良性前列腺增生、前列腺癌MSCT多期增强扫描与MVD、VEGF表达的相关性研究

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摘要目的：探讨微血管密度（MVD）与血管内皮生长因子（VEGF）在良性前列腺增生（BPH）和前列腺癌中的分布与表达情况及其与临床病理特征的关系；探讨BPH和前列腺癌MSCT多期扫描的强化特征及其与MVD、VEGF表达情况的关系。材料和方法：对25例BPH和15例前列腺癌患者术前行MSCT多期增强扫描。观察BPH和前列腺癌在不同时期的强化特征并绘制时间-密度曲线，观察BPH和前列腺癌强化峰值、最大强化幅值及时间-密度曲线的特点。所有手术切除或穿刺标本分别进行HE染色和S-P法VEGF、CD34免疫组化染色。对照分析MVD、VEGF在BPH和前列腺癌中的表达情况及其与MSCT多期扫描强化特点、临床病理特征的关系。结果：BPH与前列腺癌强化峰值到达的期相不同（P<0.01），前列腺癌强化峰值出现早于BPH。两组病例时间-密度曲线类型分布的差异有显著统计学意义（P<0.01），BPH的强化曲线以I型（20/25）为主，前列腺癌以II型和III型（11/15）为主。BPH和前列腺癌的最大强化幅值分别为（42.00±10.99）HU和（45.60±6.88）HU，两者差异无统计学意义（P>0.05）。在前列腺癌组，VEGF的表达和MVD均显著高于BPH组（P<0.05，P<0.001）。在BPH和前列腺癌，VEGF与MVD显著相关（P<0.001，P<0.05）；最大强化幅值与MVD明显相关（P<0.05）。在前列腺癌组，MVD与Gleason分级和临床分期均呈正相关（P<0.05）；VEGF与肿瘤分化程度、Gleason分级具有相关性（P<0.05）。结论：前列腺癌血供丰富，MSCT多期扫描能够显示BPH和前列腺癌的血供情况及强化特征，对前列腺癌病灶的显示和诊断起重要作用；MSCT能够在一定程度上反映BPH和前列腺癌的微血管生成及其MVD、VEGF的表达情况。

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	牛庆亮
	王滨
	王锡臻
	刘金刚
	卢洪凯
	董光

关键词 ：前列腺增生, 前列腺肿瘤, 血管内皮生长因子A, 体层摄影术, 螺旋计算机

Abstract：Objective: To investigate the expression of microvascular density(MVD) and vascular endothelial growth factor(VEGF) in benign prostatic hyperplasia(BPH) and prostate cancer; To study the relationship between the contrast-enhanced features of multi-slice spiral computed tomography(MSCT) and the angiogenesis and some clinicopathologic characteristics of BPH and prostate cancer. Materials and Methods: Twenty-five BPH and fifteen prostate cancer cases proved by histopathology were examined with multi-phase contrast-enhanced MSCT scanning before operation or biopsy. The results of MSCT were evaluated by peak value(PV) and maximum attenuation value(MAV) and time-density curve(T-DC). Hematoxylin and eosin staining and S-P immunohistochemical technique were experimented on all paraffin sections, VEGF and MVD measurements were performed. The relationships among MSCT findings, VEGF, MVD and clinicopathologic features were analyzed. Results: PV in prostate cancer was found earlier than in BPH, there was significant difference between them(P<0.01). The types of T-DC in the group of BPH were mainly found as type I(20/25), but in the group of prostate cancer were mainly found as type II and type III(11/15). The difference proved significantly(P<0.01). The MAV of BPH and prostate cancer was (42.00±10.99)HU and (45.60±6.88)HU respectively, no difference was found between them(P>0.05). The expression of VEGF, MVD in PCa were significantly higher than in BPH(P<0.05, P<0.001). In BPH and prostate cancer, there was significant correlation between VEGF and MVD(P<0.01, P<0.05) and between MVD and MAV(P<0.05, P<0.05). In prostate cancer, there were statistical correlation between MVD and Gleason grade, clinic stage(P<0.05) and between VEGF and the differentiation of the tumor and Gleason grade(P<0.05). Conclusion: Prostate cancer is a tumor rich in blood supply. MSCT scanning can reflect the blood supply and enhancement characters and the angiogenesis of BPH and prostate cancer, it has significant importance in detection and diagnosis of the prostate carcinoma lesions.

Key words： Prostatic hyperplasia Prostatic neoplasms Vascular endothelial growth factor A Tomography spiral computed

收稿日期: 2007-07-07

:	Ｒ737.25
	Ｒ697.3
	Ｒ814.42

通讯作者: 王滨

引用本文:

牛庆亮;王滨;王锡臻;刘金刚;卢洪凯;董光. 良性前列腺增生、前列腺癌MSCT多期增强扫描与MVD、VEGF表达的相关性研究[J]. , 2008, 19(1): 18-22.
NIU Qing-liang;WANG Bin;WANG Xi-zhen;LIU Jin-gang;LU Hong-kai;DONG Guang. Correlative study of the expression of VEGF and MVD with the MSCT multi-phase scan featuresin benign prostatic hyperplasia and prostate cancer. , 2008, 19(1): 18-22.

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http://www.jccmi.com.cn/CN/ 或 http://www.jccmi.com.cn/CN/Y2008/V19/I1/18