CAJ | 학술논문

目的：探讨宫颈癌CT灌注成像参数与血管内皮生长因子（VEGF）、微血管密度（MVD）的相关性及其临床应用价值。方法分析临床拟诊为宫颈癌的患者35例行宫颈 CT 灌注扫描，并与11例宫颈良性病变作对照。根据灌注所得图像得到时间‐密度曲线，分析 CT 灌注参数并结合病理、免疫组化结果进行分析。结果宫颈癌灌注时间‐密度曲线特点为速升缓降或中高位强化型，短时间达峰值，峰值高于宫颈良性对照组。宫颈癌组的灌注参数 BF 、BV 、PEI 、PMB 、M TT 、TTP 与宫颈良性病变各组间差异有统计学意义（ P ＜0．05）。 MVD 与宫颈癌灌注参数 BF 、BV 、PEI 、PMB 呈正相关，与 M TT 、TTP 呈负相关。宫颈癌Ⅰ期与Ⅱ期 MVD 值之间差异有统计学意义（ P ＜0．05）；良恶性病变组之间、不同的肿瘤临床分期之间及不同病理类型之间，VEGF 阳性表达率差异有统计学意义（ P ＜0．05）；良恶性病变组之间、不同的肿瘤临床分期之间，MVD 计数具有统计学意义（ P ＜0．05）。三组不同分化程度的宫颈癌之间 VEGF 表达及 MVD 计数有差异（ P ＜0．05），但组间不具有统计学意义。结论宫颈癌为富血供、高灌注肿瘤，CT 灌注成像参数结合 VEGF 、MVD 分析，对宫颈癌的诊断、分期及指导临床治疗具有较高的参考价值。
목적：탐토궁경암CT관주성상삼수여혈관내피생장인자（VEGF）、미혈관밀도（MVD）적상관성급기림상응용개치。방법분석림상의진위궁경암적환자35례행궁경 CT 관주소묘，병여11례궁경량성병변작대조。근거관주소득도상득도시간‐밀도곡선，분석 CT 관주삼수병결합병리、면역조화결과진행분석。결과궁경암관주시간‐밀도곡선특점위속승완강혹중고위강화형，단시간체봉치，봉치고우궁경량성대조조。궁경암조적관주삼수 BF 、BV 、PEI 、PMB 、M TT 、TTP 여궁경량성병변각조간차이유통계학의의（ P ＜0．05）。 MVD 여궁경암관주삼수 BF 、BV 、PEI 、PMB 정정상관，여 M TT 、TTP 정부상관。궁경암Ⅰ기여Ⅱ기 MVD 치지간차이유통계학의의（ P ＜0．05）；량악성병변조지간、불동적종류림상분기지간급불동병리류형지간，VEGF 양성표체솔차이유통계학의의（ P ＜0．05）；량악성병변조지간、불동적종류림상분기지간，MVD 계수구유통계학의의（ P ＜0．05）。 삼조불동분화정도적궁경암지간 VEGF 표체급 MVD 계수유차이（ P ＜0．05），단조간불구유통계학의의。결론궁경암위부혈공、고관주종류，CT 관주성상삼수결합 VEGF 、MVD 분석，대궁경암적진단、분기급지도림상치료구유교고적삼고개치。
Objective To analyze the correlation between CT perfusion parameters and changes of VEGF and MVD ex ‐pressions of cervical cancer and to evaluate its value in clinical use .Methods CT perfusion imaging was performed in 35 patients with cervical cancer diagnosed pathologically ,and 11 patients with cervical benign diseases were considered as con‐trol group .Time‐density curve was obtained by CT perfusion images .CT perfusion parameters were analyzed with patho‐logical and immunohistochemical observations .Results Time‐density curve in cervical cancer group showed rapid rise with gradual decline ,short time to peak and higher peak than control group .The values of BF ,BV ,PEI ,PMB ,M TT ,TTP for cervical cancer group and the values in control group showed statistical significance ( P < 0 .05) .MVD was positively correlated with CT perfusion parameters including BF ,BV ,PEI ,PMB ,but MVD was negatively correlated with M TT and TTP .MVD value in stage I and stage II showed difference statistically ( P < 0.05) ;There were statistical significant in VEGF expressions between benign and malignant groups ,different clinical stages and different pathological types ;there were statistical significant in MVD account between benign and malignant groups ,and different clinical stages ( P <0.05) .Three groups of different differentiation degree of cervical cancer between VEGF expression and MVD counts had difference ( P < 0 .05) ,but not statistically significant between groups .Conclusion Cervical cancer is one type of rich blood supply and high perfusion cancer ,CT perfusion imaging with VEGF and MVD expressions analysis provides a refer‐ential value for early diagnosis ,differentiation ,clinical treatment and prognosis .