磁共振波谱与胶质母细胞瘤特征分子的相关性研究  

Correlation of MR Spectroscopy and Molecular Related to Glioblastoma

作　　者：马芸[1] 方靖琴[1] 王秋实[2] 郭虹[1] 张伟国[1] 

机构地区：[1]第三军医大学大坪医院野战外科研究所放射科,400042 [2]第三军医大学大坪医院野战外科研究所病理科,400042

出　　处：《临床放射学杂志》2016年第9期1292-1296,共5页Journal of Clinical Radiology

基　　金：第三军医大学大坪医院野战外科研究所临床科研基金(2014YLC03);重庆市科技研发基地建设(国际科技合作)项目(cstc2014gjhz11002)资助

摘　　要：目的探讨磁共振波谱(MRS)与胶质母细胞瘤(GBM)特征分子的相关性,为GBM的临床评估、个性化治疗方案的选择及预后评价提供依据。方法回顾性分析本院60例经手术病理证实的GBM患者的1H-MRS表现,测量病灶实质区域的Cho/Cr、NAA/Cr及Cho/NAA值。同时,对60例患者的病理切片进行免疫组织化学染色,得到EGFR、IDH-1、P53、PTEN和NEFL特征性变化,根据染色面积进行评分。分析Cho/Cr、NAA/Cr及Cho/NAA与上述分子表达变化的相关性。结果 5个分子指标中,NEFL表达与Cho/NAA、Cho/Cr呈显著负相关(R^2=-0.836,P<0.001,R^2=-0.427,P=0.001)。ROC曲线分析表明当Cho/NAA值<4.214时,GBM可能为神经元亚型的特异度和敏感度分别为89.5%和90.9%;当Cho/Cr值<3.795时,GBM可能为神经元亚型特异度和敏感度分别为72.7%和73.7%。其余4个分子表达与1H-MRS代谢产物均无明显相关性。结论1H-MRS参数可反映NEFL的表达,NEFL是GBM神经元亚型的特征性改变,因而1H-MRS可作为反映GBM神经元亚型的重要影像学标志。Objective Investigate the correlation between MR spectroscopy（ MRS） and the characteristic molecules of glioblastoma（ GBM）,supporting evidence for planning personalized treatment and evaluating prognosis. Methods We retrospectively analyzed MRS parameters of 60 cases which had been pathologically confirmed to be GBM. Cho / Cr,NAA /Cr and Cho / NAA values of the tumors＇ solid regions were measured. At the same time,all 60 cases had immunohistochemical analysis conducted to obtain the EGFR,IDH-1,p53,PTEN and NEFL expressions. The correlation between the MRS parameter and the expression of those molecules was obtained by using SPSS software. Results There is a significant correlation between NEFL and Cho / NAA（ R^2=- 0. 836,P〈0. 001）,Cho / Cr（ R^2=- 0. 427,P = 0. 001）. When the Cho / NAA threshold value is less than 4. 214,the specificity and sensitivity is 89. 5% and 90. 9%. When the Cho / Cr threshold value is less than 3. 795,the specificity and sensitivity is 72. 7% and 73. 7%. Conclusion^1H-MRS can reflect the expression of NEFL. Considering that NEFL expression reveals GBM neuronal subtypes,therefore,MRS can be used as an important imaging sign of GBM neuronal subtypes.

关 键 词：磁共振成像 磁共振波谱 胶质母细胞瘤 分子亚型 

分 类 号：R445.2[医药卫生—影像医学与核医学] R739.41[医药卫生—诊断学]