摘要
目的 探讨星形细胞瘤质子MR波谱（1H-MRS）表现与肿瘤增殖潜力的相关性。方法术前进行MRI和1H-MRS检查且经手术病理证实的34例星形细胞瘤患者，其中Ⅰ、Ⅱ级（低级别）26例，Ⅲ、Ⅳ级（高级别）8例。34例星形细胞瘤患者中有21例（低级别17例，高级别4例）为均质性肿瘤。增殖细胞核抗原（PCNA）免疫组织化学染色，研究PCNA在高、低级别星形细胞瘤中的表达水平，并与星形细胞瘤1H-MRS的胆碱（Cho）／N-乙酰天冬氨酸（NAA）、Cho／肌酸和磷酸肌酸（Cr）相比较，明确两者间的关系。结果 21例均质性肿瘤中，高级别星形细胞瘤的Cho／NAA、Cho／Cr（中位数分别为4．895、4．845）比低级别（中位数分别为2．920、2．000）明显升高（Z：-2．597，P=0．009；Z=-2．687，P=0．007）；且Cho／NAA、Cho／Cr与PCNA的表达[吸光度（A）值中位数7．880]呈明显正相关（r=0．607，P=0．003；r=0．457，P=0．038）。但全部34例星形细胞瘤中高、低级别Cho／NAA（中位数分别为3．965、2．890）、Cho／Cr（分别为3．080、1．960）的差异无统计学意义；Cho／NAA、Cho／Cr的比值与PCNA的表达（A值中位数为8．100）不相关（r=0．060，P=0．738；r=0．125，P=0．480）。结论 运用1H-MRS检测均质性星形细胞瘤中Cho的含量对于术前活体预测星形细胞瘤的恶性程度很有价值，从而能间接判断星形细胞瘤的某些生物学行为及预后。
Objective To investigate the relationship between findings of proton magnetic resonance spectroscopy （1H-MBS） and tumor proliferative potential in patents with astrocytoma. Methods Thirty four patients of astrocytoruss proved by surgery and pathology were examined by MRI and I H-MRS, among them 26 were of grade Ⅰ or Ⅱ （ low grade） and 8 of grade Ⅲ or Ⅳ （ high grade） . Twenty one cases of astrocytomas （17 low-grade and 4 high grade respectively ） were homogeneous type. Expression of proliferating cell nuclear antigen （ PCNA ） was detected by immunohistochemical method of streptavidinbiotin-peroxidase （SP）. Results The Cho/NAA and Cho/Cr ratios of high-grade astrocytomas（M =4. 895, 4.845 respectively） were significantly higher than those of low-grade astrocytomas （M = 2. 920, 2. 000 respectively） in the 21 homogeneous astrocytomas （ Z = - 2. 597, P = 0. 009 ; Z = - 2. 687, P = 0. 007 respectively）, and the ratios were found to be significantly correlated to the expression of PCNA（A = 7. 880 ） （ r = 0. 607, P = 0. 003 ; r = 0. 457, P = 0. 038 respectively）. However, the differences of Cho/NAA, Cho/Cr ratios between the high-grade and low-grade astrocytomas were not significant when 34 cases were included, and no relationship was found between Cho/NAA（ M = 3. 965,2. 890 respectively） ,Cho/Cr （ M = 3.080,1. 960 respectively） ratios and the expression of PCNA （ A = 8. 100 ） （ r = 0. 060, P = 0. 738 ; r = 0. 125, P = 0. 480 respectively）. Conclusion By measuring the Cho/NAA and Cho/Cr ratios, l H-MRS may be a valuable method for presurgical in invo prediction of the malignant degree, tumor proliferative potential and prognosis of homogeneous-type astrocytomas.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2007年第4期348-351,共4页
Chinese Journal of Radiology
关键词
磁共振波谱学
星形细胞瘤
增殖细胞核抗原
免疫组织化学
Magnetic resonance spectroscopy
Astrocytoma
Proliferating cell nuclear antigen
Immunohistochemistry
