1H-MRS中Cho/Lip评价肝细胞肝癌血管生成的价值  

Evaluation of the Value of Hepatocellular Carcinoma Angiogenesis by the Peak Area Ratio of Cho /Lip

作　　者：姚瑶[1,2] 郑凯[3] 赵振华[1,2] 王伯胤[1,2] 

机构地区：[1]浙江省绍兴市人民医院 [2]浙江大学绍兴医院,312000 [3]中南大学湘雅医学院,长沙410000

出　　处：《医学研究杂志》2014年第8期75-79,共5页Journal of Medical Research

基　　金：浙江省中医药科技研究基金资助项目(2012ZB157);浙江省医药卫生一般研究计划项目(2011A23025);绍兴市科技局重点项目(2011KYB126)

摘　　要：目的 探讨氢质子磁共振波谱（proton magnetic resonance spectroscopy,1H-MRS）中胆碱（choline,Cho）/脂质（lipid,Lip）峰下面积比与肝细胞肝癌（hepatocellular carcinoma,HCC）血管生成的关系.方法 收集笔者医院临床拟诊为HCC的病例进行前瞻性研究,检查前均未进行任何治疗.先行肝脏常规MRI检查,病灶最大西≥2cm的病例行1 H-MRS检查.将数据传至后处理工作站,剔除谱线不满意的病例后得到57例可用于统计的谱线,记录每个受试者的Cho峰及Lip峰数值,计算出Cho/Lip峰下面积比.病灶行穿刺活检或手术切除,挑选出13例取材较多的标本进行免疫组化检查,检测HCC组织的微血管密度（micro-vascular density,MVD）和血管内皮生长因子（vascular endothelial growth factor,VEGF）表达,VEGF表达用免疫组化分数（immunore-active score,IRS）表示.将1H-MRS技术测得的代谢物指标与病理技术测得的血管参数进行统计学分析.结果 57例HCC病灶组织的Cho/Lip峰下面积比为0.322±0.475,对照组的Cho/Lip峰下面积比为0.238±0.529,病灶组显著高于对照组（P＜0.05）.行免疫组化检查的13例HCC组织的MVD值为46～172,平均MVD值为86,VEGF的平均IRS为5,两者相关性不具有统计学意义（P =0.340,P＞0.05）.MVD与Cho/Lip峰下面积比呈正相关（r=0.719,P=0.006）,而VEGF表达与Cho/Lip峰下面积比的相关性不具有统计学意义（P =0.523,P=0.065）.结论 1H-MRS不仅为HCC的诊断提供较高的临床价值,同时还可动态监测肿瘤血管生成情况.Objective The aim of this study was to explore the correlation about the peak area ratio of choline （Cho） / lipid （Lip）detected by proton magnetic resonance spectroscopy （1H-MRS） and hepatocellular carcinoma （HCC） angiogenesis.Methods A prospective study was performed in the patients of HCC by clinical examination.Conventional MRI method was carried out in all patients before all treatment.All spectra were acquired for the cases that the maximum diameter is more than 2 cm.The test data were transmitted to workstation for reprocessing,and the poor quality cases were eliminated.The peak area of Cho and Lip were measured on the liver spectra of 57 patients.Based on the level of these metabolites,we calculated the peak area ratio of Cho/Lip.We got the tumor tissues by the pathological biopsy or surgical operation for all patients,and selected 13 cases with more tissue samples for the immunohistochemical examination.Immunohistochemical examination was performed to measure the microvascular density （MVD） in HCC and the expression of vascular endothelial growth factor （VEGF） represented by immunoreactive score （IRS）.All these vessel parameters were compared with the results form 1 H-MRS.Results The peak area ratio of Cho/Lip in the experimental group and the control group were 0.322 ± 0.475 and 0.238 ± 0.529,respectively.The peak area ratio of Cho/Lip in the experimental group was significantly higher than that in the control group （P ＜ 0.05）.The MVD of 13 patients ranged from 46 to 172,and the mean of which was 86.The mean of IRS was 5 for all patients.It showed no correlation between MVD and VEGF-expression （P =0.340）.The peak area ratio of Cho/Lip in HCC showed a positive correlation with MVD （r =0.719,P =0.006）.However,there was no significant correlation between the peak area ratio of Cho/Lip and VEGF-expression （P =0.523,P =0.065）.Conclusion 1H-MRS can not only provide higher clinical application value in the diagnosis of HCC,but also dynamically monitor the tumor an

关 键 词：氢质子磁共振波谱 肝细胞肝癌 微血管密度 血管内皮生长因子 

分 类 号：R8[医药卫生—临床医学]