摘要
目的探讨多发性骨髓瘤(MM)MRI骨髓浸润模式与血管生成的相关性。方法以25例初诊MM患者为研究对象,进行传统影像学、血清肌酐、血清蛋白、β2微球蛋白、乳酸脱氢酶等检测,并根据Durie-Salmon分期系统进行分期。对骨髓瘤患者在初诊及治疗之前行脊柱T1WI、STIR和常规的T1WI增强扫描,分析骨髓瘤细胞在骨髓内的浸润模式。对照组包括非恶性血液病患者10例,其骨髓涂片及活检检查均证实为正常骨髓象。对研究组和对照组患者均进行骨髓活检及病理检查,免疫组化测定微血管密度(MVD),以CD34单抗标记微血管内皮细胞。另外,采集骨髓后分离上层血浆,采用ELISA法测定VEGF蛋白浓度,对结果进行统计学分析。结果初治MM患者骨髓上清血管内皮生长因子(VGEF)水平及MVD高于健康对照组(P<0.05)。MRI骨髓弥漫性浸润的MM患者骨髓上清VGEF水平及MVD高于MRI骨髓成像正常或局灶性浸润的患者(P<0.05)。结论 MRI骨髓弥漫性浸润模式与血管生成密切相关。
Objective To investigate the relationship of bone marrow infiltration MRI patterns with bone marrow angiogenesis in patients with multiple myeloma（MM）. Methods Twenty-five newly diagnosed MM patients were enrolled in this study. The levels of serum creatinine, albumin, β2-micoglobulin, lactate dehydrogenase and traditional imaging were routinely detected. Dufie-Salmon staging system was applied for staging. The presence of bone marrow infiltration was documented with conventional skeletal surveys. Spinal marrow were examined by MR imaging. Tl-weighted images （T1WI）, short TI inversion recovery （STIR） and enhanced T1WI were performed to analyze the bone marrow infiltration patterns. Ten patients with non-malignant hematological diseases were enrolled in control group, whose bone marrow was proved to be normal by bone marrow smear and biopsy. Patients in study group and control group all underwent bone marrow biopsy and pathological examination, microvessel density （MVD） was detected by immunohistoehemistry, and mierovaseular endothelial cells in the bone marrow biopsies was marked by a human monoelonal antibody against CD34. In addition, an enzyme-linked immunosorbent assay was used for the detection of the serum vascular endothelial growth factor （VEGF）. The results were analyzed statistically. Results The serum levels of VEGF and MVD in bone marrow of patients with newly-diagnosed MM were higher than those in the control group（ P 〈 0. 05 ）. The extent of angiogenesis, as assessed by MVD in bone marrow biopsies and serum levels of VEGF were higher in multiple myeloma patients with diffuse MRI bone marrow pattern than those in patients with normal or focal pattern（ P 〈 0.05 ）. Conclusion Diffuse MRI marrow pattern is correlated with angiogenesis.
出处
《临床医学》
CAS
2014年第4期1-3,共3页
Clinical Medicine
