大肠癌肠外浸润螺旋CT 征象与肿瘤血管生成的相关性

大肠癌肠外浸润螺旋CT 征象与肿瘤血管生成的相关性
张瑞平 李健丁
【摘要】 目的 探讨大肠癌肠外浸润的螺旋CT( SCT) 征象与病理、肿瘤微血管密度( MVD) 、血
管内皮生长因子( VEGF) 和基质金属蛋白酶-2( MMP-2) 表达的关系。方法 40 例大肠癌患者, 术前
均行SCT 多期动态扫描, 术后标本采用免疫组织化学方法染色, 检测VEGF 和MMP-2 的表达和计数
MVD。结果 螺旋CT 判断大肠癌肠外、肠壁浸润的准确率为92. 5% ( 37 / 40) 。肠外、肠壁浸润组的
转移率分别为75. 0% ( 21 /28) 和33. 3% ( 4 /12) , 其差异有统计学意义( P < 0. 05) 。大肠癌肠壁、肠外
浸润组间的CT 强化程度、MVD、VEGF 和MMP-2 的表达比较差异有统计学意义( P < 0. 05) 。CT 强化
程度与MVD 之间呈正相关( P < 0. 05) 。结论 SCT 增强扫描能较准确地判断大肠癌的肠外浸润, 且
肠外浸润预示着更高的转移倾向; CT 强化程度可作为定量分析指标初步判断肿瘤血管生成, MVD、
VEGF、MMP-2 表达与大肠癌浸润密切相关, 肿瘤血管生成在大肠癌的浸润过程中起着促进作用。
【关键词】 结肠肿瘤; 新生血管化, 病理性; 内皮生长因子; 体层摄影术, X 线计算机
Corr elation between spir al CT feat ur es of pericolic infiltra tion and tumor a ngiogenesis in color ecta l
car cinoma ZHANG Rui-ping, LI Jian-ding. Depa rtment of Radiology, the First Hospital of Shanxi
Medical University , Ta iyuan 030001, China
【Abstra ct 】 Objective To investigate the correlation of spiral CT ( SCT) features with pathology、
microvessel density ( MVD ) 、expression of vascular endothelial growth factor ( VEGF ) 、matrix
metalloproteinase-2( MMP-2 ) in colorectal carcinoma. Methods Forty patients with colorectal carcinoma
confirmed by operation were examined by SCT. The resected tumor specimens were immunohistochemically
stained for the expression of VEGF、MMP-2 and the calculation of MVD. Results The accuracy of SCT in
depicting the pericolic and wall infiltration was 92. 5% . The metastasis rates of colorectal cancer with
pericolic infiltration and wall infiltration were 75. 0% and 33. 3% , respectively, the differences were
statistically significant between the two groups( P < 0. 05) . The differences of CT enhancement value, MVD,
expressions of VEGF and MMP-2 between the two groups were statistically significant ( P < 0. 05 ) . The
enhancement degree of CT had a positive correlation with MVD ( P < 0. 05) . Conclusion SCT is accurate
for depicting pericolic and wall infiltration, pericolic infiltration in colorectal carcinoma indicates the
tendency of metastasis. The enhancement degree of CT might be used to quantitatively evaluate the tumor
angiogenesis, expressions of VEGF and MMP-2 and MVD are closely correlated with the infiltration of
colorectal cancer.
【Key words】 Colonic neoplasms; Neovasularization, pathologic; Endothelial growth factors;
Tomography, X-ray computed

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