子宫内膜癌背景抑制弥散加权成像特征与血管内皮生长因子表达及肿瘤微血管面积的相关性

摘要

目的 分析子宫内膜癌背景抑制弥散加权成像(DWIBS)表现特征,探讨肿瘤组织ADC值与血管内皮生长因子(VEGF)表达及肿瘤微血管面积的相关性.方法 收集33例子宫内膜癌患者资料,分析其DWIBS图像特征,分别测量肿瘤中心实性部分、肿瘤边缘部分和瘤周正常肌层的信号强度、ADC值.以免疫组化法检测肿瘤组织VEGF表达及微血管面积,并分析二者与ADC值的关系.结果 DWIBS原始图像、3D MIP重建及相应黑白翻转图像可立体、直观显示肿瘤病灶部位、大小及范围,肿瘤组织于原始图像上呈明显高信号,黑白翻转图像呈低信号；肿瘤组织中心实性部分、肿瘤边缘部分信号强度、ADC值间差异均无统计学意义(P均＞0.05),但与瘤周正常肌层信号强度、ADC值间差异均有统计学意义(P均＜0.05);肿瘤组织ADC值与VEGF表达和肿癌微血管面积均呈负相关(P均＜0.05).结论 DWIBS可直观显示子宫内膜癌病灶；ADC值定量测量可明确肿瘤边界,并提示肿瘤的组织病理学信息.%Objective To analyze the characteristics of endometrial carcinoma on diffusion weighted imaging with background suppression (DWIBS), and to observe the correlation between ADC values and the expression of vascular endothelial growth factor (VEGF)/microvessel area of tumor tissue. Methods Thirty-three patients of endometrial carcinoma were enrolled. The characteristics of DWIBS images were analyzed, and the signal intensity and ADC value of the solid part of tumor center, edge part of tumor and the normal myometrium surrounding tumor were measured. VEGF expression and microvessel area in endometrial carcinoma tissue were detected by immunohistochemical method, and the correlation with ADC value of the tumor tissue was analyzed. Results The original images of DWIBS, 3D MIP images and black-white inverse images three-dimensionally could visually displayed the site, size and range of the tumors which manifested as high signal intensity on original images of DWIBS and low signal intensity on inverse images. The signal intensity and ADC value were not statistically different between the solid part of tumor center and edge part of tumor (both P>0. 05), but were statistically different compared with those of the normal myometrium surrounding tumor (both P<0. 05). ADC value of tumor tissue negatively correlated with VEGF expression, microvessel area (both P<0. 05). Conclusion DWIBS can directly show endometrial carcinoma. Quantity measurement of ADC values can identify the boundary of tumor and prompt pathological information of the tumor.