMP and the MVD in 30 cases of RCC(r =0.784, P <0.05). The degree of enhancement correlated well positively with the MVD in 30cases of RCC (P < 0.05). Conclusion Multiphasic enhanced SCT scan is a reliable technique in the detection, pathologic characterization of RCC. Some SCT features are closely correlated with MVD and expressions of VEGF in RCC, which could be a noninvasive method in predicting aggressiveness and metastasis.