鼻咽癌磁共振灌注成像参数与血管内皮生长因子、微血管密度及缺氧诱导因子1α相关性研究  

Correlation between perfusion-weighted magnetic resonance imaging parameters and vascular endothelial growth factors,microvascular density , hypoxia-inducible factor 1α

作　　者：鄂宏[1] 胡英[1] 席许平[1] 于小平[2] 李飞平[2] 曾龙武[3] 张芸[3] 

机构地区：[1]中南大学湘雅医学院附属肿瘤医院放疗科,长沙410013 [2]中南大学湘雅医学院附属肿瘤医院放诊科,长沙410013 [3]中南大学湘雅医学院附属肿瘤医院病理科,长沙410013

出　　处：《肿瘤研究与临床》2017年第3期145-150,共6页Cancer Research and Clinic

基　　金：湖南省科技厅科技计划（2010FJ3097）

摘　　要：目的 探讨鼻咽癌磁共振灌注成像（PWI）的定量参数与血管内皮生长因子（VEGF）、微血管密度（MVD）及缺氧诱导因子1α（HIF-1α）的相互关系.方法 前瞻性研究94例病理确诊的鼻咽癌初治患者,在电子鼻咽纤维镜下标记出肿瘤新生物的某一区域为感兴趣区,在治疗开始前行普通磁共振及PWI检查,获取该区域的磁共振图像,计算相关参数[转运常数（Ktrans）、血液回流常数（Kep）、血管外细胞外间隙体积分数（Ve）、血浆容量分数（fPV）].对标记处进行活组织检查,用免疫组织化学法检测活组织检查标本的VEGF、MVD、HIF-1α表达,分析PWI的定量参数与各蛋白表达的相关性.结果鼻咽癌组织VEGF、HIF-1α阳性率分别为71.27%（67/94）、30.85%（29/94）.VEGF阳性与阴性表达者MVD分别为（31.27±14.81）、（23.63±16.56）个/mm2,VEGF的表达与MVD呈正相关（r=0.322,P=0.037）,HIF-1α与VEGF、MVD无相关性（P〉0.05）.VEGF表达与fPV呈正相关（r=0.339,P=0.041）,其余参数间无相关性（均P〉0.05）.结论 鼻咽癌PWI能一定程度反映鼻咽肿瘤组织的血管新生情况,可能为预测鼻咽癌的放疗敏感性提供一定指导.Objective To investigate the relationship between perfusion-weighted magnetic resonance imaging （PWI） parameters and vascular endothelial growth factor （VEGF）, microvascular density （MVD） and hypoxia-inducible factor 1α （HIF-1α） in nasopharyngeal carcinoma （NPC）. Methods 94 NPC patients were prospectively studied, and the region of interest was noted by fiberscope. Before the treatment , the common magnetic resonance and PWI were used to obtain the images of region of interest and the relative parameters including transfer constant （Ktrans）, rate constant of back flux （Kep）, extravascular extracellular volume fraction （Ve）, fractional plasm volume （fPV） were calculated, then the marking tissues were detected by biopsy. Immunohistochemical staining was conducted to detect the expressions of VEGF, MVD and HIF-1α, and the relationships between the parameters and proteins were analyzed. Results The positive rates of VEGF and HIF-1α in the NPC tissues were 71.27 % （67/94） and 30.85 % （29/94）. There was a significant positive correlation between VEGF and MVD [VEGF-positve vs. VEGF-negtive： （31.273 ± 14.81） /mm2 vs. （23.633 ±16.56） /mm2, r=0.322, P=0.037], but the expression of HIF-1αwas not significantly correlated with the VEGF and MVD. The significantly positive correlation was found between VEGF and fPV （r= 0.339, P=0.041）, besides, there were no relations among the rest parameters. Conclusion PWI parameter fPV is positively related with VEGF, indicating that PWI could show angiogensis of NPC to some degree , and provide a guidance for predicting the radiosensitivity of NPC.

关 键 词：鼻咽肿瘤 磁共振成像 灌注成像 血管内皮生长因子类 缺氧诱导因子1 Α亚基 微血管密度 

分 类 号：R739.63[医药卫生—肿瘤]