CAJ | 학술논문

目的探讨多层螺旋CT灌注成像与周围型肺癌血管生成及细胞周期蛋白D1(cyclinDl)表达的相关性.方法 73例周围型肺癌行16层螺旋CT灌注成像,分析周围型肺癌的时间密度曲线(TDC)、灌注参数图像和各灌注参数[血流量(BF)、血容量(BV)、平均通过时间(MTT)、表面通透性(PS)、强化峰值(PH)、肿块-动脉强化峰值比(PHpm/PHa)].利用免疫组织化学测定微血管密度(MVD)并标定cyclinDl,评价周围型肺癌各CT灌注参数与MVD计数及cyclinD1表达的相关性.统计学方法采用单因素方差分析及Pearson相关分析方法.结果 3组周围型肺癌(腺癌、鳞癌、其他类型癌)的TDC曲线相似,都有明显的上升支,CT值明显增加[TDC曲线的峰值分别为(44.87±6.83)、(34.91±8.05)、(40.66±5.87)HU],达峰值后变化较小,较平坦,有一个平台期;cyclinD1阳性表达44例,周围型肺癌cyclinD1阳性表达患者的MVD值明显高于阴性表达者[分别为(33.88±14.81)、(23.17±11.66)条/高倍视野,P<0.01];周围型肺癌cyclinD1阳性表达者的PH、PHpm/PHa、BF、BV、PS值[分别为(60.56±6.27)HU、(20.71±2.54)、(245.54±69.73)ml·100 mg-1·min-1、(12.17±3.50)ml/100 mg、(20.11±7.34)ml·100 mg-1·min-1]明显高于阴性表达者[(56.39±6.87)HU、(19.02±3.27)、(194.23±80.89)ml·100 mg-1·min-1、(9.67±3.00)ml/100 mg、(14.10±7.45)ml·100 mg-1·min-1],差异有统计学意义(P值均<0.05);3组周围型肺癌中,cyclinD1阳性表达的PH、PHpm/PHa、BF、BV、PS值与MVD均呈正相关,其中,BV、PS、BF值的r值分别为0.409、0.517、0.503,呈显著性相关(P值均<0.01);PH、PHpm/PHa的r值分别为0.319、0.324,呈低度相关(P值均<0.05).cyclinD1阴性表达者PH、PHpm/PHa、BF、BV、PS值与MVD均无相关性.结论多层螺旋CT灌注成像与肿瘤血管生成具有较好的相关性,能够反映肿瘤的血管生成及cyclinD1表达,提供了一种定量评价周围型肺癌血流模式的非创伤性方法,有利于周围型肺癌的诊断. 目的探討多層螺鏇CT灌註成像與週圍型肺癌血管生成及細胞週期蛋白D1(cyclinDl)錶達的相關性.方法 73例週圍型肺癌行16層螺鏇CT灌註成像,分析週圍型肺癌的時間密度麯線(TDC)、灌註參數圖像和各灌註參數[血流量(BF)、血容量(BV)、平均通過時間(MTT)、錶麵通透性(PS)、彊化峰值(PH)、腫塊-動脈彊化峰值比(PHpm/PHa)].利用免疫組織化學測定微血管密度(MVD)併標定cyclinDl,評價週圍型肺癌各CT灌註參數與MVD計數及cyclinD1錶達的相關性.統計學方法採用單因素方差分析及Pearson相關分析方法.結果 3組週圍型肺癌(腺癌、鱗癌、其他類型癌)的TDC麯線相似,都有明顯的上升支,CT值明顯增加[TDC麯線的峰值分彆為(44.87±6.83)、(34.91±8.05)、(40.66±5.87)HU],達峰值後變化較小,較平坦,有一箇平檯期;cyclinD1暘性錶達44例,週圍型肺癌cyclinD1暘性錶達患者的MVD值明顯高于陰性錶達者[分彆為(33.88±14.81)、(23.17±11.66)條/高倍視野,P<0.01];週圍型肺癌cyclinD1暘性錶達者的PH、PHpm/PHa、BF、BV、PS值[分彆為(60.56±6.27)HU、(20.71±2.54)、(245.54±69.73)ml·100 mg-1·min-1、(12.17±3.50)ml/100 mg、(20.11±7.34)ml·100 mg-1·min-1]明顯高于陰性錶達者[(56.39±6.87)HU、(19.02±3.27)、(194.23±80.89)ml·100 mg-1·min-1、(9.67±3.00)ml/100 mg、(14.10±7.45)ml·100 mg-1·min-1],差異有統計學意義(P值均<0.05);3組週圍型肺癌中,cyclinD1暘性錶達的PH、PHpm/PHa、BF、BV、PS值與MVD均呈正相關,其中,BV、PS、BF值的r值分彆為0.409、0.517、0.503,呈顯著性相關(P值均<0.01);PH、PHpm/PHa的r值分彆為0.319、0.324,呈低度相關(P值均<0.05).cyclinD1陰性錶達者PH、PHpm/PHa、BF、BV、PS值與MVD均無相關性.結論多層螺鏇CT灌註成像與腫瘤血管生成具有較好的相關性,能夠反映腫瘤的血管生成及cyclinD1錶達,提供瞭一種定量評價週圍型肺癌血流模式的非創傷性方法,有利于週圍型肺癌的診斷.
목적 탐토다층라선CT관주성상여주위형폐암혈관생성급세포주기단백D1(cyclinDl)표체적상관성.방법 73례주위형폐암행16층라선CT관주성상,분석주위형폐암적시간밀도곡선(TDC)、관주삼수도상화각관주삼수[혈류량(BF)、혈용량(BV)、평균통과시간(MTT)、표면통투성(PS)、강화봉치(PH)、종괴-동맥강화봉치비(PHpm/PHa)].이용면역조직화학측정미혈관밀도(MVD)병표정cyclinDl,평개주위형폐암각CT관주삼수여MVD계수급cyclinD1표체적상관성.통계학방법채용단인소방차분석급Pearson상관분석방법.결과 3조주위형폐암(선암、린암、기타류형암)적TDC곡선상사,도유명현적상승지,CT치명현증가[TDC곡선적봉치분별위(44.87±6.83)、(34.91±8.05)、(40.66±5.87)HU],체봉치후변화교소,교평탄,유일개평태기;cyclinD1양성표체44례,주위형폐암cyclinD1양성표체환자적MVD치명현고우음성표체자[분별위(33.88±14.81)、(23.17±11.66)조/고배시야,P<0.01];주위형폐암cyclinD1양성표체자적PH、PHpm/PHa、BF、BV、PS치[분별위(60.56±6.27)HU、(20.71±2.54)、(245.54±69.73)ml·100 mg-1·min-1、(12.17±3.50)ml/100 mg、(20.11±7.34)ml·100 mg-1·min-1]명현고우음성표체자[(56.39±6.87)HU、(19.02±3.27)、(194.23±80.89)ml·100 mg-1·min-1、(9.67±3.00)ml/100 mg、(14.10±7.45)ml·100 mg-1·min-1],차이유통계학의의(P치균<0.05);3조주위형폐암중,cyclinD1양성표체적PH、PHpm/PHa、BF、BV、PS치여MVD균정정상관,기중,BV、PS、BF치적r치분별위0.409、0.517、0.503,정현저성상관(P치균<0.01);PH、PHpm/PHa적r치분별위0.319、0.324,정저도상관(P치균<0.05).cyclinD1음성표체자PH、PHpm/PHa、BF、BV、PS치여MVD균무상관성.결론 다층라선CT관주성상여종류혈관생성구유교호적상관성,능구반영종류적혈관생성급cyclinD1표체,제공료일충정량평개주위형폐암혈류모식적비창상성방법,유리우주위형폐암적진단.
Objective To investigate the relationship between multi-slice spiral CT perfusion imaging and tumor angiogenesis and cell cycle protein D1 (cyclinD1) expression in patients with peripheral lung cancer. Methods Seventy-three patients with peripheral lung cancer underwent 16-slice spiral CTperfusion imaging. The CT perfusion imaging were analyzed for time density curve (TDC), perfusion parametric maps and the respective perfusion parameters (BF, BV, PS, PH, and PHpm/PHa). Correlation between the respective perfusion parameters and immunohistochemical findings of MVD measurement and cyclinD1 expression were evaluated. Statistical method used one factor analysis of variance (One-wayANOVA) and Pearson correlation analysis. Results The shape of TDC of three groups of peripheral lung cancers (adenocarcinoma, squamous cell carcinoma, and other type of cancer) was similar. They showed a steeper slope, was obvious increase of nodular HU value [ peak height of TDC is respectively (44. 87±6. 83), (34. 91 ± 8.05), (40. 66±5. 87) HU ], changed little after reaching peak height, became flat at peak, had a platform. Forty-four patients were cyclinD1 positive expression, the peripheral lung cancers with cyclinD1 positive expression showed significantly higher MVD value than that of the peripheral lung cancers with cyclinD1 negative expression [ respectively (33.88± 14. 81), (23. 17±11.66) band/high magnification, P < 0. 01]. The cancers with cyclinD1 positive expression showed significantly higher PH,PHpm/PHa, BF,BV, PS value than those of the cancers with cyelinD1 negative expression[respectively P <0. 05]. MVD was positively correlated with PH, PHpm/PHa, BF, BV, and PS of the three groups ofcancers with cyclinD1 positive expression. Among, the correlation coefficient (r value) of BV, PS, BF was0. 409, 0. 517,0. 503 respectively(all P < 0. 01). MVD was significantly correlated with them. The r valueof PH, PHpm/PHa is 0. 319,0. 324 respectively(all P < 0. 05). MVD was less correlated with them. MVDwas not correlated with PH, PHpm/PHa, BF, BV, and PS of the three groups of cancers with cyclinD1 negative expression. Conclusions Multi-slice spiral CT perfusion imaging moderately correlated with tumorangiogenesis and reflected MVD measurement and cyclinD1 expression. It provided not only a noninvasive method of quantitative assessment for blood flow patterns of peripheral lung cancer but also an applicable diagnostic method for peripheral lung cancer.