An Initial Study of Tumor-vessel Signs in Malignant Change of Tubulovillous Adenoma on 64-slice Spiral CT_West China Medical Journal

Authors：

 LIHong , MAChun , LIRu-hui , MINGBing , ZHANGYong

Department of Radiology, the People's Hospital of Deyang City, Deyang, Sichuan 618000, P. R. China;

Corresponding author：

Keywords：

Tumor vessels; Tubulovillous adenoma; Tumor malignant change; Tomography; X-ray computer

DOI：

10.7507/1002-0179.20150087

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Objective To investigate the correlation between tumor-vessel signs on 64-slice spiral CT (MSCT) and malignant change of tubulovillous adenoma in the colon and rectum. Methods A retrospective study of the image and the clinical data of 16 patients with tubulovillous adenoma or malignant change proved by pathologies from February 2010 to October 2012 was conducted. The tumor-vessel signs were analyzed by multiplanar reformation (MPR) and maximum intensity projection (MIP) on picture archiving and communication systems workstation. Results Among the 16 cases of tubulovillous adenoma or malignant change, 2 cases of tumor diameter≤2 cm had no tumor-vessel sign; and in the 14 cases of tumor diameter >2 cm, 13 were observed to bear tumor-vessel signs. The size of the tumor and tumor-vessel signs showed a certain correlation (r=0.618, P=0.002). And the manifestation of tumor-vessel signs had obvious differences between benign and malignant tumor. For the adenoma group, it showed venous blood vessel involvement, and downy and natural contour; for the adenocarcinoma group, it showed arterial blood vessel involvement, blood vessels with uneven thickness, visible expansion and irregular defect manifestations. No obvious difference was detected among tumor-vessel signs of adenocarcinoma with different malignant degree. Conclusion MSCT combined with image reconstruction techniques (such as MPR and MIP) can clearly demonstrate tumor blood supply, and tumor-vessel in the arterial phase may suggest a high risk of malignant change of tubulovillous adenoma in the colon and rectum.

Citation： LIHong, MAChun, LIRu-hui, MINGBing, ZHANGYong. An Initial Study of Tumor-vessel Signs in Malignant Change of Tubulovillous Adenoma on 64-slice Spiral CT. West China Medical Journal, 2015, 30(2): 295-299. doi: 10.7507/1002-0179.20150087 Copy

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1. Shaked Y, Bertolini F, Man S, et al. Genetic heterogeneity of the vasculogenic phenotype parallels angiogenesis:implications for cellular surrogate marker analysis of antiangiogenesis[J]. Cancer Cell, 2005, 7(1):101-111.
2. Christenson J. Intestinal motor physiology[M]//Feldman M, Scharschmidt BF, Sleisenger MH. Gastrointestinal and liver disease. 6 th ed. Philadelphia:WB Saunders, 1998:1437-1450.
3. 杨雪, 李贞茂, 李易, 等. 大肠腺瘤性息肉的特点及与癌变关系的探讨[J]. 西部医学, 2010, 22(12):2223-2225.
4. F.L.格林尼, D.L.佩基, I.D.弗莱明, 等. AJCC癌症分期手册[M]. 毛伟征, 苏东明, 李雪萍, 等, 译. 6版. 沈阳:辽宁科技出版社, 2005:113-119.
5. Greene FL. TNM staging for malignancies of the digestive tract:2003 changes and beyond[J]. Semin Surg Oncol, 2003, 21(1):23-29.
6. 房静远. 关注结直肠腺瘤的诊治研究[J]. 中华消化杂志, 2010, 30(7):433-435.
7. Nicholls RJ, Zinicola R, Binda GA. Indications for colorectal resection for adenoma before and after polypectomy[J]. Tech Coloproctol, 2004, 8(Suppl 2):s291-s294.
8. Gondal G, Grotmol T, Hofstad B, et al. Grading of distal colorectal adenomas as predictors for proximal colonic neoplasia and choice of endoscope in population screening:experience from the Norwegian Colorectal Cancer Prevention study (NORCCAP)[J]. Gut, 2003, 52(3):398-403.
9. 梁光春, 陈静, 莫育芹, 等. 结肠息肉病理表现及临床治疗分析[J]. 中国医药科学, 2012, 2(6):88-89.
10. 董米连, 虞哲科, 王先福, 等. 大肠癌患者大肠腺瘤的发病、分布及其与癌的位置关系[J]. 实用临床医学, 2009, 10(2):69-70.
11. 田洪裕, 顾秀珍. 大肠息肉452例内镜诊治结果分析[J]. 中华消化内镜杂志, 2002, 19(3):183-184.
12. 李庆龙, 高剑波, 吕培杰, 等. 直肠绒毛管状腺瘤的CT诊断[J]. 实用放射学杂志, 2013, 29(7):1116-1118.
13. Coe SG, Wallace MB. Colonoscopy:new approsches to better outcome[J]. Curr Opin Gastroenterol, 2012, 28(1):70-75.
14. 吴正阳, 赵俊功, 赵培荣, 等. 结肠绒毛状肿瘤的CT表现[J]. 实用放射学杂志, 2011, 27(10):1512-1514.
15. 李启明, 李宁, 陈正堂. 血管内皮生长因子与肿瘤转移[J]. 重庆医学, 2006, 35(22):2085-2087.
16. 潘宇祥. 血管内皮生长因子与肿瘤转移的研究进展[J]. 四川生理科学杂志, 2013, 35(2):83-85.
17. Hiratsuka S. Vasculogenensis, angiogenesis and special features of tumor blood vessels[J]. Front Biosci (Landmark Ed), 2011, 16:1413-1427.
18. Folkman J. What is the evidence that tumors are angiogenesis dependent[J]. J Natl Cancer Inst, 1990, 82(1):4-6.
19. 杨丹, 王继华. 肿瘤血管供应模式及其分子机制[J]. 中南医学科学杂志, 2014, 42(2):196-200.
20. 刘佩芳, 鲍润贤, 牛昀, 等. 乳腺良恶性病变动态增强MRI表现特征与血管生成相关性的初步研究[J]. 中华放射学杂志, 2002, 36(11):967-972.
21. 李攀. 胃癌及胃间质瘤64层螺旋CT灌注成像的初步临床应用研究[D]. 郑州:郑州大学, 2011.
22. 徐妍妍, 王武, 孙宏亮, 等. 结直肠癌256层CT全肿瘤灌注与肿瘤血管生成间关系[J]. 实用放射学杂志, 2012, 28(9):1371-1375.
23. 吴俊本. 螺旋CT灌注成像与直肠癌肿瘤血管生成的相关性研究[D]. 青岛:青岛大学, 2008.
24. 李颖嘉, 文戈, 叶长生. 乳腺良恶性肿瘤血管生成形态学变化特征的研究[J]. 中国临床医学影像杂志, 2009, 20(9):681-684.
25. Bian XW, Jiang XF, Chen JH, et al. Increased angiogenic capabilities of endothelial cells from microvessels of malignant human gliomas[J]. Int Immunopharmacol, 2006, 6(1):90-99.

West China Medical Journal

An Initial Study of Tumor-vessel Signs in Malignant Change of Tubulovillous Adenoma on 64-slice Spiral CT

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