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目的 探讨肝细胞癌 (hepatocellularcarcinoma ,HCC)细胞凋亡 (apoptosis)和增殖与CT表现的关系。方法 手术切除并经病理证实的肝细胞癌 42例 ,所有病例均行螺旋CT平扫和动、静脉双期增强扫描。采用TdT缺口末端标记法 (TUNEL)和免疫组织化学SP法分别检测各标本的AI和PCNA -LI。结果 随着肿瘤的增大 ,凋亡指数 (Apoptosisindex ,AI)降低 ,PCNA -LI增高 (Ρ <0 .0 5 )。肿瘤包膜完整组AI高于无包膜或包膜欠完整组 (Ρ <0 .0 5 ) ,而增殖指数 (PCNA -Labelingindex ,PCNA -LI)在肿瘤包膜完整组低于无包膜或包膜欠完整组 (Ρ <0 .0 5 )。AI在门静脉无癌栓组高于门静脉有癌栓组 (Ρ <0 .0 1) ,PCNA -LI在门静脉无癌栓组低于门静脉有癌栓组 (Ρ <0 .0 1)。无淋巴结转移组中 ,AI较淋巴结转移组高 ,而PCNA -LI低于淋巴结转移组 (Ρ <0 .0 1)。AI和PCNA -LI呈负相关关系 (Ρ <0 .0 1)。结论 HCC的SCT表现与细胞凋亡和PCNA存在较为密切的相关关系 ,根据肝细胞癌的CT表现 ,可在一定程度上了解细胞凋亡和PCNA的表达情况
Objective To investigate the relationship between apoptosis, proliferation and CT in hepatocellular carcinoma (HCC). Methods Forty-two patients with hepatocellular carcinoma were confirmed by pathology. All patients underwent spiral CT scan and dynamic and venous double-phase contrast-enhanced scanning. The T and TUNEL and SP immunohistochemical methods were used to detect the AI and PCNA-LI of each specimen. Results As tumor size increased, the Apoptosis index (AI) decreased and PCNA-LI increased (P <0.05). The complete AI of the tumor capsule was higher than that of the non-capsule or incomplete capsule group (P <0.05), while the proliferation index (PCNA-LIP) Envelope undercomplete group (Ρ <0. 05). The incidence of AI in portal vein without tumor embolus was higher than that in portal vein (P <0.01). PCNA-LI was lower in portal vein without tumor embolus than in portal vein (P <0.01). In the group without lymph node metastasis, AI was higher than that in lymph node metastasis, and PCNA-LI was lower than that in lymph node metastasis (P <0.01). There was a negative correlation between AI and PCNA-LI (P <0.01). Conclusion The expression of SCT in HCC is closely related to apoptosis and PCNA. According to the CT findings of hepatocellular carcinoma, we can know the expression of PCNA and apoptosis in a certain extent