摘要
目的探讨多模态磁共振成像与胶质母细胞瘤(glioblastoma, GBM)中组织因子(tissue factor, TF)表达水平的相关性及其作为TF影像学标志物的价值。方法回顾性分析本院2014年8月至2018年11月经手术治疗并取得病理证实的60例GBM患者的术前常规及功能磁共振成像资料,经后处理得到各参数(包括坏死比、表面规律性、强化区域体积、水肿区域体积及容量转移常数K^trans、相对脑血容量rCBV、相对脑血流量rCBF)。肿瘤组织经TF免疫组化染色后统计其表达量,分析各参数与TF表达量的相关性,应用ROC曲线分析获得鉴别TF高表达和低表达GBM的各影像学参数的最佳阈值及其敏感度和特异性。结果坏死比、K^trans值、rCBV值、rCBF值与TF表达量呈正相关(r=0.665,r=0.631,r=0.661,r=0.619,P值均<0.001)。TF高表达组的坏死比、K^trans、rCBV、rCBF均显著高于低表达组(P<0.01)。ROC曲线分析各参数均能很好反映TF的表达,rCBF的AUC达到0.907(0.889,0.857),坏死比的AUC为0.869(0.846,0.676),K^trans的AUC为0.854(0.813,0.833),rCBV的AUC为0.804(0.944,0.571)。常规磁共振与灌注磁共振参数联合运用对TF表达量反映能力更好,坏死比联合K^trans 的AUC为0.982(1,0.875),坏死比联合rCBV的AUC为0.939(0.889,0.905),坏死比联合rCBF的AUC为0.971(0.944,0.857)。结论多种磁共振参数(坏死比、K^trans、rCBV及rCBF)能够较好地反映GBM患者肿瘤内TF的表达,可作为GBM中TF表达量的MRI影像学标志物。
Objective To explore the correlation between multimodal magnetic resonance imaging(MRI) and expression of tissue factor(TF) in glioblastoma(GBM), and investigate the values of MRI parameters as imaging markers for TF. Methods The preoperative routine and functional MRI data of 60 patients with GBM confirmed by surgery and pathology in our hospital from August 2014 to November 2018 were retrospectively collected and analyzed for the parameters, including necrosis ratio, surface regularity, enhanced area volume, edema area volume, volume transfer constant K^trans, relative cerebral blood volume(rCBV) and relative cerebral blood flow(rCBF) by post-processing. The expression of TF in the GBM tissue was detected with immunohistochemical staining, and then the correlation between above each parameter and TF expression was analyzed. Receiver operating characteristic(ROC) curve analysis was used to obtain the optimal threshold values, sensitivity and specificity of various imaging parameters in differentiation between GBM with TF of high expression and of low expression. Results The necrosis ratio, and K^trans, rCBV and rCBF values were positively correlated with TF expression level(r=0.665, r=0.631, r=0.661, r=0.619, all P<0.001). The necrosis ratio and K^trans, rCBV and rCBF values were significantly higher in the highly-expressed TF group than the lowly-expressed TF group(P<0.01). ROC analysis showed that all these MRI parameters presented TF level well, with area under curve(AUC) of rCBF reaching 0.907(0.889, 0.857), that of necrosis ratio 0.869(0.846, 0.676), that of K^trans 0.854(0.813, 0.833), and that of rCBV 0.804(0.944, 0.571). The combination of conventional magnetic resonance and perfusion magnetic resonance parameters showed even better presention for TF expression level, with the AUC of necrosis ratio combined with K^trans 0.982(1, 0.875), necrosis ratio with rCBV 0.939(0.889, 0.905), and necrosis ratio with rCBF 0.971(0.944, 0.857). Conclusion Various magnetic resonance parameters(necrosis ratio, K^trans, rCBV and rCBF) can better reflect TF expression in GBM patients, and can be used as imaging markers for TF expression in GBM.
作者
周波
童海鹏
陈晓
薛巍
徐凯
张伟国
ZHOU Bo;TONG Haipeng;CHEN Xiao;XUE Wei;XU Kai;ZHANG Weiguo(Department of Radiology,Daping Hospital,Army Medical University(Third Military Medical University),Chon旳ing,400042,China)
出处
《第三军医大学学报》
CAS
CSCD
北大核心
2020年第3期307-313,共7页
Journal of Third Military Medical University
基金
国家自然科学基金面上项目(81571660,81871421)
重庆市影像医学与核医学临床医学研究中心(CSTC2015YFPT-gcjsyjzx0175)~~
