肾透明细胞癌磁敏感加权成像与HIF-1α表达、微血管密度的相关性研究  

Study on the correlation of susceptibility weighted imaging with HIF-1αexpression,microvessel density in clear cell renal cell carcinoma

作　　者：储毅威 孙军[1] 潘靓[1] 陈杰[1] 邢伟[1] CHU Yiwei;SUN Jun;PAN Liang;CHEN Jie;XING Wei(Department of Imaging,the Third Affiliated Hospital of Soochow University,Changzhou,Jiangsu Province 213003,China;Department of Imaging,Changzhou De’an Hospital,Changzhou,Jiangsu Province 213003,China)

机构地区：[1]苏州大学附属第三医院影像科,江苏常州213003 [2]常州市德安医院影像科,江苏常州213003

出　　处：《实用放射学杂志》2023年第2期247-250,共4页Journal of Practical Radiology

基　　金：江苏省卫生健康委员会重点科研项目(K2019023)。

摘　　要：目的探讨不同病理级别肾透明细胞癌(ccRCC)的磁敏感加权成像(SWI)与缺氧诱导因子1α(HIF-1α)表达、微血管密度(MVD)的相关性。方法回顾性选取经病理证实的ccRCC患者53例。所有患者分为低级别组(FuhrmanⅠ+Ⅱ,n=28)和高级别组(FuhrmanⅢ+Ⅳ,n=25),术前2周行肾脏SWI扫描。测量SWI图像上肿瘤面积并对瘤内磁敏感信号强度(ITSS)进行半量化分析。使用受试者工作特征(ROC)曲线评估SWI表现鉴别高、低级别ccRCC的诊断效能。Spearman相关性分析评价SWI半量化指标(ITSS形态、ITSS主要结构、ITSS面积比例、坏死)与HIF-1α、MVD的相关性。结果肿瘤面积及ITSS主要结构鉴别高、低级别ccRCC的诊断价值较高。SWI半量化指标与HIF-1α表达(r=0.403,P=0.025;r=0.437,P=0.005;r=0.472,P=0.043;r=0.293,P=0.001)及MVD(r=0.416,P=0.018;r=0.489,P=0.011;r=0.329,P=0.002;r=0.458,P=0.023)存在一定的相关性。结论SWI可用于术前无创性评估ccRCC病理分级;SWI半量化指标在术前评估肿瘤缺氧状态和血管生成方面可提供有用信息。Objective To explore the susceptibility weighted imaging(SWI)of clear cell renal cell carcinoma(ccRCC)in different pathological grades,and its correlation with the hypoxia inducible factor-1α(HIF-1α)expression and microvessel density(MVD).Methods Retrospective select of 53 patients with pathologically proven ccRCC were performed.All patients were divided into low-grade group(FuhrmanⅠ+Ⅱ,n=28)and high-grade group(FuhrmanⅢ+Ⅳ,n=25).SWI was performed within two weeks before the surgery.The tumor area on SWI image was measured and intratumoral susceptibility signal intensity(ITSS)was analyzed by semi-quantitatively.The receiver operating characteristic(ROC)curve was used to assess the diagnostic efficiency that SWI performance identified high and low grade ccRCC.Spearman correlation analysis was performed to evaluate the relationship between the semi-quantitative indexes of SWI(the morphology of ITSS,the main structure of ITSS,proportion of ITSS area,necrosis)and HIF-1αor MVD.Results The tumor area and the main structure of ITSS had high diagnostic value in differentiating high-grade and low-grade ccRCC.The semi-quantitative indexes of SWI showed certain correlation with HIF-1αexpression(r=0.403,P=0.025;r=0.437,P=0.005;r=0.472,P=0.043;r=0.293,P=0.001)and MVD(r=0.416,P=0.018;r=0.489,P=0.011;r=0.329,P=0.002;r=0.458,P=0.023).Conclusion SWI can be a noninvasive approach for preoperative evaluation of ccRCC pathological grading.The semi-quantitative indexes of SWI can provide useful information in preoperative evaluation of tumor hypoxic state and angiogenesis.

关 键 词：肾透明细胞癌 磁敏感加权成像 缺氧诱导因子1Α 微血管密度 

分 类 号：R737.11[医药卫生—肿瘤] R445.2[医药卫生—临床医学]