动态增强MRI定量参数与鼻咽癌乏氧、血管生成病理指标的相关性分析

A correlation study between DCE-MRI quantitative parameters and immunohistochemical labeling indices for hypoxia and angiogenesis in nasopharyngeal carcinoma

目的探讨鼻咽癌动态增强MRI定量参数容量转移常数(K^trans)、速率常数(K ep)、血浆容积分数(V p)、血管外细胞外间隙的容量分数(V e)值与原发灶组织乏氧和血管生成病理指标的相关性。方法选取68例鼻咽癌初诊患者进行鼻咽部DCE-MRI检查,通过图像后处理得出定量参数K^trans、K ep、V p、V e值。所有患者在MRI检查后2周内行纤维鼻咽镜在肿块最明显处取出活检病理结果,病理标本采用免疫组化分析计数微血管密度(MVD)、血管内皮生长因子(VEGF)、乏氧诱导因子1α(HIF-1α)表达。以上相关性应用Spearman’s等级相关分析。结果鼻咽癌原发灶DCE-MRI参数K^trans分别与MVD、VEGF、HIF-1α表达呈正相关(P<0.05),相关系数分别为:K^trans与MVD(γ=0.652)、K trans与VEGF(γ=0.551)、K^trans与HIF-1α(γ=0.469);定量参数K ep与MVD、VEGF、HIF-1α表达呈正相关(P<0.05),相关系数分别为:K ep与MVD(γ=0.441)、K ep与VEGF(γ=0.365)、K ep与HIF-1α(γ=0.485);定量参数V p与MVD、VEGF呈正相关(P<0.05),相关系数分别为:V p与MVD(γ=0.366)、V p与VEGF(γ=0.362)。然而定量参数V e与以上病理指标无统计学相关性。结论可根据鼻咽癌原发灶DCE-MRI定量对肿瘤乏氧状态、血管生成、灌注等微循环状态进行有效评估。

Objective To investigate the relationship between the dynamic enhanced magnetic resonance(DCE-MRI)quantitative parameters K trans,K ep,V p,V e and pathological indicators,which reflect tumor hypoxia,tumor angiogenesis in NPC.Methods Continuous sixty-eight patients with NPC received DCE-MRI and nasopharyngeal biopsy before treatment.We investigated quantitative kinetic parameters(K trans,K ep,V e and V p)by using DCE-Tool based on extended Tofts’model.HIF-1α,VEGF expression and MVD expressions were detected by immunohistochemistry(IHC)staining.Finally,the correlations were analyzed by Spearman’s rank coefficient analysis.A P value<0.05 was considered statistically significant.Results K trans was positively associated with MVD,VEGF positive expression and HIF-1αpositive expression respectively(γ=0.652,γ=0.551,γ=0.469;P<0.05).K ep was positively associated with MVD count,VEGF positive expression and HIF-1αpositive expression respectively(γ=0.441,γ=0.365,γ=0.485;P<0.05).There were significantly positive correlations between vp and the MVD count,VEGF expression respectively(γ=0.366,γ=0.362;P<0.05).However,there was no significant relationship between V e and any immunohistochemical labeling indices in our study.Conclusion According to DCE-MRI quantitative parameters of nasopharyngeal carcinoma,tumor hypoxia and tumor angiogenesis perfusion of microcirculation status can be effectively evaluated noninvasively.