核磁共振波谱在肿瘤诊疗中的应用研究进展

Progress in Nuclear Magnetic Resonance Spectroscopy for Early Cancer Diagnosis

在介绍肿瘤样品代谢物的核磁共振波谱技术的研究方法的基础上,从离体组织和活体组织两个方面综述核磁共振波谱(NMR)在诊断肿瘤方面的应用进展,分析了它在肿瘤诊疗中的应用前景。在离体组织方面,人们通过1H和31P-NMR谱观测病人的体液样品、培养的细胞、切除的组织等来研究脂质、磷脂等代谢物的分布,观测肿瘤与对照组织之间的差别。其中利用组织提取物的方法能够得到分辨率较高的图谱,非常适合应用于肿瘤诊断和治疗方法的研究。高分辨魔角旋转(HR-MAS)的方法在肿瘤诊断研究方面展现出新的生命力,利用高分辨魔角旋转技术可以直接得到组织细胞中很多分子水平的代谢物结构和组成信息,因此它在癌症的早期诊断中具有很好的前景。在活体核磁共振波谱诊断肿瘤方面,主要应用1H和31P核磁共振波谱,结合MRI为非侵入性肿瘤分析提供了一种临床可用的方法。MRI与MRS技术的结合将使核磁共振波谱在医学领域有更大的应用空间。

Based on more than 100 references, the present paper reviews the progress in the application of nuclear magnetic resonance （NMR） spectroscopy, an effective method to study the variation in chemical composition and molecular structure in biological samples for early diagnosis of cancer at molecular level. In the past several decades, numerous works have demonstrated that NMR spectroscopy may be developed into a sensitive diagnosis method to detect cancer in early stage. Because of the rapid development of NMR spectroscopic techniques, it becomes possible to record NMR spectra of biological samples in both in-vitro and in-vivo manner. Systematic spectral differences between biological samples from cancer patients and normal controls can be observed from both liquid-state and solid-state ^1H, ^31P NMR spectra and used to reflect the changes in metabolic behavior of malignant tissues. This paper has summarized NMR spectroscopic investigation on biological fluid, cultured cancerous cells, resected tissues, as well as in-vivo malignant tissues by using various advanced NMR techniques including recently developed high-resolution magic angle spinning （HR-MAS）and magnetic resonance spectroscopy and imaging （MRSI） methods. First, characteristic peaks, which are related to choline, phosphocholine （PC） and glycerophosphocholine, can be observed in both ^1H and ^31P NMR spectra of biological fluid samples from cancer patients. These results indicate that alternation in the metabolic pattern occurs with the progression of cancer. The research on cultured cells by using NMR spectroscopy showed that the signal of various phospholipids and their metabolites such as PME increased significantly in cultured cancer cells. For resected tissues, two methods can be utilized. The first one is to investigate the tissues directly by using HR-MAS spectroscopy. The second method is to extract various metabolites with various solvents such as CHCl3/methonal mixtures, HClO4 solutions, etc. and then analysis of the extracted solutions is performed using conventional liquid NMR spectroscopy. Significant differences on the content of various amino acids, metabolites of phospholipids, can be observed between malignant tissues and normal controls in NMR spectra. Recently, MRSI that can acquire ^1H-NMR spectra of suspected tissues during the process of MRI diagnosis is available. The approach makes it possible for the surgeons to judge whether the suspected tissues are malignant or not before surgical operation. The above results demonstrate that NMR spectroscopy possesses bright perspective in diagnosing cancers and differentiating different types of cancers based on the metabolic behavior of cancerous tissues.