学术论文

      脑胶质瘤1H-MRS胆碱相对值与肿瘤增殖抗原Ki-67表达的关系

      Correlation between Cho/Cr ratio and expression of Ki-67 in brain glioma

      摘要:
      目的:用3.0T多体素1H-MRS分析脑胶质瘤氢质子磁共振波谱表现,探讨低、高级别胶质瘤胆碱相对值(Cho/Cr)与肿瘤增殖抗原Ki-67表达的关系.方法:经病理证实的脑胶质瘤患者57例,其中低级别胶质瘤(Ⅰ、Ⅱ级)28例,高级别胶质瘤(Ⅲ、Ⅳ级)29例;所有患者在术前行3.0T 1H-MRS检查,检测肿瘤实质部分Cho/Cr值,分析Cho/Cr值与胶质瘤病理级别的关系;术后病理切片行Ki-67免疫组织化学染色,测定Ki-67标记指数(Ki-67LI),分析Ki-67LI与胶质瘤病理级别及Cho/Cr值的相关性.结果:①低、高级别胶质瘤肿瘤实质部分Cho/Cr比值差异有统计学意义(P<0.001),脑胶质瘤肿瘤实质部分的Cho/Cr比值与肿瘤级别呈显著正相关(r=0.616,P<0.001).Cho/Cr的ROC曲线下面积为0.856,取Cho/Cr=2.44为阈值鉴别不同级别脑胶质瘤,其敏感性为79.3%,特异性为82.1%.②低级别胶质瘤Ki-67LI为(3.41±2.35)%,高级别胶质瘤Ki-67LI为(19.78±11.45)%,两者差异有统计学意义(Z=-0.617,P<0.001);Ki-67LI与胶质瘤病理级别呈显著正相关(r=0.804,P<0.001),与Cho/Cr值呈显著正相关(r=0.490,P<0.001).结论:脑胶质瘤Cho/Cr值与Ki-67的表达具有相关性,可作为术前无创评价肿瘤细胞增殖活性及恶性程度的影像学指标,有利于临床治疗方案的选择及预后的评估.
      Abstract:
      Objective:To study the 3.0T multivoxel proton magnetic spectroscopy(1H-MRS) findings in brain glioma and to investigate the correlation between Cho/Cr ratio and expression of Ki-67.Methods:Fifty-seven patients of brain gliomas were studied,including 28 cases of low-grade group(grade Ⅰ ~Ⅱ),29 cases of high-grade group(grade Ⅲ~Ⅳ).All of them under went 3.0T 1H-MRS examination before operation.The Cho/Cr ratios were detected.We analyzed the correlation between Cho/ Cr ratio and pathological grade of gliomas.Ki-67 immunohistochemical staining and Ki-67 labeling index(Ki-67LI) were mea sured after operation.We also analyzed the correlation between Ki-67LI and the pathological grade,the Cho/Cr ratio of gliomas.Results:①Significant differences were found in the ratios of Cho/Cr between low grade gliomas and high grade gliomas (P<0.001).The ratio of Cho/Cr was positively correlated with the tumor grade (r=0.616,P<0.001).The area under the curve(AUC) of Cho/Cr was 0.856.The threshold value of Cho/Cr ratio for differential diagnosis high grade and low grade brain gliomas was 2.44,the sensitivity was 79.3%,the specificity was 82.1%.②Ki-67LI of low grade glioma was (3.41±2.35)%,Ki-67LI of high grade glioma was (19.78±11.45)%,the difference was statistically significant(Z=-0.617,P<0.001).The Ki-67LI was positively correlated with the tumor grade and the Cho/Cr ratio (r=0.804,P<0.001).Conclusion:The Cho/Cr ratios of gliomas are correlated with the expression of Ki-67.It may be a useful image index,which can evaluate the proliferation activity and malignancy degree of glioma,without invasion.And it may be helpful in the clinical treatment and prognosis assessment.
      作者: 胡丽娟 廖凯兵
      Author: HU Li-juan LIAO Kai-bing
      作者单位: 湖北省中西医结合医院放射科,湖北武汉,430015
      刊 名: 中国临床医学影像杂志 ISTICPKU
      年,卷(期): 2017, 28(3)
      分类号: R739.4 R730.264 R445.2
      在线出版日期: 2017年4月12日