CT能谱成像评估胰头癌血管增生及纤维化的实验研究

Pancreatic head carcinoma accounts for about 2/3～3/4 of pancreatic carcinoma, which is one of the most malignant carcinoma. Vascular proliferation of tumor parenchyma and interstitial fibrosis are important factors in pancreatic cancer growth, invasion and metastasis. The study found that vascular proliferation of tumor parenchyma is closely related to the emergence and development of pancreatic carcinoma. Microvessel density (MVD) is an important index for evaluation of tumor’s vascular proliferation. With the higher of MVD counting, the tumor prognosis is poor. Activated pancreatic stellate cells (PCS) are rich in pancreatic carcinoma tissues, PCS promotes the synthesis of extra-cellular matrix and interstitial fibrosis, and it accelerates tumor’s growth and metastasis.This study is designed to establish rabbits model with VX2 tumor in pancreatic head and investigate the value of dual-energy spectral computed tomographic imaging (DESCT) in the evaluation of vascular proliferation and fibrosis for tumor. We compared the CT spectral imaging features among tumor, peritumor tissues and normal pancreatic parenchyma, All spectral parameters are analyzed retrospectively and correlate with MVD counting and the degree of fibrosis. The purpose of this study is to clarify the mechanisms of tumor hemodynamic changes and evaluate the pathology changes of pancreatic carcinoma model from micro-aspect by imaging. This study establish the foundation of animal experiments for providing an effective, safe, convenient and repeatable imaging method in vivo to evaluate the vascular proliferation of tumor parenchyma, antiangiogenic therapy and targeted therapy of PCS for toumors.

胰腺癌的恶性程度极高，其中胰头癌约占2/3～3/4。肿瘤实质内血管生成及间质纤维化是胰腺癌生长、侵袭及转移的重要因素。研究发现：胰腺癌实质中肿瘤血管生成与其进展密切相关，微血管密度（MVD）是评价肿瘤血管生成的重要指标，MVD增高，肿瘤预后不佳；且胰腺癌组织中富含活化的星状细胞（PCS），PCS促进细胞外基质合成及间质纤维化，加速肿瘤生长和转移。本研究通过建立兔VX2胰头癌模型，应用CT能谱成像技术，测量分析肿瘤、肿瘤边缘组织及正常胰腺实质的动态增强扫描各期能谱参数，并与相应组织的MVD、纤维化程度进行对比，找出各组织能谱参数与MVD、纤维化程度间的相关性，探明瘤灶血流动力学变化的机制，拟通过影像学检查从微观角度对胰腺癌模型的病理改变进行评估，为临床评价胰腺癌血管生成、监测抗肿瘤血管生成疗效及针对PCS靶向治疗提供有效、无创、便捷、可在活体重复实施的影像学检查方法奠定动物实验基础。

胰腺癌的恶性程度极高，其中胰头癌约占2/3～3/4。肿瘤实质内血管生成及间质纤维化是胰腺癌生长、侵袭及转移的重要因素。研究发现：胰腺癌实质中肿瘤血管生成与其进展密切相关，微血管密度（MVD）是评价肿瘤血管生成的重要指标，MVD增高，肿瘤预后不佳；且胰腺癌组织中富含活化的星状细胞（PCS），PCS促进细胞外基质合成及间质纤维化，加速肿瘤生长和转移。本研究通过建立兔VX2胰头癌模型，应用CT能谱成像技术，测量分析肿瘤、肿瘤边缘组织及正常胰腺实质的动态增强扫描各期能谱参数，并与相应组织的MVD、纤维化程度进行对比，找出各组织能谱参数与MVD、纤维化程度间的相关性，探明瘤灶血流动力学变化的机制，拟通过影像学检查从微观角度对胰腺癌模型的病理改变进行评估，为临床评价胰腺癌血管生成、监测抗肿瘤血管生成疗效及针对PCS靶向治疗提供有效、无创、便捷、可在活体重复实施的影像学检查方法奠定动物实验基础。我们成功建立新西兰大白兔的VX2胰头癌模型，并对其进行能谱CT扫描，通过对能谱CT扫描参数及病理标本进行对照分析发现：MVD与病灶的强化程度存在着相关性，但瘤体内部的纤维化程度不仅与病灶程度强化相关，还决定了其强化方式。因此，能谱CT扫描参数的变化情况可以较好的反应瘤体内部的病理改变。