CAJ | 학술논문

目的：探讨肝细胞癌（HCC）螺旋CT多期扫描动脉期、门脉期强化值与肿瘤分化程度、CD34、CK19、GPC3、P53、Ki67表达的相关性。方法67例经病理证实的HCC患者进行CT多期扫描，分别计算67个癌灶的动脉期强化值和门脉期强化值。肝穿刺组织进行HE染色和免疫组化法检测，评定肿瘤分化程度、CK19、CD34、GPC3、P53、Ki67表达强度。对HCC动脉期、门脉期强化值与上述细胞因子表达关系进行多元线性回归分析，筛选、建立理想的多元线性回归方程。结果67个癌灶呈“快进快出”表现，符合典型的HCC CT表现特征。 HCC动脉期强化值为（38.9±13.1）HU；多元线性回归方程为：动脉期强化值=27.381-10.0161×CK19+4.245×CD34+3.503×GPC3。HCC门脉期强化值为（44.7±11.7）HU；多元线性回归方程为：门脉期强化值=26.869+8.809×CK19+4.800×CD34+3.610×GPC3。结论多期增强扫描可反映多种细胞因子的表达、HCC的生物学特性。
목적：탐토간세포암（HCC）라선CT다기소묘동맥기、문맥기강화치여종류분화정도、CD34、CK19、GPC3、P53、Ki67표체적상관성。방법67례경병리증실적HCC환자진행CT다기소묘，분별계산67개암조적동맥기강화치화문맥기강화치。간천자조직진행HE염색화면역조화법검측，평정종류분화정도、CK19、CD34、GPC3、P53、Ki67표체강도。대HCC동맥기、문맥기강화치여상술세포인자표체관계진행다원선성회귀분석，사선、건립이상적다원선성회귀방정。결과67개암조정“쾌진쾌출”표현，부합전형적HCC CT표현특정。 HCC동맥기강화치위（38.9±13.1）HU；다원선성회귀방정위：동맥기강화치=27.381-10.0161×CK19+4.245×CD34+3.503×GPC3。HCC문맥기강화치위（44.7±11.7）HU；다원선성회귀방정위：문맥기강화치=26.869+8.809×CK19+4.800×CD34+3.610×GPC3。결론다기증강소묘가반영다충세포인자적표체、HCC적생물학특성。
Objective Objective To study the relationship between the difference contrast enhancement density in arterialphase and portalphase on multiphase spiral CT with histologic differentiation and expressions of CK19,CD34,GPC3, P53,Ki67 in hepatocellular carcinoma (HCC) patients, and to explore the biological features of HCC by multiphase spiral CT. Methods Neoplastic foci from 67 patients with HCC confirmed histopathologically were studied.Multiphase spiral CT scans was performed. The difference contrast enhancement density in arterialphase and portalphase were calculated. The histologic differentiation was estimated by HE staining in liver biopsy samples. The expressions of CK19,CD34,GPC3,P53 and Ki67 were detected by immunohistochemical methods. The multiple linear regression equation was established with the difference contrast enhancement density in arterialphase and portalphase,the histologic differentiation and the expressions of cytokines. Results Sixty-seven neoplastic foci performed typical CT feature of HCC with"contrast enhancement density in arterialphase and wash-out in portalphase". The difference contrast enhancement density in arterialphase was (38.9 ± 13.1)HU. The multiple linear regression equation showed the difference contrast enhancement density in arterialphase=27.381-10.0161 ×CK19 +4.245 ×CD34+3.503 ×GPC3. The difference contrast enhancement density in portalphase was (44.7 ±11.7)HU. The multiple linear regression equation showed the difference contrast enhancement density in portal-phase=26.869+8.809 ×CK19+4.800 ×CD34+ 3.610 ×GPC3. Conclusion Multiphase spiral CT is a method to reflect the expressions of various cytokines for assessing biological behaviors of HCC.