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目的探讨结、直肠癌螺旋CT(SCT)灌注成像与其血管生成的相关性。方法对30例结、直肠癌患者进行SCT单层动态增强扫描,绘制所选层面的癌灶、靶动脉的感兴趣区的时间-密度曲线(TDC)。根据TDC计算癌灶的血流灌注量(PF)。测定癌组织的微血管密度(MVD)和血管内皮生长因子(VEGF)的表达。将结、直肠癌的PF与MVD、VEGF的表达进行比较,且三者亦分别与临床病理因素(Dukes分期、浆膜浸润及淋巴结转移)进行比较。结果结、直肠癌的PF随着病理分期期别的升高有下降趋势,与MVD的趋势一致。VEGF的表达阳性率为87%(26/30)。PF与MVD、VEGF的表达之间均无显著相关性(r分别为0.16,0.19,P值均>0.05)。MVD与VEGF间也无显著相关性(r=-0.03,P>0.05);PF、MVD及VEGF在Dukes分期、浆膜浸润、淋巴结转移比较中差异均无统计学意义。结论SCT灌注成像与MVD、VEGF均能反映结、直肠癌的血管生成状况,但它们之间无明显相关性。
Objective To investigate the correlation between spiral CT (perfusion imaging) and angiogenesis in colorectal cancer. Methods Thirty patients with colorectal cancer underwent single-layer dynamic contrast-enhanced scanning (SCT), and the time-density curve (TDC) of the focal lesion and the target region of interest were plotted. Focal blood perfusion (PF) was calculated from TDC. Microvessel density (MVD) and expression of vascular endothelial growth factor (VEGF) in cancer tissue were determined. The expressions of PF, MVD and VEGF in the node and rectal cancer were compared with those in the pathological stage (Dukes stage, serosal invasion and lymph node metastasis). Results, PF of rectal cancer with the pathological stage of the other increases have a downward trend, consistent with the trend of MVD. The positive rate of VEGF expression was 87% (26/30). There was no significant correlation between PF, MVD and VEGF expression (r = 0.16, 0.19, P> 0.05). There was no significant correlation between MVD and VEGF (r = -0.03, P> 0.05). There was no significant difference in the expression of PF, MVD and VEGF between Dukes stage, serosal invasion and lymph node metastasis. Conclusion Both SCT perfusion imaging and MVD and VEGF can reflect the angiogenesis of colorectal cancer, but there is no significant correlation between them.