磁共振扩散加权成像监测恩度与贝伐单抗抗肿瘤血管生成的实验研究  

Monitoring the effect of anti-angiogenic drugs by MR diffusion weighted imaging：an experimental study

作　　者：史红媛[1] 田迎[1] 罗松[1] 朱飞鹏[1] 王守巨[1] 金利新 王建东[3] 卢光明[1] 

机构地区：[1]南京军区南京总医院医学影像科,江苏南京210002 [2]西门子医疗,江苏南京210002 [3]南京军区南京总医院病理科,江苏南京210002

出　　处：《实用放射学杂志》2012年第4期612-617,共6页Journal of Practical Radiology

摘　　要：目的 评价磁共振扩散加权成像（diffusion weighted imaging,DWI）早期监测抗肿瘤血管生成药物疗效的可行性.方法 将20只荷人肺腺癌裸鼠随机分为3组,对照组和恩度（Endostar）组各7只,联合贝伐单抗（Bevacizumab,Avastin）组6只.治疗第3天对照组和恩度组行DWI成像并测量ADC值,采用t检验比较2组ADC值.扫描完成后每组各取1只裸鼠肿瘤组织行透射电镜观察.治疗第10天3组均行DWI成像,采用方差分析比较各组的ADC值.扫描完成后剖取肿瘤组织行病理学检查.结果 治疗第3天,恩度组的ADC值明显高于对照组,两者差异有统计学意义（t=-5.505,P〈0.01）,此时2组肿瘤体积没有明显差异.透射电镜结果显示恩度组肿瘤组织内部分细胞发生变性,并出现凋亡现象.治疗第10天恩度组和联合贝伐单抗组的ADC值均高于对照组（P值分别为0.018和0.001）,联合贝伐单抗组ADC值高于恩度组,差异没有统计学意义（P=0.211）.此时恩度组和联合贝伐单抗组肿瘤体积均小于对照组,差异有统计学意义（P值分别为0.000和0.003）,联合贝伐单抗组体积小于恩度组,差异无统计学意义（P=0.100）.病理学HE染色显示恩度组可见少部分坏死区域,联合贝伐单抗组的坏死区域范围较大.免疫组化结果显示对照组、恩度组及联合贝伐单抗组肿瘤组织MVD值和VEGF的表达均呈下降趋势,其中MVD值两两之间差异均有统计学意义（P〈0.05）,各组间VEGF差异无统计学意义（χ2=3.455,P=0.178）.结论 DWI成像能够提供肿瘤组织的微观结构和水分子扩散信息,可以无创地早期监测给予抗肿瘤血管生成药物后肿瘤微环境的变化.Objeetive To evaluate the feasibility of MR diffusion weighted imaging （1）WI） in monitoring the effect of anti-anglo genic drugs. Methods 20 nude mice hearing human lung carcinoma A549 were randomly divided into 3 groups： control group（group A,n 7） ,Endostar group（group B,n 7）and Endostar combined with Bevacizumab（Awlstin） group （group C,n=6）. DWI was per formed at day3 after the treatment and apparent diffusion coefficient（ADC） values measured. ADC values were statistically analyzed and compared with t test. Thereafter two tumors respectively in group A and group C were collected and observed for the electron microscope. At day 10 after treatment all the mice underwent DWI. ADC values were statistically analyzed and compared with （）ne- Way AN（）VA. Then tumors were collected for pathological examination. Results At day 3 after starting therapy, ADC wdues in group 13 were significantly higher than that in group A, and there were siginificant differences between them（t= -5.505,P〈0.01）. There was no difference in tumor volumes between groups at this time. A part of A549 cells degenerated and was in apoptotic cell death showed by the electron microscope. At day 10 after treatment, ADC values in group 13 and group C were all higher than that in group A. LSD test showed that ADC values in group Band groupC were higher than that in group A（P values were0.018 and 0.001,respectively）,hut there were no statistical differences between groupBandgroupC（P--0.211）. The tumor volumes in group 13 and group C were smaller than that in group A（P values were 0. 000 and 0. 003,respectively）,but there were no stalistical differ ences hetween group Band group C（P =0. 100）. The hematoxylin and eosin （HE） staining of the tumors showed a small amount necrotic tumor tissues in group B,and large sheet of necrotic zones in group C. The resuhs of immunohistochemisty demonstrated that microvessel densily（MVI）） and wlscular endothelial growth factor（Vg（;F） had downtrend i

关 键 词：磁共振成像 恩度 贝伐单抗 肺癌 小鼠 实验 

分 类 号：R445.2[医药卫生—影像医学与核医学] R734.2[医药卫生—诊断学]