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目的探讨肾透明细胞癌MSCT增强征象与肿瘤血管形成的相关性。方法回顾性分析50例肾透明细胞癌MSCT增强征象与MVD、VEGF表达的关系。结果 (1)50例CRCC的MVD平均为(34±10.78)条/视野,VEGF阳性表达率94%(47/50)。MVD与VEGF的阳性表达无相关性(rs=0.0502,P>0.05)。(2)CT征像与MVD及VEGF的表达:肿瘤直径>3.0cm组,肿瘤内有出血坏死组,有静脉癌栓组的VEGF阳性表达、MVD均高于相对应组,各组间均有统计学意义(P<0.05);有淋巴结转移组及无假包膜组的MVD均高于相对应组,各组间均有统计学意义(P<0.05)。CMP期肿瘤强化CT值、强化程度、强化比值与MVD呈正相关(r分别为0.817、0.812及0.457,P均<0.05)。(3)本组CRCCⅠ期13例,Ⅱ期15例,Ⅲ期13例,Ⅳ期9例。MSCT对CRCC检出率、定性诊断正确率均为100%,分期正确率88%(44/50)。结论肾透明细胞癌的MSCT增强影像特征可客观反映CRCC中MVD及VEGF的阳性表达,可无创地判断RCC的发生、发展、侵袭和转移,能为临床选择抗肿瘤血管生成治疗提供影像依据。
Objective To investigate the correlation between MSCT enhanced signs of renal clear cell carcinoma and tumor angiogenesis. Methods Retrospective analysis of 50 cases of renal clear cell carcinoma MSCT enhanced signs and MVD, VEGF expression. Results (1) The average MVD of 50 cases of CRCC was (34 ± 10.78) / field, and the positive rate of VEGF was 94% (47/50). There was no correlation between MVD and the positive expression of VEGF (rs = 0.0502, P> 0.05). (2) The CT signs and the expression of MVD and VEGF: The tumor diameter> 3.0cm group, tumor hemorrhagic necrosis group, VEGF vein tumor embolus group positive expression, MVD were higher than the corresponding group, between the groups have Statistical significance (P <0.05). MVD in lymph node metastasis group and non-pseudocapsule group were higher than those in corresponding group, with statistical significance (P <0.05). There was a positive correlation between enhanced CT value and degree of enhancement and MVD in CMP stage (r = 0.817,0.812 and 0.457, respectively, P <0.05). (3) The group of 13 cases of CRCCⅠ, 15 cases of stage Ⅱ, 13 cases of stage Ⅲ, 9 cases of stage Ⅳ. MSCT detection rate of CRCC, qualitative diagnostic accuracy rate was 100%, staging accuracy rate of 88% (44/50). Conclusions The MSCT enhanced features of renal clear cell carcinoma can objectively reflect the positive expression of MVD and VEGF in CRCC, and can judge the occurrence, development, invasion and metastasis of RCC noninvasively, which can provide the imaging basis for the clinical selection of anti-tumor angiogenesis.