不成熟微血管在评估肺癌 CT 灌注特征与分化程度关系中的作用。

Role of immature microvessels in assessing the relationship between CT perfusion characteristics and differentiation grade in lung cancer.

机构信息

Department of Radiology, Xiang Ya Hospital, Central South University, Changsha, Hunan, P.R. China.

出版信息

Arch Med Res. 2010 Nov;41(8):611-7. doi: 10.1016/j.arcmed.2010.11.005.

DOI:10.1016/j.arcmed.2010.11.005

PMID:21199730

Abstract

BACKGROUND AND AIMS

We undertook this study to investigate the association between CT perfusion characteristics and differentiation grade in lung cancer, as well as the pathological basis of this association.

METHODS

Seventy three patients received CT perfusion scan and pathological biopsy, and 30 of them were available for comparison. In these 30 patients, the region detected with pathological biopsy was consistent with the region of interest of CT perfusion. We compared the CT perfusion parameters [blood volume (BV), blood flow (BF), and peak enhancement intensity (PEI)] of these patients with their differentiation grade of lung cancer and microvessel count, which includes microvessel density (MVD) and maturity.

RESULTS

The lower the grade of differentiation of the nodules, the more drastically perfusion parameters decreased. BF was best correlated with differentiation grade (r = -0.845, p = 0.000), compared to BV and PEI (r = -0.674, -0.438, p = 0.000, 0.015, respectively). Poorly differentiated lung cancer showed significantly higher density of immature microvessels than that of highly differentiated lung cancer (p = 0.001). There was a correlation between the differentiation grade and the density of immature microvessels (r = 0.669, p = 0.000), but there was no significant correlation with MVD and the density of mature microvessel (r = 0.345, 0.269, p = 0.062, 0.150, respectively). The density of immature microvessels still increased with declining BF value in the nodules when the grade of differentiation of lung cancer was under control (r = -0.748, p = 0.000).

CONCLUSIONS

CT perfusion characteristics are helpful to differentiate lung cancer differentiation, pathologically basing on the density of immature microvessels rather than MVD.

摘要

背景与目的

本研究旨在探讨肺癌 CT 灌注特征与分化程度的相关性及其相关的病理学基础。

方法

对 73 例患者进行 CT 灌注扫描和病理活检，其中 30 例患者的 CT 灌注感兴趣区与病理活检区一致。比较这些患者的 CT 灌注参数（血容量[BV]、血流[BF]和峰值增强强度[PEI]）与其肺癌分化程度和微血管计数（包括微血管密度[MVD]和成熟度）。

结果

结节分化程度越低，灌注参数下降越明显。BF 与分化程度的相关性最好（r=-0.845，p=0.000），而 BV 和 PEI 的相关性较差（r=-0.674，-0.438，p=0.000，0.015）。低分化肺癌的不成熟微血管密度明显高于高分化肺癌（p=0.001）。分化程度与不成熟微血管密度呈正相关（r=0.669，p=0.000），但与 MVD 和成熟微血管密度无显著相关性（r=0.345，0.269，p=0.062，0.150）。在控制肺癌分化程度的情况下，随着 BF 值的降低，结节中不成熟微血管的密度仍呈下降趋势（r=-0.748，p=0.000）。