CAJ | 학술논문

目的探讨磁共振动态增强成像(DCE-MRI)评价肝外胆管癌血管生成及病理分级的价值.方法对57例肝外胆管癌患者术前行常规MRI、DCE-MRI扫描,计算肝外胆管癌病灶早期信号增强率(eSER)及延迟期信号增强率(dSER).采用免疫组织化学方法检测肝外胆管癌标本组织的微血管密度(MVD)、血管内皮生长因子(VEGF)表达,并分析eSER、dSER与MVD、VEGF及病理分级的关系.结果肝外胆管癌病灶eSER、dSER与MVD存在明显正相关(r=0.62,P＜0.05;r =0.45,P ＜0.05).肝外胆管癌标本组织VEGF表达阳性组的eSER明显高于VEGF表达阴性组(t=3.53,P ＜0.05),VEGF表达阳性组与阴性组对应的dSER之间差异无统计学意义(t=1.35,P＞0.05).不同分化肝外胆管癌病灶的eSER、dSER各组间差异均无统计学意义(F =2.65,P＞0.05;F =2.23,P＞0.05).结论 eSER、dSER能反映肝外胆管癌血管生成水平,DCE-MRI有助于在活体上对肝外胆管癌生物学特性进行评估.
목적 탐토자공진동태증강성상(DCE-MRI)평개간외담관암혈관생성급병리분급적개치.방법 대57례간외담관암환자술전행상규MRI、DCE-MRI소묘,계산간외담관암병조조기신호증강솔(eSER)급연지기신호증강솔(dSER).채용면역조직화학방법검측간외담관암표본조직적미혈관밀도(MVD)、혈관내피생장인자(VEGF)표체,병분석eSER、dSER여MVD、VEGF급병리분급적관계.결과 간외담관암병조eSER、dSER여MVD존재명현정상관(r=0.62,P＜0.05;r =0.45,P ＜0.05).간외담관암표본조직VEGF표체양성조적eSER명현고우VEGF표체음성조(t=3.53,P ＜0.05),VEGF표체양성조여음성조대응적dSER지간차이무통계학의의(t=1.35,P＞0.05).불동분화간외담관암병조적eSER、dSER각조간차이균무통계학의의(F =2.65,P＞0.05;F =2.23,P＞0.05).결론 eSER、dSER능반영간외담관암혈관생성수평,DCE-MRI유조우재활체상대간외담관암생물학특성진행평고.
Objective To investigate the role of dynamic contrast-enhanced MRI (DCE-MRI) in the estimation of tumor angiogenesis and pathologic grading of extrahepatic cholangiocarcinoma.Methods Routine preoperative MRI and DCE-MRI scanning were performed on 57 patients with extrahepatic cholangiocarcinoma.The early signal enhancement ratio (eSER) and delayed signal enhancement ratio (dSER) of DCE-MRI were calculated.Microvessel density (MVD) and vascular endothelial growth factor (VEGF) expressions were detected in the extrahepatic cholangiocarcinoma tissue samples using immunohistochemical methods.The relations between the eSER or dSER and MVD,VEGF and the pathological grading of extrahepatic cholangiocarcinoma were analyzed.Results There was a positive correlation between the eSER or dSER and MVD of extrahepatic cholangiocarcinoma (r =0.62,P ＜ 0.05 ; r =0.45,P ＜ 0.05).The eSER of extrahepatic cholangiocarcinoma with a positive VEGF expression was higher than those with a negative VEGF expression (t =3.53,P ＜ 0.05).There was no significant difference in dSER between the positive VEGF expression group and the negative VEGF expression group (t =1.35,P ＞0.05).There was no significant difference in the eSER or dSER among the different differentiated extrahepatic cholangiocarcinoma (F =2.65,P ＞ 0.05 ; F =2.23,P ＞ 0.05).Conclusions The eSER and dSER reflected tumor angiogenesis of extrahepatic cholangiocarcinoma,and DCE-MRI contributed to the evaluation of biological features of extrahepatic cholangiocarcinoma in vivo.