Correlation of lymph node metastasis with CT perfusion parameters and angiogenesis in esophageal squamous cell carcinoma

Objective:To evaluate the relationship of lymph node metastasis with CT perfusion parameters and angiogenesis in esophageal squamous cell carcinoma.Methods:Multi-detector row spiral CT(MDCT) perfusion was performed in 50 patients with esophageal carcinoma.The micro-vascular density(MVD) and VEGF expression were examined by means of SP immuno-histochemical technique.The correlation of lymph node metastasis with CT perfusion parameters,including blood volume(BV),blood flow(BF),mean transit time(MTT),surface permeability(PS),MVD and VEGF expression were analyzed.Results:The BF,BV and MTT values of esophageal squamous cell carcinoma with and without lymph node metastasis were(128.81±50.05)ml/(100g·min),(7.64±3.11) ml/100g,(5.62±1.97)s and(105.55±43.18)ml/(100g·min),(6.33±1.71)ml/100g,(7.16±3.32)s respectively,with no significant statistical differences(P0.05).Significant difference of the PS value [(18.32±5.39) vs(9.66±2.46)ml/(100g·min)] was found between patients with or without lymph node metastasis(P0.01).Taking PS value(10ml/100g·min) as the threshold for the diagnosis of lymph node metastasis,the sensitivity,specificity,positive and negative likelihood ratio were 95.8%,65.4%,2.77 and 0.06 respectively.The lymph node metastasis showed positive correlation to MVD and VEGF expression with r values as 0.752 and 0.384 respectively(P0.01).Conclusion:CT perfusion imaging is helpful for the preoperative diagnosis of lymph node metastasis in esophageal squamous cell carcinoma,and PS value is the most valuable diagnostic index.