【摘要】 目的　探讨周围型肺癌螺旋CT征象和动态CT增强与肿瘤内微血管密度 (MVD)的关系。方法　 3 3例经手术和病理证实的周围型肺癌 (鳞癌 14例 ,腺癌 19例 )术前行螺旋CT平扫和动态增强扫描 ,病理标本采用LSAB免疫组化法检测其MVD。结果　周围型肺腺癌MVD明显高于鳞癌 ,其MVD分别为 63 .4± 11.9和 5 0 .2± 16.3 (P <0 .0 5 ) ,边缘区和间质部分的MVD高于坏死区、瘢痕区和实质部分。肺癌MVD值与CT影像上肿瘤直径、分叶征、血管集束征、胸膜凹陷征及纵隔淋巴结转移均有密切关系 (P均 <0 .0 5 )。肺腺、鳞癌平均CT强化值分别为 ( 4 3 .4± 11.8)HU和 ( 3 4.6± 10 .7)HU (P <0 .0 5 ) ,与其相应的MVD值均呈正相关 (r =0 .719,P <0 .0 1;r =0 .819,P <0 .0 1)。结论　周围型肺腺癌的部分CT征象和CT增强幅度与其MVD值有密切关系 ,可用于预测肿瘤的组织学类型和评价其恶性程度。更多还原

【Abstract】 Objective To investigate the relationship among the CT appearances, the dynamic CT enhancement and the microvessel density (MVD) of peripheral lung cancer. Methods Thirty three patients with peripheral lung cancer proved by surgery and pathology underwent enhancement dynamic CT scan before operation, including 14 squamous cell carcinoma and 19 adenocarcinoma. The MVD was measured in resected tumor specimens with immunohistochemical method of LSAB. Results The MVD value of adenocarcinoma was significantly higher than that of squamous cell carcinoma (63.4±11.9 versus 50.2±16.3, P<0.05). The MVD values were higher in junction zone and interstitial areas than those in parenchymal areas, necrotic zones and scar areas of tumors. There were significant relationships among the MVD value and diameter of tumor, lobulation sign, vessel convergence sign, pleural retraction sign and lymph node metastasis (P< 0.05 ). The mean enhanced CT values was (43.4±11.8) HU in adenocarcinomas, and (34.6±10.7) HU in squamous cell carcinomas (P<0.05). The CT values of both adenocarcinoma and squamous cell carcinoma had positive correlations to their corresponding MVD values (r=0.719, P<0.01;r=0.819, P<0.01). Conclusion The CT appearances and the enhanced CT values of peripheral lung carcinomas are closely related to their MVD values, which might be an indicator to identify the histological classification and to predict the malignant degree of tumor.更多还原