發(fā)布時間：2018-03-13 08:08

  本文選題：雙源CT　切入點：碘濃度　出處：《華中科技大學》2013年碩士論文　論文類型：學位論文

【摘要】：目的：研究雙源CT大腸癌碘濃度與癌組織CD31標記MVD計數(shù)的相關(guān)性，探討碘濃度對判斷腫瘤侵襲及轉(zhuǎn)移能力的價值；以及癌周脂肪碘濃度對進展期大腸癌周圍脂肪侵犯評價的能力。 材料與方法：收集中南醫(yī)院2012年1月-2012年10月經(jīng)結(jié)腸鏡活檢或術(shù)后病理證實大腸癌患者30例，其中男性17例，女性13例，，年齡41-74歲，平均年齡約67歲。所有病例均在術(shù)前行常規(guī)平掃和雙源CT增強掃描（50-55s），得到的數(shù)據(jù)資料傳入后處理工作站對圖像進行后處理及相關(guān)分析，分別測量病灶及癌周脂肪碘濃度；大腸癌病理組織采用S-P免疫組化法進行CD31表達的檢測，并計數(shù)微血管密度（MVD）。根據(jù)術(shù)后病理結(jié)果，30例患者分別按有、無漿膜侵犯及轉(zhuǎn)移進行分組，分析各組間碘濃度與MVD計數(shù)的相關(guān)性，碘濃度與腫瘤漿膜侵犯、轉(zhuǎn)移能力大小的關(guān)系；以及癌周脂肪碘濃度與脂肪受侵的關(guān)系。 結(jié)果：30例病例中，參照術(shù)后病理結(jié)果：20例大腸癌漿膜侵犯病例碘濃度為2.40±0.44mg/ml，10例無漿膜侵犯病例碘濃度測值為1.97±0.34mg/ml；11例有轉(zhuǎn)移的病例碘濃度測值為2.56±0.38mg/ml，19例無轉(zhuǎn)移的病例為2.07±0.39mg/ml,兩組差別均有統(tǒng)計學意義(P0.05)；10例有腸周脂肪受侵的病例，癌周脂肪碘濃度為0.75±0.28mg/ml,20例無腸周脂肪侵犯病例碘濃度測值為0.11±0.11mg/ml，差異有統(tǒng)計學意義（P0.05）。Pearson相關(guān)分析顯示：病灶碘濃度與MVD計數(shù)呈正相關(guān)（P0.01）。利用SPSS18軟件ROC曲線法選取最佳靈敏度和特異度最佳臨界值：漿膜侵犯組碘濃度當界值為2.05mg/ml時，靈敏度是75%，特異度是70%；轉(zhuǎn)移組碘濃度當界值為2.25mg/ml時，靈敏度81.8%，特異度78.9%；脂肪侵犯組癌周脂肪碘濃度當界值為0.25mg/ml時，靈敏度是100%，特異度是86.4%。 結(jié)論：雙源CT大腸癌碘濃度測定與MVD計數(shù)呈正相關(guān)，可以評價腫瘤血管生成；癌周脂肪碘濃度測定有助于判斷脂肪是否受侵。碘圖能夠成為評價大腸癌局部侵犯及遠處轉(zhuǎn)移能力大小的工具。
[Abstract]:Objective: to study the correlation between iodine concentration and CD31 labeled MVD count in colorectal carcinoma with dual-source CT, and to explore the value of iodine concentration in judging tumor invasion and metastasis. And the ability of pericancerous fat iodine concentration to evaluate peripheral fat invasion of advanced colorectal cancer. Materials and methods: thirty patients with colorectal cancer confirmed by colonoscopic biopsy or postoperative pathology from January 2012 to 2012 in Central South Hospital were collected, including 17 males and 13 females aged 41-74 years. The average age was about 67 years old. All the patients underwent conventional plain scan and dual-source CT enhanced scan for 50-55 s. The data were transmitted to the post-processing workstation for post-processing and correlation analysis, and the concentration of fat and iodine in the lesion and pericancerous area were measured respectively. S-P immunohistochemical method was used to detect the expression of CD31, and the microvessel density (MVD) was counted. According to the pathological results, 30 patients were divided into groups according to their presence, no serosal invasion and metastasis. The correlation between iodine concentration and MVD count, the relationship between iodine concentration and tumor serosa invasion and metastasis ability, and the relationship between iodine concentration in pericancerous fat and fat invasion were analyzed. Results of the 30 cases, According to postoperative pathological results, iodine concentration in 20 patients with serosal invasion of colorectal cancer was 2.40 鹵0.44 mg / ml, the iodine concentration of 10 cases without serosal invasion was 1.97 鹵0.34 mg / ml, the iodine concentration of 11 cases with metastasis was 2.56 鹵0.38 mg / ml, and that of 19 cases without metastasis was 2.07 鹵0.39 mg / ml, there was statistical difference between the two groups. There were 10 cases with periintestinal fat invasion. The iodine concentration of pericancerous fat was 0.75 鹵0.28 mg / ml in 20 cases without pericardial fat invasion, and the iodine concentration was 0.11 鹵0.11 mg / ml. The difference was statistically significant (P 0.05). Pearson correlation analysis showed that there was a positive correlation between iodine concentration and MVD count (P 0.01). The best Ling was selected by ROC curve method of SPSS18 software. The best critical value of sensitivity and specificity: iodine concentration in the serosal invading group when the boundary value was 2.05 mg / ml, The sensitivity was 75 and the specificity was 70. When the threshold of iodine concentration in the metastatic group was 2.25 mg / ml, the sensitivity was 81.8 and the specificity was 78.9. In the fat invasion group, the sensitivity was 100 and the specificity was 86.4 when the limit was 0.25 mg / ml. Conclusion: the measurement of iodine concentration in colorectal carcinoma with double source CT is positively correlated with MVD count, which can be used to evaluate tumor angiogenesis. The determination of iodine concentration in pericancerous fat is helpful to determine whether the fat is invaded or not. Iodograms can be used to evaluate the ability of local invasion and distant metastasis of colorectal cancer.
【學位授予單位】：華中科技大學
【學位級別】：碩士
【學位授予年份】：2013
【分類號】：R735.34;R730.44

【參考文獻】

相關(guān)期刊論文 前10條

1 劉國兵;吳光耀;;直腸癌術(shù)前影像學分期[J];武漢大學學報(醫(yī)學版);2010年05期

2 霍耀林;;藤原惺窩和江戶儒學[J];井岡山學院學報;2009年06期

3 李建生,李康印,陳虎義,牛娟琴,解肖冰;螺旋CT膽道立體成像對膽道梗阻性疾病診斷價值的研究[J];臨床放射學雜志;2001年10期

4 曹慧芳;史浩;柯勇;劉日華;孟威;;多層螺旋CT掃描在結(jié)直腸癌診斷和術(shù)前分期中的應(yīng)用價值[J];醫(yī)學影像學雜志;2007年07期

5 周鵬;高雪梅;;直腸癌術(shù)后復發(fā)的CT診斷[J];中國醫(yī)藥導報;2009年29期

6 管生,高劍波,李蔭太,陳學軍,楊學華,楊曉鵬,程敬亮;低張水灌腸螺旋CT掃描對大腸癌的術(shù)前分期研究[J];中華放射學雜志;2001年04期

7 趙澤華,劉文瑾,徐嵩森,王康,王偉忠;多層螺旋CT對于結(jié)腸鏡檢查失敗病人的應(yīng)用[J];中華放射學雜志;2004年12期

8 張瑞平;李健丁;;大腸癌腸外浸潤螺旋CT征象與腫瘤血管生成的相關(guān)性[J];中華放射學雜志;2007年02期

9 張永高,高劍波,楊學華,張謝夫,張云漢,郭華,陳學軍,周志剛,楊曉鵬,岳松偉;大腸癌漿膜侵犯螺旋CT征象與MVD、nm23-H_1表達間關(guān)系的研究[J];中國醫(yī)學影像技術(shù);2004年01期

10 王素梅,尹太,陳巨坤,劉愛軍,劉偉;螺旋CT對胃癌分期的價值[J];中國醫(yī)學影像學雜志;2000年05期

本文編號：1605513