microvascular density

微血管密度
  • 文章类型: Journal Article
    骨肉瘤是最常见的原发性恶性骨肿瘤。尽管化疗最近取得了进展,但播散性疾病患者的预后仍然很差。此外,目前的治疗方案具有严重副作用的显著风险.因此,对于具有改善的安全性的有效疗法存在未满足的临床需求.牛磺罗定是一种抗菌剂,已显示可在不同类型的癌细胞系中诱导细胞死亡。
    在这项研究中,我们研究了牛磺罗定在骨肉瘤动物模型中的抗肿瘤和抗血管生成作用。注射K7M2鼠骨肉瘤细胞,肌内和腹膜内,在第0天进入60只BALB/c小鼠。然后将动物随机接受2%牛磺罗定(800mg/kg)治疗,牛磺罗定1%(400毫克/千克),或通过静脉内或腹膜内给药的NaCl0.9%对照7天。
    35天后,小鼠被安乐死,并收集肿瘤进行分析。18只小鼠由于并发症被排除在分析之外。从第9天至第21天,2%牛磺罗定腹膜内治疗组中的体重显著降低,与该组中的死亡率升高一致。与对照组相比,1%(p=0.003)和2%(p=0.006)腹膜内牛磺罗定治疗组中的腹膜内肿瘤重量显著更低。对肌内肿瘤或静脉内施用牛磺罗定没有观察到抗肿瘤作用。治疗组之间的微血管密度或有丝分裂率没有显着差异。2%牛磺罗定腹膜内组的体重减轻和死亡率升高表明,较低的1%剂量是优选的。
    总而言之,没有抗血管生成活性的证据,牛磺罗定对骨肉瘤的抗肿瘤作用是有限的。此外,其毒性特征给予进一步评估。鉴于这些观察,需要进一步研究完善牛磺罗定在骨肉瘤治疗中的应用。
    UNASSIGNED: Osteosarcoma is the most common malignant primary bone tumor. The prognosis for patients with disseminated disease remains very poor despite recent advancements in chemotherapy. Moreover, current treatment regimens bear a significant risk of serious side effects. Thus, there is an unmet clinical need for effective therapies with improved safety profiles. Taurolidine is an antibacterial agent that has been shown to induce cell death in different types of cancer cell lines.
    UNASSIGNED: In this study, we examined both the antineoplastic and antiangiogenic effects of taurolidine in animal models of osteosarcoma. K7M2 murine osteosarcoma cells were injected, both intramuscular and intraperitoneal, into 60 BALB/c mice on day zero. Animals were then randomized to receive treatment with taurolidine 2% (800 mg/kg), taurolidine 1% (400 mg/kg), or NaCl 0.9% control for seven days by intravenous or intraperitoneal administration.
    UNASSIGNED: After 35 days, mice were euthanized, and the tumors were harvested for analysis. Eighteen mice were excluded from the analysis due to complications. Body weight was significantly lower in the 2% taurolidine intraperitoneal treatment group from day 9 to 21, consistent with elevated mortality in this group. Intraperitoneal tumor weight was significantly lower in the 1% (p = 0.003) and 2% (p = 0.006) intraperitoneal taurolidine treatment groups compared to the control. No antineoplastic effects were observed on intramuscular tumors or for intravenous administration of taurolidine. There were no significant differences in microvessel density or mitotic rate between treatment groups. Reduced body weight and elevated mortality in the 2% taurolidine intraperitoneal group suggest that the lower 1% dose is preferable.
    UNASSIGNED: In conclusion, there is no evidence of antiangiogenic activity, and the antitumor effects of taurolidine on osteosarcoma observed in this study are limited. Moreover, its toxic profile grants further evaluation. Given these observations, further research is necessary to refine the use of taurolidine in osteosarcoma treatment.
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  • 文章类型: Editorial
    在这篇社论中,我们特别关注胰腺炎症影响胰腺癌的机制.胰腺癌仍然是最致命的癌症类型之一。胰腺癌的发病率和死亡率最高的是发达国家。胰腺癌发病率和死亡率的趋势在世界范围内差异很大。更好地了解病因和确定危险因素对于这种疾病的一级预防至关重要。胰腺肿瘤的特征在于复杂的微环境,其协调代谢改变并支持该生态位内的各种细胞类型之间的相互作用的环境。在这篇社论中,我们强调推动我们理解这些过程的基础研究。在我们的实验中心,我们仔细研究了胰腺炎症和胰腺癌的相关机制.我们专注于肥大细胞(MC)的作用。MC含有促血管生成因子,包括类胰蛋白酶,这与各种肿瘤的血管生成增加有关。在这篇社论中,我们探讨了MC在胰腺导管腺癌组织和邻近正常组织血管生成中的作用。评估包括c-Kit受体阳性MC的密度,类胰蛋白酶阳性MC的密度,类胰蛋白酶阳性MC的区域,和微血管密度方面的血管生成。
    In this editorial, we focus specifically on the mechanisms by which pancreatic inflammation affects pancreatic cancer. Cancer of the pancreas remains one of the deadliest cancer types. The highest incidence and mortality rates of pancreatic cancer are found in developed countries. Trends of pancreatic cancer incidence and mortality vary considerably worldwide. A better understanding of the etiology and identification of the risk factors is essential for the primary prevention of this disease. Pancreatic tumors are characterized by a complex microenvironment that orchestrates metabolic alterations and supports a milieu of interactions among various cell types within this niche. In this editorial, we highlight the foundational studies that have driven our understanding of these processes. In our experimental center, we have carefully studied the mechanisms of that link pancreatic inflammation and pancreatic cancer. We focused on the role of mast cells (MCs). MCs contain pro-angiogenic factors, including tryptase, that are associated with increased angiogenesis in various tumors. In this editorial, we address the role of MCs in angiogenesis in both pancreatic ductal adenocarcinoma tissue and adjacent normal tissue. The assessment includes the density of c-Kit receptor-positive MCs, the density of tryptase-positive MCs, the area of tryptase-positive MCs, and angiogenesis in terms of microvascularization density.
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  • 文章类型: Journal Article
    为了比较浅表视网膜血管密度(SRVD)的变化,深视网膜血管密度(DRVD),近视前学龄儿童反复低水平红光(RLRL)和0.01%阿托品暴露后黄斑区的视网膜厚度(RT)。
    前瞻性随机试验。将69名睫状肌麻痹屈光>-0.75D和≤0.50D的学童随机分配到RLRL和0.01%阿托品组。SRVD,DRVD,和RT在基线和6个月时使用扫频源光学相干断层扫描进行测量。黄斑区分为三个同心环(中央凹,Parafovea,和前凹)使用早期治疗糖尿病视网膜病变研究。
    六个月后,整个,侧腹,两组中心凹周围SRVD均显著升高(P均<0.05)。多因素回归分析显示两组间无显著性差异(均P>0.05),而两组中心凹SRVD均保持稳定(均P>0.05)。在RLRL组中,整体和中心凹DRVD显著增加(均P<0.05),而在中央凹和旁凹DRVD中没有观察到统计学差异。0.01%阿托品组DRVD稳定(P均>0.05)。两组患者的RT变化差异均无统计学意义(均P>0.05)。相比之下,SRVD没有显著变化,DRVD,在我们之前的研究中,安慰剂组六个月后进行RT。
    在RLRL和0.01%阿托品组中,SRVD相似地增加,而DRVD仅在前一组增加。近视前学童治疗六个月后,两组的RT均无明显变化。
    这项研究观察了低水平红光和0.01%阿托品对视网膜血管的影响,为预防近视进展提供有价值的见解。
    UNASSIGNED: To compare changes in superficial retinal vascular density (SRVD), deep retinal vascular density (DRVD), and retinal thickness (RT) of the macular zone after repeated low-level red light (RLRL) and 0.01% atropine exposure in premyopic schoolchildren.
    UNASSIGNED: Prospective randomized trial. Sixty-nine schoolchildren with cycloplegic refraction >-0.75 D and ≤0.50 D were randomly assigned to RLRL and 0.01% atropine groups. SRVD, DRVD, and RT were measured using swept-source optical coherence tomography at baseline and six months. The macular zone was divided into three concentric rings (fovea, parafovea, and perifovea) using the Early Treatment Diabetic Retinopathy Study.
    UNASSIGNED: After six months, the whole, parafoveal, and perifoveal SRVD significantly increased in the two groups (all P < 0.05). Multivariate regression analyses showed that none of these changes varied significantly between the two groups (all P > 0.05), whereas foveal SRVD remained stable in both groups (all P > 0.05). In the RLRL group, the whole and perifoveal DRVD increased significantly (all P < 0.05), whereas no statistical difference was observed in the foveal and parafoveal DRVD. DRVD remained stable in the 0.01% atropine group (all P > 0.05). No significant differences were observed in RT changes between the two groups (all P > 0.05). In comparison, there were no significant changes in SRVD, DRVD, or RT after six months in the placebo group in our previous study.
    UNASSIGNED: SRVD increased similarly in the RLRL and 0.01% atropine groups, whereas DRVD increased only in the former group. There were no significant RT changes in either group after six months of treatment in premyopic schoolchildren.
    UNASSIGNED: This research observed the effects of low-level red light and 0.01% atropine on retinal vasculature, offering valuable insights into myopia progression prevention.
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  • 文章类型: Journal Article
    胶质母细胞瘤是中枢神经系统中侵袭性最强的肿瘤,尽管进行了多模式治疗,但生存率仍低于15个月。肿瘤在切除后经常复发。肿瘤血管生成,新血管的形成,对肿瘤进展和侵袭有积极的影响,尽管在专业文献中关于其对生存的影响存在争议。这项研究旨在将原发性和继发性胶质母细胞瘤中血管生成标志物(CD34,CD105)的免疫表达与增殖指数Ki67和p53相关联。这项回顾性研究包括54例在县急诊临床医院病理科诊断为胶质母细胞瘤的患者。使用CD34和CD105抗体测定微血管密度,结果与p53,IDH1,ATRX和Ki67的免疫表达相关。新生血管的数量因病例而异,以不同的形状和口径为特征,内皮细胞表现出修饰的形态和中度至明显的多态性。有肾小球样的新血管,与内皮细胞中CD34或CD105的强烈阳性相关,被观察到,胶质母细胞瘤的特征。在所有情况下,CD34标志物的平均微血管密度值均较高,尽管与CD105相比没有统计学上的显着差异。突变IDH1和ATRX胶质母细胞瘤,野生型p53胶质母细胞瘤,Ki67指数超过20%的患者显示出更丰富的微血管密度,统计相关性未达到显著性。这项研究分别使用免疫组织化学标记CD34和CD105强调了原发性和继发性胶质母细胞瘤中微血管密度的各种百分比间隔,评估的微血管密度与p53或Ki67之间没有统计学上的显着相关性。
    Glioblastoma is the most aggressive tumor in the central nervous system, with a survival rate of less than 15 months despite multimodal therapy. Tumor recurrence frequently occurs after removal. Tumoral angiogenesis, the formation of neovessels, has a positive impact on tumor progression and invasion, although there are controversial results in the specialized literature regarding its impact on survival. This study aims to correlate the immunoexpression of angiogenesis markers (CD34, CD105) with the proliferation index Ki67 and p53 in primary and secondary glioblastomas. This retrospective study included 54 patients diagnosed with glioblastoma at the Pathology Department of County Emergency Clinical Hospital Târgu Mureș. Microvascular density was determined using CD34 and CD105 antibodies, and the results were correlated with the immunoexpression of p53, IDH1, ATRX and Ki67. The number of neoformed blood vessels varied among cases, characterized by different shapes and calibers, with endothelial cells showing modified morphology and moderate to marked pleomorphism. Neovessels with a glomeruloid aspect, associated with intense positivity for CD34 or CD105 in endothelial cells, were observed, characteristic of glioblastomas. Mean microvascular density values were higher for the CD34 marker in all cases, though there were no statistically significant differences compared to CD105. Mutant IDH1 and ATRX glioblastomas, wild-type p53 glioblastomas, and those with a Ki67 index above 20% showed a more abundant microvascular density, with statistical correlations not reaching significance. This study highlighted a variety of percentage intervals of microvascular density in primary and secondary glioblastomas using immunohistochemical markers CD34 and CD105, respectively, with no statistically significant correlation between evaluated microvascular density and p53 or Ki67.
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  • 文章类型: Journal Article
    评估使用光学相干断层扫描血管造影(OCTA)评估的双眼患有同期糖尿病视网膜病变(DR)的糖尿病患者的微血管间差异。
    在这项横断面研究中,使用200kHzOCTA设备获取中心凹的扫频源6×6mmOCTA扫描。血管密度(VD)和分形维数在二值化计算,浅表毛细血管丛(SCP)和深毛细血管丛(DCP)的血管分割图像。测量中心凹无血管区(FAZ)面积(FAZA)和周长(FAZP)并计算FAZ圆度(FAZC)。评估并比较了不同DR分期的眼睛之间的绝对差异(δabs)和不对称指数。VD的差异,FD,使用线性混合模型评估左眼和右眼之间的FAZ参数。
    共纳入168例糖尿病患者的336只眼进行分析,这些患者的DR分期从轻度非增生到增生性DR不等。intereye比较显示SCP中的VD显著降低(估计[95%CI]=-0.009[-0.01;-0.006],P<0.01),以及SCP中明显较低的FD(-0.007[-0.009;-0.005],与右眼相比,左眼的P<0.01)。在没有DR的眼中,左眼的FAZC低于右眼,中度DR,和PDR(P<0.05)。在更晚期的疾病阶段,FAZδabs和不对称指数更高(P<0.05)。
    OCTA指标提供了有关DR等全身性疾病中视网膜微脉管系统的重要信息。我们的结果表明,与右眼相比,SCP的VD和FD较低,而左眼的FAZ损害较高,这两者之间存在显着差异。
    UNASSIGNED: To evaluate microvascular intereye differences in diabetic patients with same-stage diabetic retinopathy (DR) in both eyes as assessed using optical coherence tomography angiography (OCTA).
    UNASSIGNED: In this cross-sectional study, fovea-centered swept-source 6 × 6 mm OCTA scans were acquired using a 200 kHz OCTA device. Vessel density (VD) and fractal dimension were calculated on binarized, vessel-segmented images in the superficial capillary plexus (SCP) and deep capillary plexus (DCP). Foveal avascular zone (FAZ) area (FAZA) and perimeter (FAZP) was measured and FAZ circularity (FAZC) calculated. Absolute difference (δabs) and asymmetry index between eyes was assessed and compared across DR stages. Differences of VD, FD, and FAZ parameters between left and right eye were evaluated using linear mixed models.
    UNASSIGNED: A total of 336 eyes of 168 diabetic patients without DR and with DR stages ranging from mild nonproliferative to proliferative DR were included for analysis. The intereye comparison revealed significantly lower VD in the SCP (estimate [95% CI] = -0.009 [-0.01; -0.006], P < 0.01), as well as a significantly lower FD in the SCP (-0.007 [-0.009; -0.005], P < 0.01) of the left compared to the right eye. FAZC of the left compared to the right eye was lower in eyes without DR, moderate DR, and PDR (P < 0.05). FAZ δabs and asymmetry index were higher in more advanced disease stages (P < 0.05).
    UNASSIGNED: OCTA metrics provide important information on the retinal microvasculature in systemic diseases such as DR. Our results reveal a significant intereye difference with lower VD and FD in the SCP as well as higher FAZ impairment of the left compared to the right eye.
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  • 文章类型: Journal Article
    探讨重度非增生性糖尿病视网膜病变(NPDR)参与者视网膜和脉络膜血管丛的血管密度(VD)与其各自视网膜层和脉络膜厚度之间的相关性。
    我们回顾性分析了42例糖尿病(DM)和严重NPDR患者的42只眼的数据。此外,对41例健康对照者的41只眼进行了评价。使用光学相干断层扫描血管造影(OCTA)对两组进行测量,包括中央凹血管区(FAZ)的面积和周长以及浅表毛细血管丛(SCP)中的血管密度(VD),深毛细血管丛(DCP),和脉络膜毛细血管(CC)。将这些测量值与内部/中间视网膜层的视网膜厚度(RT)和脉络膜厚度(CT)进行比较。该研究评估了相应血管网络中RT或CT与VD之间的相关性,即浅表毛细血管丛(SCP),深毛细血管丛(DCP),或CC。
    重度NPDR组所有丛的内部RT和VD均显着低于健康对照组。此外,重度NPDR组的FAZ面积和周长较大.SCP组的内部RT与VD相关(健康对照组和严重NPDR组的r=0.67和r=0.71,分别为;p<0.05)。在CC中,CT与VD呈负相关(在健康对照组和严重NPDR组中,r=-0.697和r=-0.759,分别为;p<0.05)。重度NPDR组DCP的中间RT与VD显著相关(r=-0.55,p<0.05),但不是健康对照组。
    视网膜或脉络膜厚度与VD密切相关。因此,患有严重NPDR的患者必须考虑不同视网膜层和脉络膜的不同解剖和功能实体.
    UNASSIGNED: To explore the correlation between the vessel density (VD) of the retina and choroid vascular plexuses and the thicknesses of their respective retinal layers and choroid membranes in participants with severe non-proliferative diabetic retinopathy (NPDR).
    UNASSIGNED: We retrospectively analyzed the data of 42 eyes of 42 participants with diabetes mellitus (DM) and severe NPDR. In addition, 41 eyes of 41 healthy controls were evaluated. Measurements were taken for both groups using optical coherence tomography angiography (OCTA), including the area and perimeter of the foveal vascular zone (FAZ) and the vascular density (VD) in the superficial capillary plexus (SCP), deep capillary plexus (DCP), and choroid capillary (CC). These measurements were compared with the retinal thickness (RT) of the inner/intermediate retinal layers and choroidal thickness (CT). The study evaluated the correlation between RT or CT and VD in the respective vascular networks, namely superficial capillary plexus (SCP), deep capillary plexus (DCP), or CC.
    UNASSIGNED: The inner RT and VD in all plexuses were significantly lower in the severe NPDR group than in the healthy controls. Furthermore, the FAZ area and perimeter were larger in the severe NPDR group. Inner RT was correlated with VD in the SCP group (r=0.67 and r=0.71 in the healthy control and severe NPDR groups, respectively; p<0.05). CT negatively correlated with VD in the CC (r=-0.697 and r=-0.759 in the healthy control and severe NPDR groups, respectively; p<0.05). Intermediate RT significantly correlated with VD in the DCP of the severe NPDR group (r=-0.55, p<0.05), but not in the healthy control group.
    UNASSIGNED: Retinal or choroidal thickness strongly correlated with VD. Therefore, patients with severe NPDR must consider the distinct anatomical and functional entities of the various retinal layers and the choroid.
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  • 文章类型: Journal Article
    外周微血管反应性降低与主要不良心脏事件(MACE)的风险增加有关。用于外周微血管功能的非侵入性评估的工具是有限的,并且现有技术在健康人群和心血管疾病(CVD)患者中的验证不佳。这里,我们利用手持式入射暗场成像工具(CytoCam)来检验与健康个体(无CVD危险因素)相比的假设,正式诊断为冠状动脉疾病(CAD)或具有≥2个CAD危险因素(内皮功能障碍;ED)的受试者会表现出外周微血管反应性受损.共有17名参与者(11名健康,6ED)被纳入本试点研究。CytoCam用于测量舌下微血管总血管密度(TVD),灌注血管密度(PVD),和微血管血流指数(MFI)响应于局部应用乙酰胆碱(Ach)和舌下施用硝酸甘油(NTG)。与健康个体相比,ED队列中的基线MFI和PVD显着降低。令人惊讶的是,应用乙酰胆碱和硝酸甘油后,两组3个微血管灌注参数均有显著改善.这些结果表明,尽管基线微血管密度和灌注降低,在患有CAD或多种疾病危险因素的个体中,人体内对内皮依赖性和非依赖性血管活性剂的外周微血管反应性保持完整.
    Reduced peripheral microvascular reactivity is associated with an increased risk for major adverse cardiac events (MACEs). Tools for noninvasive assessment of peripheral microvascular function are limited, and existing technology is poorly validated in both healthy populations and patients with cardiovascular disease (CVD). Here, we used a handheld incident dark-field imaging tool (CytoCam) to test the hypothesis that, compared with healthy individuals (no risk factors for CVD), subjects formally diagnosed with coronary artery disease (CAD) or those with ≥2 risk factors for CAD (at risk) would exhibit impaired peripheral microvascular reactivity. A total of 17 participants (11 healthy, 6 at risk) were included in this pilot study. CytoCam was used to measure sublingual microvascular total vessel density (TVD), perfused vessel density (PVD), and microvascular flow index (MFI) in response to the topical application of acetylcholine (ACh) and sublingual administration of nitroglycerin (NTG). Baseline MFI and PVD were significantly reduced in the at-risk cohort compared with healthy individuals. Surprisingly, following the application of acetylcholine and nitroglycerin, both groups showed a significant improvement in all three microvascular perfusion parameters. These results suggest that, despite baseline reductions in both microvascular density and perfusion, human in vivo peripheral microvascular reactivity to both endothelial-dependent and -independent vasoactive agents remains intact in individuals with CAD or multiple risk factors for disease.NEW & NOTEWORTHY To our knowledge, this is the first study to comprehensively characterize in vivo sublingual microvascular structure and function (endothelium-dependent and -independent) in healthy patients and those with CVD. Importantly, we used an easy-to-use handheld device that can be easily translated to clinical settings. Our results indicate that baseline microvascular impairments in structure and function can be detected using the CytoCam technology, although reactivity to acetylcholine may be maintained even during disease in the peripheral microcirculation.
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  • 文章类型: Journal Article
    本研究旨在通过分析眼底图像的血管结构,探讨视网膜血管异常与弱视之间的可能关系。
    在这项观察性研究中,收集36例单侧弱视患者的视网膜眼底图像,双侧弱视33例,和36名健康对照志愿者。我们开发了一种基于U-Net的定制训练算法,将眼底图像中的血管数字化,以量化血管密度(面积和分形维数),骨架长度,和分叉点的数量。对于统计比较,这项研究将参与者分为两组.单侧弱视患者的弱视眼睛和同伴眼睛组成配对组,而双侧弱视患者和健康对照者组成独立组。
    在配对组中,血管面积(P=0.007),血管分形维数(P=0.007),弱视眼的血管骨骼长度(P=0.002)明显小于同伴眼。在独立小组中,与对照组相比,双侧弱视的血管分形维数(P=0.006)和骨骼长度(P=0.048)显著降低.弱视眼的血管面积也与最佳矫正视力显着相关。
    这项研究表明,弱视眼的视网膜血管密度和骨骼长度明显小于对照组,表明视网膜血管特征的变化与弱视状态之间存在关联。
    我们的算法提出了弱视视网膜血管的变化,这些变化对于临床医生和研究人员来说都更具生物学意义。
    UNASSIGNED: This study aimed to investigate the possible relationship between retinal vascular abnormalities and amblyopia by analyzing vascular structures of fundus images.
    UNASSIGNED: In this observational study, retinal fundus images were collected from 36 patients with unilateral amblyopia, 33 patients with bilateral amblyopia, and 36 healthy control volunteers. We developed a customized training algorithm based on U-Net to digitalize the vasculature in the fundus images to quantify vascular density (area and fractal dimension), skeleton length, and number of bifurcation points. For statistical comparisons, this study divided participants into two groups. The amblyopic eyes and the fellow eyes of patients with unilateral amblyopia formed the paired group, while bilateral amblyopic patients and healthy controls formed the independent group.
    UNASSIGNED: In the paired group, the vascular area (P = 0.007), vascular fractal dimension (P = 0.007), and vascular skeleton length (P = 0.002) of the amblyopic eyes were significantly smaller than those of the fellow eyes. In the independent group, significant decreases in the vascular fractal dimension (P = 0.006) and skeleton length (P = 0.048) were observed in bilateral amblyopia compared to control. The vascular area was also significantly correlated with best-corrected visual acuity in amblyopic eyes.
    UNASSIGNED: This study demonstrated that retinal vascular density and skeleton length in amblyopic eyes were significantly smaller compared to control, indicating an association between the changes in retinal vascular features and the state of amblyopia.
    UNASSIGNED: Our algorithm presents amblyopic retinal vascular changes that are more biologically interpretable for both clinicians and researchers.
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  • 文章类型: Journal Article
    背景:血管生成是大肠癌生长的关键步骤,进展和转移。CT是结直肠癌患者术前临床评估的常规影像学检查。本研究旨在探讨术前CT增强率(CER)和CT灌注参数对结直肠癌血管生成的预测价值。以及术前CER和CT灌注参数与血清标志物的关联。
    方法:本回顾性分析包括42例结直肠腺癌患者。微血管密度(MVD)的中位数作为临界值,将42例患者分为高密度组(MVD≥35/场,n=24)和低密度组(MVD<35/场,n=18),收集25例结直肠良性病变患者作为对照组。CER的统计分析,CT灌注参数,在所有组进行血清标记。绘制受试者工作曲线(ROC),评价相关CT灌注参数对肿瘤血管生成的诊断效能;Pearson相关分析探讨CER,CT灌注参数和血清标志物。
    结果:CER,血容量(BV),血流量(BF),渗透性表面(PS)和糖类抗原19-9(CA19-9),糖类抗原125(CA125),癌胚抗原(CEA),三叶因子3(TFF3),血管内皮生长因子(VEGF)在结直肠腺癌中的表达明显高于对照组,高密度组各项指标均显著高于低密度组(P<0.05);结直肠腺癌患者的达峰时间(TTP)明显低于对照组,与低密度组相比,高密度组的水平明显降低(P<0.05)。组合参数BF+TTP+PS和BV+BF+TTP+PS表现出最高的曲线下面积(AUC),都在0.991。Pearson相关分析显示,血清CA19-9、CA125、CEA、TFF3和VEGF与CER呈正相关,BV,BF,和PS(P<0.05),这些指标与TTP呈负相关(P<0.05)。
    结论:术前一些单一和联合CT灌注参数可以准确预测结直肠腺癌的肿瘤血管生成。术前CER和CT灌注参数与血清标志物有一定关联。
    BACKGROUND: Angiogenesis is a critical step in colorectal cancer growth, progression and metastasization. CT are routine imaging examinations for preoperative clinical evaluation in colorectal cancer patients. This study aimed to investigate the predictive value of preoperative CT enhancement rate (CER) and CT perfusion parameters on angiogenesis in colorectal cancer, as well as the association of preoperative CER and CT perfusion parameters with serum markers.
    METHODS: This retrospective analysis included 42 patients with colorectal adenocarcinoma. Median of microvessel density (MVD) as the cut-off value, it divided 42 patients into high-density group (MVD ≥ 35/field, n = 24) and low-density group (MVD < 35/field, n = 18), and 25 patients with benign colorectal lesions were collected as the control group. Statistical analysis of CER, CT perfusion parameters, serum markers were performed in all groups. Receiver operating curves (ROC) were plotted to evaluate the diagnostic efficacy of relevant CT perfusion parameters for tumor angiogenesis; Pearson correlation analysis explored potential association between CER, CT perfusion parameters and serum markers.
    RESULTS: CER, blood volume (BV), blood flow (BF), permeability surface (PS) and carbohydrate antigen 19 - 9 (CA19-9), carbohydrate antigen 125 (CA125), carcinoembryonic antigen (CEA), trefoil factor 3 (TFF3), vascular endothelial growth factor (VEGF) in colorectal adenocarcinoma were significantly higher than those in the control group, the parameters in high-density group were significantly higher than those in the low-density group (P < 0.05); however, the time to peak (TTP) of patients in colorectal adenocarcinoma were significantly lower than those in the control group, and the high-density group showed a significantly lower level compared to the low-density group (P < 0.05). The combined parameters BF + TTP + PS and BV + BF + TTP + PS demonstrated the highest area under the curve (AUC), both at 0.991. Pearson correlation analysis showed that the serum levels of CA19-9, CA125, CEA, TFF3, and VEGF in patients showed positive correlations with CER, BV, BF, and PS (P < 0.05), while these indicators exhibited negative correlations with TTP (P < 0.05).
    CONCLUSIONS: Some single and joint preoperative CT perfusion parameters can accurately predict tumor angiogenesis in colorectal adenocarcinoma. Preoperative CER and CT perfusion parameters have certain association with serum markers.
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  • 文章类型: Journal Article
    目的:评估一站式能谱和灌注CT参数对结直肠癌癌灶中微血管密度(MVD)的预测价值。
    方法:回顾性分析2019年9月至2022年11月我院经术前结肠镜或手术病理证实的82例结直肠癌患者的临床及CT资料。利用GEAW4.7后处理工作站的GSIViewer软件的Protocols通用模块测量能谱CT图像,在40kev~140kev的单一能量范围内测量动静脉期病变及邻近正常肠壁的CT值,并计算了40kev-90kev之间的能谱曲线斜率(λ);碘浓度(IC),水浓度(WC),通过在病变处和邻近正常肠壁的碘浓度图和水浓度图上放置感兴趣区域(ROI)来测量有效-Z(Eff-Z)和归一化碘浓度(NIC)。使用GSI灌注软件连续动态扫描灌注CT图像,并应用CT灌注4.0软件进行分析。血容量(BV),血流量(BF),表面渗透率(PS),达到峰值的时间(TTP)分别测量病变和邻近正常结直肠壁的平均通过时间(MTT)。根据病理结果,将肿瘤分为低MVD组(MVD<35/视场,n=52例)和高MVD组(MVD≥35/视野,n=30例),使用中位数为35/视场作为MVD分组标准。对收集的数据进行统计分析,绘制受试者的工作特征曲线(ROC),和曲线下面积(AUC),灵敏度,特异性,和Yoden指数分别计算了能谱和灌注CT各参数及组合参数的预测效能。
    结果:CT值,IC,NIC,λ,高MVD组结直肠癌动脉期和静脉期的40kev~140kev单能量的Eff-Z高于低MVD组,差异均有统计学意义(p<0.05)。动脉期40kev~120kev各单能量CT值的AUC均大于0.8,说明动脉期对于结直肠癌的高或低MVD有较好的预测价值;AUC对于动脉IC、NIC和IC+NIC均大于0.9,表明在动脉结直肠癌中,能谱CT的单一参数和组合参数在预测MVD水平方面都非常有效。静脉期40kev~90kev单能量CT值的AUC大于0.9,其诊断效能更具代表性;静脉期IC和NIC的AUC大于0.8,说明静脉期结直肠癌的IC和NIC能谱参数对高、低MVD的差异有很好的预测价值,在IC中具有最大的诊断功效。高MVD组的BV和BF值均高于低MVD组,差异有统计学意义(P<0.05),和BF的AUC,BV,和BV+BF分别为0.991、0.733和0.997,用BV+BF测定结直肠癌MVD水平的诊断效能最高。
    结论:一站式CT能谱和灌注成像技术可以准确反映活体肿瘤组织的MVD,这反过来又反映了肿瘤的血管生成,在某种程度上有助于确定恶性肿瘤,基于CT能谱和灌注参数的活体结直肠癌肿瘤组织浸润转移研究.
    OBJECTIVE: Evaluation of the predictive value of one-stop energy spectrum and perfusion CT parameters for microvessel density (MVD) in colorectal cancer cancer foci.
    METHODS: Clinical and CT data of 82 patients with colorectal cancer confirmed by preoperative colonoscopy or surgical pathology in our hospital from September 2019 to November 2022 were collected and analyzed retrospectively. Energy spectrum CT images were measured using the Protocols general module of the GSI Viewer software of the GE AW 4.7 post-processing workstation to measure the CT values of the arterial and venous phase lesions and the neighboring normal intestinal wall in a single energy range of 40 kev∼140 kev, and the slopes of the energy spectrum curves (λ) were calculated between 40 kev-90 kev; Iodine concentration (IC), Water concentration (WC), Effective-Z (Eff-Z) and Normalized iodine concentration (NIC) were measured by placing a region of interest (ROI) on the iodine concentration map and water concentration map at the lesion and adjacent to the normal intestinal wall.Perfusion CT images were scanned continuously and dynamically using GSI Perfusion software and analyzed by applying CT Perfusion 4.0 software.Blood volume (BV), blood flow (BF), surface permeability (PS), time to peak (TTP), and mean transit time (MTT) were measured respectively in the lesion and adjacent normal colorectal wall. Based on the pathological findings, the tumors were divided into a low MVD group (MVD < 35/field of view, n = 52 cases) and a high MVD group (MVD ≥ 35/field of view, n = 30 cases) using a median of 35/field of view as the MVD grouping criterion. The collected data were statistically analyzed, the subjects\' operating characteristic curve (ROC) was plotted, and the area under curve (AUC), sensitivity, specificity, and Yoden index were calculated for the predicted efficacy of each parameter of the energy spectrum and perfusion CT and the combined parameters.
    RESULTS: The CT values, IC, NIC, λ, Eff-Z of 40kev∼140kev single energy in the arterial and venous phase of colorectal cancer in the high MVD group were higher than those in the low MVD group, and the differences were all statistically significant (p < 0.05). The AUC of each single-energy CT value in the arterial phase from 40 kev to 120 kev for determining the high or low MVD of colorectal cancer was greater than 0.8, indicating that arterial stage has a good predictive value for high or low MVD in colorectal cancer; AUC for arterial IC, NIC and IC + NIC were all greater than 0.9, indicating that in arterial colorectal cancer, both single and combined parameters of spectral CT are highly effective in predicting the level of MVD. The AUC of 40 kev to 90 kev single-energy CT values in the intravenous phase was greater than 0.9, and its diagnostic efficacy was more representative; The AUC of IC and NIC in venous stage were greater than 0.8, which indicating that the IC and NIC energy spectrum parameters in venous stage colorectal cancer have a very good predictive value for the difference between high and low MVDs, with the greatest diagnostic efficacy in IC.The values of BV and BF in the high MVD group were higher than those in the low MVD group, and the differences were statistically significant (P < 0.05), and the AUC of BF, BV, and BV + BF were 0.991, 0.733, and 0.997, respectively, with the highest diagnostic efficacy for determining the level of MVD in colorectal cancer by BV + BF.
    CONCLUSIONS: One-stop CT energy spectrum and perfusion imaging technology can accurately reflect the MVD in living tumor tissues, which in turn reflects the tumor angiogenesis, and to a certain extent helps to determine the malignancy, invasion and metastasis of living colorectal cancer tumor tissues based on CT energy spectrum and perfusion parameters.
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