脑胶质瘤的MRI影像表现及其与IL-17、IL-24、VEGF、GFAP的相关性研究

MRI findings of gliomas and their correlation with IL-17,IL-24,VEGF and GFAP

目的探讨脑胶质瘤的MRI影像表现及其与脑胶质瘤组织中白细胞介素-17(IL-17)、白细胞介素-24(IL-24)、血管内皮生长因子(VEGF)、胶质纤维酸性蛋白(GFAP)阳性表达的相关性。方法回顾性分析我院神经外科68例经手术病理证实为脑胶质瘤患者的临床资料并将其纳入研究组,以79例因脑出血行开颅手术患者为对照组。分析研究组患者的MRI影像表现并通过HE染色、免疫组化SP法检测2组患者中IL-17、IL-24、VEGF、GFAP表达的差异性,应用Speraman等级相关分析IL-17、IL-24、VEGF、GFAP表达与MRI表现的关系。结果脑胶质瘤位于大脑半球者65例(95.59%),脑胶质瘤位于小脑半球者3例(4.41%)。66例(97.06%)表现为T1WI低、T2WI混杂信号伴周围中—重度水肿,2例(2.94%)表现为T1WI稍高、T2WI混杂信号;肿瘤内出血31例(45.58%),无出血37例(54.42%);2例(2.94%)表现为轻度水肿,2例(2.94%)表现为中度水肿,64例(94.12%)表现为重度水肿;44例(64.71%)脑胶质瘤内见流空血管影,脑胶质瘤生长速度快,瘤体均较大,最大截面为0.7 cm×1.2 cm~10.3 cm×9.6 cm,形态不规则。DWI呈弥散受限改变66例(97.06%),无弥散受限2例(2.94%);增强扫描后均匀强化59例(86.76%),不均匀9例(13.24%);59例(86.76%)呈花环状或花瓣状明显强化,环壁部分呈栅栏状,9例(13.24%)呈轻度结节状强化。IL-17、VEGF在对照组中不表达,研究组IL-17、VEGF表达阳性率高于对照组,IL-24、GFAP表达阳性率低于对照组,差异均有统计学意义(P<0.05)。Speraman等级相关分析显示,IL-24、GFAP表达阳性率随脑胶质瘤分级升高呈下降趋势,呈显著负相关(r=-0.711、-0.577,P<0.05);IL-17、VEGF表达阳性率随脑胶质瘤分级升高呈上升趋势,以Ⅳ型胶质瘤表达最高,呈显著正相关(r=0.670、0.614,P<0.05)。结论脑胶质瘤MRI表现具有瘤体大、累及脑叶多、形态不规则,信号不均匀,水肿明显的特点,肿瘤组织中IL-17、IL-24、VEGF、GFAP的阳性表达能够反映脑胶质瘤分级程度。

Objective To investigate the MRI features of gliomas and their correlation with the expression of IL-17,IL-24,VEGF and GFAP in gliomas.Methods The clinical data of 68 patients with brain glioma confirmed by surgery and pathology in neurosurgery department of our hospital were retrospectively analyzed and regarded as the study group,and 79 patients who underwent craniotomy for cerebral hemorrhage were regarded as the control group.MRI imaging findings of the study group were analyzed.The differences in the expression of IL-17,IL-24,VEGF and GFAP between the two groups were detected by HE staining and immunohistochemical SP method.The relationship between the expression of IL-17,IL-24,VEGF,GFAP and MRI performance was analyzed by Spearman rank correlation analysis.ResultsSixty-five cases(95.59%)of gliomas located in cerebral hemisphere and 3 cases(4.41%)in cerebellar hemisphere.The MRI of 66 cases(97.06%)showed low signal on T1WI,mixed signal on T2WI with moderate to severe peripheral edema,and the MRI of 2 cases(2.94%)showed slightly high signal on T1WI,mixed signal on T2WI.There were 31 cases(45.58%)of internal bleeding and 37 cases(54.42%)of no bleeding.There were 2 cases(2.94%)with mild edema,2 cases(2.94%)with moderate edema,and 64 cases(94.12%)with severe edema.Forty-four cases(64.71%)had flow void shadow in glioma,of whom the gliomas grew rapidly and were large in size,with the maximum cross section of gliomas ranged from 0.7 cm×1.2 cm to 10.3 cm×9.6 cm,and the morphology was irregular.There were 66 cases(97.06%)with limited change,2 cases(2.94%)without diffusion limitation on DWI;59 cases(86.76%)with homogeneous enhancement,9 cases(13.24%)with inhomogeneous enhancement;59 cases(86.76%)with obvious flower ring or petal enhancement,palisade ring wall,and 9 cases(13.24%)with mild nodular enhancement.IL-17 and VEGF were not expressed in the control group,and the positive rates of IL-24 and GFAP in the study group were lower than those in the control group,the positive rates of IL-17 and VEGF expression in the study group were higher than those in the control group,with significant differences(P<0.05).Spearman rank correlation analysis showed that the positive rates of IL-24 and GFAP expression decreased with the increase of glioma grade,with a significantly negative correlation(r=-0.711,-0.577,P<0.05),and the positive rates of IL-17 and VEGF increased with the increase of glioma grade,the highest expression was found in typeⅣglima with a significant positive correlation(r=0.670,0.614,P<0.05).Conclusion The MRI features of gliomas are large size,involving many lobes,irregular shape,uneven signal and obvious edema,and the positive expression of IL-17,IL-24,VEGF and GFAP in tumor tissue can reflect the grade of gliomas.