【摘要】 目的探讨非小细胞肺癌(NSCLC)血管内皮生长因子(VEGF)的表达水平与动态增强MRI指标间的关系,从影像学角度评价肿瘤血管生成在NSCLC的诊断及淋巴结转移中的价值。方法分析33例NSCLC患者的动态增强MRI资料,测量病灶的最大强化斜率(Smax)及峰值到达时间(TTP),手术标本用免疫组化染色检测其VEGF表达水平。对病灶Smax、TTP值、VEGF表达水平及淋巴结转移情况进行统计学分析。结果33例NSCLC患者Smax及TTP值分别为(1.40±0.50)和(143.00±35.50)s;其中早期患者Smax和TTP分别为(1.21±0.30)和(187.50±28.96)s,中晚期患者为(1.97±0.70)和(96.00±16.12)s,(P<0.01和P<0.05);有淋巴结转移组Smax和TTP值分别为(2.14±0.69)和(90.5±22.55)s,无淋巴结转移组则为(1.26±0.33)和(198.08±26.88)s,(P<0.01)。VEGF阳性表达者22例,中晚期患者的阳性表达高于早期(P<0.01),淋巴结转移组高于非淋巴结转移组(P<0.01);NSCLC患者Smax与VEGF阳性表达呈明显的正相关(r=0.723,P<0.01),而TTP值与它们呈负相关(r=-0.538,P<0.01)。结论动态增强MRI有关指标能够反映NSCLC的肿瘤血管生成,并与淋巴结转移情况密切相关,有助于NSCLC的诊断及分期,并且可以从肿瘤生物学行为方面补充恶性肿瘤国际临床病期分类(TNM)不足。更多还原

【Abstract】 Objective To evaluate tumor angiogenesis and clinical significance by dynamic contrast-enhanced(DCE) MR imaging in non-small cell lung cancer(NSCLC).Methods Thirty-three consecutive patients firstly found mass by plain film or CT were examined with non-contrast conventional MR imaging,dynamic contrastenhanced scan.Vascular endothelial growth factor(VEGF) was stained with immuno-histochemical technique in thirty-three NSCLC cases diagnosed surgically and pathologically.Some parameters of DCE MRI,the maximum slope(Smax),the time to peak(TTP),VEGF expression and lymphnode metastases were compared.Results In 33 NSCLC patients,Smax was(1.40±0.50),and TTP was(143.00±35.50)s.Smax in stage Ⅰ was lower than that in stage Ⅱ and Ⅲ [(1.21±0.30)s vs(1.97±0.70)s and(2.14±0.69)s,P<0.01)],but TTP in stage Ⅰ was [(187.50±28.96)s,which was later than that in stage Ⅱ and Ⅲ [(96.00±16.12)s and(90.5±22.55)s,P<0.05].In thirty-three NSCLC,twenty-two patients were VEGF positive expressions and eleven were negative.VEGF expression levels in patients with NSCLC in stage Ⅱ and Ⅲ were higher,but TTP was lower than those in stage(P<0.01 and P<0.05).The VEGF expression of tumor was positively correlated with the Smax(P<0.01),but negatively correlated with the TTP(P<0.01).Conclusion Parameters of DCE MRI,especially Smax and TTP,can reflect tumor angiogenesis and correlate to lymph-node metastasis closely,which are beneficial to staging the lung cancer and serving as a supplement to the current staging system for NSCLC in biological behaviour.更多还原