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

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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。

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	胡丽娟
	廖凯兵

关键词 ：神经胶质瘤, Ki-67抗原, 磁共振成像

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 underwent 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 measured 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.

Key words： Glioma Ki-67 antigen Magnetic resonance imaging

收稿日期: 2016-05-09

PACS:	Ｒ739.4
	Ｒ730.264
	Ｒ445.2

通讯作者: 胡丽娟，湖北省中西医结合医院放射科，430015。E-mail：aloe_hlj@126.com

作者简介: 胡丽娟（1981-），女，湖北鄂州人，主治医师。E-mail：aloe_hlj@126.com

引用本文:

胡丽娟，廖凯兵. 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[J]. 中国临床医学影像杂志, 2017, 28(3): 153-156.
HU Li-juan, LIAO Kai-bing. Correlation between Cho/Cr ratio and expression of Ki-67 in brain glioma. JOURNAL OF CHINA MEDICAL IMAGING, 2017, 28(3): 153-156.

链接本文:

http://www.jccmi.com.cn/CN/ 或 http://www.jccmi.com.cn/CN/Y2017/V28/I3/153

[1]Ostrom QT, Gittleman H, Farah P, et al. CBTRUS statistical report: Primary brain and central nervous system tumors diagnosed in the United States in 2006-2010[J]. Neurooncology, 2013, 15(Suppl 2): ii1-56.
[2]梅莉，郑建刚，许建兴，等. 多体素1H磁共振波谱在胶质瘤诊断中的价值[J]. 南京医科大学学报，2009，29（8）：1169-1171.
[3]Terzi A, Saglam EA, Barak A, et al. The significance of immunohistochemical expression of Ki-67, p53, p21, and p16 in meningiomas tissue arrays[J]. Pathol Res Pract, 2008, 204(5)： 305-314.
[4]贺丹，杨丽，朱青峰，等. 1H-MRS在颅内胶质瘤分级中的应用价值[J]. 中国临床医学影像杂志，2011，22（2）：77-82.
[5]姜亮，刘文，肖朝勇，等. 探讨联合应用MRS和DWI在脑胶质瘤分级中的诊断价值[J]. 临床放射学杂志，2015，34（4）：514-519.
[6]Weybright P, Maly P, Gomez-Hassan D, et al. MR spectroscopy in the evaluation of recurrent contrast-enhancing lesions in the posterior fossa after tumor treatment[J]. Neuroradiology, 2004, 46(7): 541-549.
[7]项威，陈东，胡继良，等. 联合应用MRS及DWI对胶质瘤及侵袭性进行临床评估[J]. 中国微侵袭神经外科杂志，2014，19（6）：241-244.
[8]楼晓剑，蒋定尧，倪丽欣，等. 脑星形细胞瘤3T MRI 3D多体素1H-MRS术前分级及病理对照研究[J]. 中国CT和MRI杂志，2015，13（11）：16-20.
[9]Zeng Q, Liu H, Zhang K, et al． Noninvasive evaluation of cerebral glioma grade by using multivoxel 3D proton MＲ spectroscopy[J]． Magn Ｒeson Imaging, 2011, 29(1): 25-31.
[10]Brodzki A, Lopuszyński W, Brodzki P, et al. Diagnostic and prognostic value of cellular proliferation assessment with Ki-67 protein in dogs suffering from benign and malignant perianal tumors[J]. Folia Biol(Krakow), 2014, 62(3): 235-241.
[11]Wykosky J, Fenton T, Furnari F, et al. Therapeutic targeting of epidermal growth factor receptor in human cancer: successes and limitations[J]. Chin J Cancer, 2011, 30(1): 5-12.
[12]Kayaselcuk F, Zorludemir S, Gumurduhu D, et al. PCNA and Ki-67 in central nervous system tumors: correlation with the histological type and grade[J]. Neurooncology, 2002, 57(2): 115-121.
[13]Yamashita Y, Kasugai I, Sato M, et al. CDC25A mRNA levels significantly correlate with Ki-67 expression in human glioma samples[J]. J Neurooncol, 2010, 100(1): 43-49.
[14]Qu DW, Xu HS, Han XJ, et al. Expression of Cyclin D1 and Ki-67 proteins in gliomas and its clinical significance[J]. Eur Rev Med Pharmacol Sci, 2014, 18(4): 516-519.
[15]Shimizu H, Kumabe T, Shirane R, et al. Correlation between choline level measured by proton MR spectroscopy and Ki-67 labeling index in gliomas[J]. AJNR, 2000, 21(4): 659-665.
[16]Tamiya T, Kinoshita K, Ono Y, et al. Proton magnetic resonance spectroscopy reflects cellular proliferative activity in astrocytomas[J]. Neuroradiology, 2000, 42(5): 333-338.