胶质瘤及瘤周^1HMRS与肿瘤细胞增殖活性分析

Correlation of ^1HMRS imaging and proliferative activity in the tumor and peritumoral zone of gliomas.

目的运用氢质子磁共振波谱(1HMRS)成像技术评估波谱代谢物比值与胶质瘤瘤体及瘤周水肿带病理的相关性。方法前瞻性对11例幕上可疑胶质瘤患者术前行常规MR检查及波谱分析,免疫组化K i-67标记术后瘤体及瘤周标本以检测具增殖活性的肿瘤细胞。结果胶质瘤瘤体和瘤周水肿带NAA/Cr、Cho/Cr、Cho/NAA比值以及瘤周水肿带与正常脑组织Cho/NAA差异有统计学意义(P<0.01),瘤周水肿带与正常脑组织NAA/C、rCho/Cr比值差异有统计学意义(P<0.05);胶质瘤瘤体及瘤周水肿带具增殖活性的肿瘤细胞密度分别为14.34%±6.26%、7.92%±2.08%,两者比较差异有统计学意义(P<0.01);瘤体及瘤周水肿带Cho/NAA比值与肿瘤细胞增殖活性显著正相关,相关系数分别为(r=0.680,P=0.021)、(r=0.649,P=0.031),而NAA/C、rCho/Cr比值与肿瘤细胞增殖活性无明显相关。结论胶质瘤波谱代谢物Cho/NAA比值与肿瘤细胞增殖活性显著正相关,1HMRS具有评价胶质瘤生物学行为的潜能。

Objective To evaluate the correlation between the metabolic ratios of magnetic resonance spectral imaging and the pathology from the centre and peritumoral edema zone of the gliomas. Methods Eleven cases of consecutive patients with suspected supratentorial hemispheric gliomas underwent conventional MRI exam and spectral analysis before surgical operation and the glioma specimens were stained with hematoxylin - eosin and monoclonal antibodies against Ki - 67 to detect the tumor cell proliferative activity after surgical operation. Results The differences in the NAA/Cr,Cho/Cr and Cho/NAA ratios between the tumor centre and peritumoral edema zone were significant and so was the difference in the Cho/ NAA ratio between the normal brain tissue and the peritumoral edema zone （P 〈 0. 01 ） In addition, there were significant differences in the NAA/Cr and Cho/Cr ratios between the normal brain tissue and the peritumoral edema zone （ P 〈 0. 05 ）. The proliferative active tumor cell density was significantly higher in the tumor centre than in the peritumoral edema zone （ 14. 336 ±6. 259% vs 7. 923 ±2. 075% ） （P 〈0. 01 ）. The Cho/NAA ratio was significantly and positively correlated with the proliferative activity in both tumor centre and peritumoral edema zone [ （ r = 0. 680, P = 0. 021 ）, （ r = 0. 649, P = 0. 031 ） , respectively]. The ratios of NAA/Cr and Cho/Cr ratio were not correlated with the tumor cell proliferative activity. Conclusions The spectral metabolic ratio of Cho/NAA of glioma is significantly and positively with the tumor cell proliferative activity and ^1HMRS may have the potential to evaluate the biological behavior of glioma.