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Background and Purpose: Hepatocellular carcinoma (hepatocellular carcinoma, HCC) in our home three malignancies, the prognosis is very poor. Angiogenesis is a malignant tumor growth and metastasis, tumor angiogenesis is regulated by a variety of factors, including vascular endothelial growth factor (VEGF), placental growth factor (PLGF) and tumor angiogenesis is closely related, in a variety of tumor occurrence, development, invasion and metastasis in play an important role in determining tumor prognosis. More use of microvascular density (MVD) to evaluate tumor angiogenesis, MVD and tumor invasion and prognosis. The tumor imaging performance characteristics are based, according to their histopathological and tumor biological characteristics, the application of multi-slice spiral CT (SCT) for HCC diagnosis, treatment and prognosis provided an effective means. SCT signs of pathological and biological characteristics of the tumor control analysis, to explore intrinsic link between imaging and biology research in recent years one of the hot spots. The purpose of this study is through the study of VEGF in HCC PLGF expression and MVD with spiral CT signs of the relationship between the estimated HCC neovascularization state of CT, the ability of invasion and metastasis, and thus more conducive to deepening the basis of its CT imaging pathology understanding, have important clinical implications for improving the assessment of liver cancer diagnosis, treatment options and prognosis. Materials and methods: surgical removal of pathologically confirmed HCC specimens analyzed 39 cases did not receive radiation therapy, chemotherapy, and other non-surgical treatment, including 30 males and 9 females, aged 32-81 years old. Using Streptomyces avidin-peroxidase connection method (SP) according to the general steps detect intratumoral of VEGF, PLGF expression and MVD using 400 magnification were counted to determine the pathological grading the statistics of VEGF, PLGF and positive expression between the MVD. GE LIGHT SPEED 16 spiral CT machine, the first scan using high-pressure syringe injection of non-ionic iodinated contrast Omnipaque 80-1 00mL. Injection speed of 3.0-4.0mL / s. Arterial phase (25-30S), respectively, after the injection of contrast medium, the portal venous phase (50-60S) and parenchymal phase (90-1 20S) the three scan, scan parameters are 30KV ,250-300mA, thickness, interval 5-10mm, and the pitch is 1.0, necessary when using the 3-5mm thick. Analysis of preoperative CT signs, including the size of the tumor, the edge (with or without pseudocapsule formation), invasion and metastasis, and enhanced type (arterial supply, arteriovenous the dual blood for type hypovascular type). And statistical relationship between the CT signs of VEGF, PLGF and MVD positive expression. The application SPSS 13.0 software package, the measurement data using t test or analysis of variance, count data with x2 test data processing, to P lt; 0.05 was statistically significant. Results 1.VEGF PLGF expression, MVD in HCC and the relationship of 39 patients with HCC, VEGF positive expression in 33 cases, the positive rate was 84.62%; the PLGF positive expression of 30 cases, the positive rate was 76.92%; MVD changes in the range of 16 - 59, mean (x) 32.79, standard deviation (s) of 14.25. VEGF and PLGF positive expression in HCC has a certain relationship (x2 = 7.59, P = 0.018). Tumor tissue VEGF positive and negative expression, MVD values ??were 35.67 ± 13.63 and 17.0 ± 1.41, significantly different (P = 0.002); the PLGF positive, negative expression the MVD the average were 35.46 ± 14.02 and 23.89 ± 11.69, also exist difference (P = 0.031). HCC in of PLGF the expression and MVD and pathological grade was significantly associated (P values ??were 0.001,0.034). Of SCT diagnostic results in 2.HCC 39 patients with HCC, hepatic artery for blood type 26 cases, accounting for 66.67%, followed by the hepatic artery and portal vein dual blood supply to the 10 cases, accounting for 25.64%, hypovascular type 3 cases, accounting for 7.69%. Tumor diameter gt; 5 cm in 18 cases, 21 cases ≤ 5cm; have more complete pseudocapsule 11 cases, 28 See, for example, incomplete capsule or pseudocapsule. In 13 cases of high-risk group of cases, 4 cases in the liver, see sub-foci formation, two cases at the same time and have portal vein tumor and liver doors lymph node metastasis, and five cases see the door vein tumor bolt to form after two cases have peritoneal lymph nodes and adrenal metastasis . 3. Hepatocellular carcinoma enhanced CT features and VEGF, the relationship between the of PLGF expression and MVD 3.1 artery for blood group and less for VEGF, PLGF and MVD positive expression rate between blood type significant difference (P = 0.023, 0.022,0.001); artery for blood type and double for blood type between PLGF MVD positive expression rate was significantly different (P values ??were 0.03 1,0.004) between VEGF expression was no significant difference (P = 0.465); double for the blood type, less for VEGF, PLGF and MVD positive expression rate between blood type was no significant difference (P values ??were 0.133,0.500,0.138). 3.2HCC pseudocapsule or capsule less complete set of VEGF positive expression rate in pseudocapsule group (P = 0.004); of PLGF MVD positive expression of pseudocapsule show no significant difference (P values ??were 0.194,0.20). A 3.3VEGF the expression of HCC with or without invasion and metastasis correlation (P = 0.333), HCC invasiveness and metastasis of PLGF MVD were higher than those without metastasis (P values ??were 0.0 15,0.003.) 3.4VEGF, of PLGF expression and tumor size was no correlation (P values ??were 0.590,0.312); MVD with HCC tumors of different sizes and different, and the difference was statistically significant (P = 0.019). Conclusion: 1, exists between the expression of VEGF and PLGF correlation, both positive and negative expression groups MVD have a significant difference in VEGF, PLGF as related regulatory factors for HCC angiogenesis. 2, PLGF expression and MVD and pathological grade of HCC is closely related to the higher pathologic grade PLGF the MVD-positive expression rate is higher, indicating a highly malignant tumor cell proliferation rate is also fast, more microvascular, PLGF may to some extent reflect the degree of differentiation of HCC angiogenesis may play an important role in tumor progression. HCC of CT enhanced signs (pseudocapsule formation, with or without invasion and metastasis and blood supply type, etc.) is closely related to VEGF, PLGF expression and MVD tumor angiogenesis HCC growth, development, and transfer of the morphological basis VEGF, PLGF of expression and MVD and to a certain extent reflect the characteristics of blood supply of HCC. HCC of CT performance characteristics of angiogenesis, VEGF, PLGF expression of multiple factors, analysis of HCC enhanced spiral CT signs of tumor angiogenesis, can further understand the significance of CT signs of HCC to evaluate the biological characteristics HCC invasion, metastasis and blood supply in some degree of predictability, so as to provide more help HCC diagnosis, treatment options and prognosis estimated.
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