CAJ | 학술논문

目的初步探讨非小细胞肺癌(NSCLC)CT灌注成像血流量(BF)与肿瘤微血管超微结构特点的关系.方法经手术病理证实的28例NSCLC患者均行CT灌注检查和病理学检查,按中位BF值将28例NSCLC患者分为高灌注组和低灌注组,分析高灌注组和低灌注组患者肿瘤组织病变微血管超微结构的表现以及转移情况的差异.结果全组28例NSCLC患者的中位BF值为36.40ml·100 g-1·min-1.以中位BF值为界,将28例患者分为低灌注组(14例)和高灌注组(14例),低灌注组患者的BF值为(30.844±4.79)ml·100 g-1·min-1,高灌注组患者的BF值为(49.67±10.89)ml·100 g-1·min-1,差异有统计学意义(p＜0.001).低灌注组有9例(64.3％)患者发生淋巴结转移或远处转移,高灌注组有4例(28.6％)患者发生淋巴结转移或远处转移,低灌注组和高灌注组转移率的差异无统计学意义(P =0.128).有转移组患者的BF值为(30.78 ±5.24)ml· 100 g-1·min-1,无转移组患者的BF值为(50.73±11.16)ml·100 g-1·min-1,差异有统计学意义(P =0.015).低灌注组患者的NSCLC微血管成熟度较高灌注组更差,表现为管腔更狭窄,基底膜完整性更差,癌细胞与管壁关系更密切,而且管腔内更容易见到癌细胞.结论 CT灌注成像的BF值可能与NSCLC微血管超微结构的异常有关,并有助于评价NSCLC发生转移的风险.
목적 초보탐토비소세포폐암(NSCLC)CT관주성상혈류량(BF)여종류미혈관초미결구특점적관계.방법 경수술병리증실적28례NSCLC환자균행CT관주검사화병이학검사,안중위BF치장28례NSCLC환자분위고관주조화저관주조,분석고관주조화저관주조환자종류조직병변미혈관초미결구적표현이급전이정황적차이.결과 전조28례NSCLC환자적중위BF치위36.40ml·100 g-1·min-1.이중위BF치위계,장28례환자분위저관주조(14례)화고관주조(14례),저관주조환자적BF치위(30.844±4.79)ml·100 g-1·min-1,고관주조환자적BF치위(49.67±10.89)ml·100 g-1·min-1,차이유통계학의의(p＜0.001).저관주조유9례(64.3％)환자발생림파결전이혹원처전이,고관주조유4례(28.6％)환자발생림파결전이혹원처전이,저관주조화고관주조전이솔적차이무통계학의의(P =0.128).유전이조환자적BF치위(30.78 ±5.24)ml· 100 g-1·min-1,무전이조환자적BF치위(50.73±11.16)ml·100 g-1·min-1,차이유통계학의의(P =0.015).저관주조환자적NSCLC미혈관성숙도교고관주조경차,표현위관강경협착,기저막완정성경차,암세포여관벽관계경밀절,이차관강내경용역견도암세포.결론 CT관주성상적BF치가능여NSCLC미혈관초미결구적이상유관,병유조우평개NSCLC발생전이적풍험.
Objective To investigate the correlation between blood flow assessed by CT perfusion imaging and characteristics of microvascular ultrastructure in non-small cell lung cancer (NSCLC).Methods twenty-eight patients with non-small cell lung cancer proven surgically and pathologically underwent perfusion CT examination.The patients were divided into a hyper-perfusion group and a hypoperfusion group by the median value of blood flow,and then the differences of microvascalar ultrastructure in the two groups were analyzed.Results The median BF value of the 28 patients was 36.40 ml · 100 g-1 · min-1 Take this median value as the boundary,the group with hypo-perfusion showed a significantly lower BF value than the group with hyper-perfusion [(30.84±4.79) ml · 100 g-1 · min-i vs.(49.67 ± 10.89) ml · 100 g-1 · min-1,t =-5.925,P ＜0.001].The group with lymph node metastasis showed a significantly lower BF value than the group without lymph node metastasis [(30.78 ±5.24) ml · 100 g-1 · min-1 vs.(50.73 ± 11.16)ml · 100 g-1 · min-1,t =3.490,P =0.015].The maturity of microvessels of the hyper-perfusion group was higher than that of the hypo-perfusion group.Under the electron microscope,the microvessels in the hypo-perfusion group showed a more narrow lumen,poorer integrity of basement membrane,a more close relationship between cancer cells and microvascular wall,and cancer cells were more easily seen in the microvascular lumen.Conclusion The blood flow value of CT perfusion imaging may be related with the abnormal microvascular ultrastructure,and may be helpful to the prediction of metastasis risk in NSCLC.