Cheng Zhu-zhong, Xu Guo-hui, Huang Juan, Yang Ning-jing, Yang Yu-jie, Cao Ying, He Ren, Xi Xiao-qiu
Department of Radiology, Sichuan Cancer Hospital, Chengdu 610041, China.
Sichuan Da Xue Xue Bao Yi Xue Ban. 2009 May;40(3):521-4.
To explore the relationships between perfusion values of pancreatic cancers and the microvessel density of tumors (MVD) and vessel endothelial growth factor (VEGF), and the clinical value of multiple-slice spiral CT perfusion imaging in diagnosing pancreatic cancers.
Forty-two people with normal pancreas and eighteen patients with pancreatic cancers underwent multiple-slice spiral CT perfusion examinations. The time-density curve (TDC) of the region of interest (ROI) was drawn with the software equipped in the spiral CT. The CT perfusion parameters of the ROI peak reinforcement values were calculated, including blood flow (BF), blood volume (BV), time to start (TTS), time to peak (TTP), permeability, and mean of the patlak blood volume (pBV). Twenty patients (11 with pancreatic cancers and 9 with chronic pancreatitis) were chosen for CD34 and VGEF antibody immunohistochemistry staining on the same layers of pancreatic tissues as the CT perfusion targeted. The associations between the imaging of CT perfusion and MVD and VFGF were examined.
The patients with pancreatic cancers had lower BF, VB, and pBV, and higher permeability than the normal controls (P<0.01). No differences appeared between the two groups in time to start and time to peak (P>0.05). The difference in average MVD of the 9 patients with chronic pancreatitis (13.8 +/- 9.6), and the 11 patients with pancreatic cancers (30.5 +/- 14.8) was statistically significant. Eight patients with pancreatic cancers showed strong positive VEGF and three showed weak positive VEGF. Only one patient with chronic pancreatitis showed strong positive VEGF while eight showed weak positive VEGF. The difference in positive rate of VEGF between the two groups of patients was statistically significant (P<0.01). The MVD in patients with pancreatic cancers (median 40.2) was correlated with BF (median 26.9), TTS (median 14.8), and TTP (median 145.3) (r=0.42, 0.63, and 0.45, respectively). The expression of VGEF (median 4.3) was negatively correlated with BV (r=-0.39).
Imaging of CT perfusion has certain clinical value for diagnosing pancreatic cancers. The imaging of CT perfusion reflects the MVD and VEFG in the tumor tissues.
探讨胰腺癌灌注值与肿瘤微血管密度（MVD）及血管内皮生长因子（VEGF）之间的关系，以及多层螺旋CT灌注成像在诊断胰腺癌中的临床价值。
对42例胰腺正常者和18例胰腺癌患者进行多层螺旋CT灌注检查。用螺旋CT配备的软件绘制感兴趣区（ROI）的时间-密度曲线（TDC）。计算ROI峰值强化值的CT灌注参数，包括血流量（BF）、血容量（BV）、开始时间（TTS）、达峰时间（TTP）、通透性和帕塔克血容量平均值（pBV）。选取20例患者（11例胰腺癌患者和9例慢性胰腺炎患者），在与CT灌注靶向相同层面的胰腺组织上进行CD34和VGEF抗体免疫组化染色。研究CT灌注成像与MVD及VFGF之间的关联。
胰腺癌患者的BF、VB和pBV低于正常对照组，通透性高于正常对照组（P<0.01）。两组在开始时间和达峰时间上无差异（P>0.05）。9例慢性胰腺炎患者的平均MVD（13.8±9.6）与11例胰腺癌患者的平均MVD（30.5±14.8）差异有统计学意义。8例胰腺癌患者VEGF呈强阳性，3例呈弱阳性。慢性胰腺炎患者中仅1例VEGF呈强阳性，8例呈弱阳性。两组患者VEGF阳性率差异有统计学意义（P<0.01）。胰腺癌患者的MVD（中位数40.2）与BF（中位数26.9）、TTS（中位数14.8）和TTP（中位数145.3）相关（r分别为0.42、0.63和0.45）。VGEF的表达（中位数4.3）与BV呈负相关（r=-0.39）。
CT灌注成像对胰腺癌的诊断具有一定的临床价值。CT灌注成像反映了肿瘤组织中的MVD和VEFG。
