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目的 比较研究肝细胞癌 (hepatocellularcarcinoma ,HCC)螺旋CT动脉、门静脉 (简称门脉 )双期增强扫描 ,癌灶边缘强化特征与其组织病理学改变之间的相关性 ,探讨HCC癌灶边缘强化的组织病理学基础及其对HCC生物学行为和预后的影响。方法 经手术病理证实的HCC 42例。全肝平扫后 ,分别于开始注射对比剂后 2 0s、6 0s行全肝螺旋CT动、门脉双期扫描。 5 μm厚组织切片进行HE染色和Ⅷ因子相关抗原 (F8RA)多克隆抗体免疫组织化学 (简称免疫组化 )染色 ,重点观察肿瘤包膜、包膜内有无癌细胞浸润、包膜内阳性血管的多少。结果 42例中 ,动脉期显示肿瘤包膜呈高密度13例 ,低密度 8例 ,无明显包膜 2 1例。门脉期显示肿瘤包膜呈高密度 2 7例 ,低密度 2例 ,无明显包膜13例。CT显示肝内子灶 14例 ,其中 9例为单个子灶 ,5例为多个子灶。HE染色示肿瘤有纤维结缔组织包膜 2 5例 ,其中 16例包膜内可见癌细胞浸润 ;F8RA免疫组化染色 ,15例纤维结缔组织内含有阳性肿瘤血管 ,10例纤维结缔组织较厚 ,但其内阳性血管较少。肿瘤无明显纤维结缔组织包膜 17例 ,其中8例癌组织与非癌变肝组织彼此呈交替生长、两者之间无明确分界。结论 HCC螺旋CT动、门脉双期增强扫描 ,癌灶边缘强化特征可反映其组织病理学改变 ,并能在一定程度?
Objective To compare the correlation between spiral CT features of portal vein (portal vein) and hepatocellularcarcinoma (HCC) with double-phase contrast-enhanced scanning in the diagnosis of hepatocellular carcinoma (HCC) and its histopathological changes. Pathological Basis and Its Impact on HCC Biological Behavior and Prognosis. Methods 42 cases of HCC confirmed by surgery and pathology. Whole liver plain scan, respectively, after the start of injection of contrast agent 20s, 60s line hepatic artery CT, portal vein double-phase scan. 5 μm thick tissue sections were stained with HE staining and polyclonal antibody against factor Ⅷ factor (F8RA) for immunohistochemistry (immunohistochemical staining). The focus of the study was to observe the tumor capsule, the presence or absence of cancer cell infiltration in the capsule and the positive vessels in the capsule How much. Results Among the 42 cases, the arterial phase showed high density of tumor capsule in 13 cases, low density in 8 cases and no obvious capsule in 21 cases. The portal vein tumor showed high density of 27 cases, low density in 2 cases, no significant capsule in 13 cases. CT showed 14 cases of intrahepatic foci, of which 9 cases of a single foci, 5 cases of multiple foci. Hematoxylin and eosin (HE) staining showed that there were 25 cases of fibrous connective tissue envelopes in tumor, of which 16 cases were found to be infiltrating into the envelope; F8RA immunohistochemical staining, 15 cases of fibrous connective tissue containing positive tumor vessels, 10 cases of fibrous connective tissue thick, However, its less positive blood vessels. There were 17 cases of tumor with no fibrous connective tissue capsule, of which 8 cases of cancerous tissue and non-cancerous liver tissue grew alternately with each other. There was no definite demarcation between the two. Conclusions HCC spiral CT, portal enhanced double-phase scanning, edge enhancement of the lesion can reflect the histopathological changes, and to some extent?