李华^1,2，于晓玲¹，梁萍¹，曹晓林¹，李猛¹，范瑾¹
（1. 中国人民解放军总医院 介入超声科，北京 100853；2. 沈阳军区兴城疗养院 超声科,辽宁 兴城，125105）

[摘  要] 目的 探讨肝细胞癌超声造影增强时间参数与血管内皮生长因子表达水平之间的关系，寻求可能无创、有效评价肿瘤血管形成的超声造影增强时间参数。资料与方法 对23例具有单发结节（且最大径小于5cm）、无门静脉侵袭及肝外转移的肝细胞癌患者行超声造影检查，绘制时间-强度曲线取得各增强时间参数。穿刺活检取得23个癌灶组织标本并行VEGF免疫组化染色，对VEGF表达水平进行分级。分析增强时间参数与VEGF表达分级的相关性。结果 肿瘤达峰早于肝实质的时间（p-t TTP）与VEGF表达水平之间呈负相关（r= -0.600，P=0.002）；肿瘤达峰时间（t TTP）与VEGF表达之间在统计学上无相关性（r= -0.318，P=0.140）；p TTP与VEGF表达水平之间呈负相关（r=-0.539，P=0.008）。结论 p-t TTP对评估肝细胞癌VEGF表达水平有价值，超声造影有助于评价肝细胞癌血管形成，有望成为无创评价肿瘤血管形成的方法。
[关键词] 超声造影；血管内皮生长因子；肝细胞癌
[中图分类号] R445.1      [文献标志码] B
[文章编号] 1674-1633(2009)11-0010-03

LI Hua^1,2,YU Xiao-ling¹,LIANG Ping¹, CAO Xiao-lin¹, LI Meng¹, FAN Jin¹
(1.Department of Interventional Ultrasound,the PLA General Hospital,Beijing 100853,  China;2. Department of Ultrasound, Xingcheng Sanatorium of Shenyang Military Region,Xingcheng Liaoning 125105,China)

Abstract: Objective The aim of the study was to investigate the relation of enhanced-time parameters of contrast-enhanced ultrasonography (CEUS) on hepatocellular carcinoma (HCC) with expression of vascular endothelial growth factor (VEGF), and to find the enhanced-time parameters of CEUS which could noninvasively and effectively assess the angiogenesis of the tumor. Materials and Methods 23 nodular HCCs (maximal diameter < 5cm) without portal vein invasion and metastasis underwent CEUS and biopsy. The parameters of CEUS were obtained by using time-intensity curve of contrast enhancement. Immunohistochemical staining with VEGF was performed, and the staining results of VEGF were graded. Spearman’s rank correlation test was used between parameters of CEUS and VEGF expression. Results p-t TTP of CEUS was significantly correlated to VEGF expression ( r=-0.600, P=0.002 ) of the tumor. But VEGF expression was not correlated to t TTP. Conclusion The parameter of CEUS, p-t TTP, is helpful to estimate VEGF expression of HCC. The quantification of CEUS seems to be helpful to reflect angiogenesis of HCC. CEUS is a promising method to assess the vascularity and angiogenesis of tumor.
Key words: contrast-enhanced ultrasonography;vascular endothelial growth factor;hepatocellular carcinoma