【作者】 刘立志； 吴沛宏； 李立； 吕衍春； 谢传淼； 候景辉；

【Author】 Liu Li-zhi Wu Pei-hong~* Li Li Lv Lian-chun Xie Zhuan-miao Hou Jin-hui. *Imaging Diagnostic & Interventional Center,Cancer Center,Sun Yat-sen University,Guangzhou 510060,China

【机构】 中山大学肿瘤医院肿瘤防治中心影像介入科； 中山大学肿瘤医院病理科；

【摘要】 目的:探讨鼻咽癌 MRI 动态参数与肿瘤血管生成组织病理学指标微血管密度 (microvessel density,MVD)和血管内皮生长因子(vascular endothelial growth factor, VEGF)的相关性。方法:28例鼻咽癌初诊病人,先进行 MR 动态增强扫描,其后行鼻咽纤维镜活检,获取伪彩显示的最大上升斜率图,计算 MR 动态参数,包括最大上升斜率平均值、最大线性斜率、强化峰值和强化百分数,并与活检标本的血管生成组织病理学指标微血管密度和血管内皮生长因子进行相关性分析。观察肿瘤最大上升斜率图特征,测量肿瘤“热点”的 MR 动态参数,并与活检部位的 MR 参数进行两配对样本的 Wilcoxon 秩和检验。结果:MVD 与最大上升斜率平均值(r=0．834,p=0．000)、强化峰值(r=0．541,P=0．003)、最大线性斜率(r=0．643,P=0．000)和强化百分数(r=0．397,P=0．037)等 MRI 动态参数间有相关性,为正相关关系。VEGF 与最大上升斜率平均值(r=0．644,P=0．000)、强化峰值(r=0．456, P=0．015)、最大线性斜率(r=0．635,P=0．000)和强化百分数(r=0．503,P=0．006)等 MRI 动态参数间有相关性,为正相关关系。肿瘤“热点”多位于肿瘤靠近中心位置,其各项 MRI 动态参数值均大于活检部位的各项 MRI 动态参数值(P=0．000)。结论:MRI 动态增强可用来作为一种对活体鼻咽癌进行整体血管生成活性评价的无创性方法。基于活检标本的组织病理学方法就对活体鼻咽癌进行整个肿瘤的血管生成活性的评价而言可能不是理想的方法。更多还原

【Abstract】 OBJECTIVE:To investigate the relationship between parameters of MR dynamic enhancement and histopathological markers of tumor angiogenesis MVD (microvessel density) and VEGF(vascular endothelial growth factor).METHODS:Twenty-eight patients with nasopharyngeal carcinoma underwent dynamical contrast enhanced MR imaging before endoscopy.The maximum slope of increasement was calculated pixel-by-pixel and displayed by the color-coded parametric maps.The dynamic parameters MMSlop(mean maximum slop),PH(peak height),SSLP(step stop),SI% (singnal intensity) of biopsy regions and “hotspot” were measured.The correlation of dynamic MR parameters and histopathologic results in biopsy regions were analyzed.Wilcoxon signed rariks test of MRI dynamic parameters between “hotspot” and biopsy regions was performed also.RESULTS:A statistically significant correlation existed between MVD and MMSlop (r=0.834,P=0.000)、PH (r=0.541,P=0.003)、SSLP (r=0.643, P=0.000) and SI% (r=0.397,P=0.037) in biopsy regions.A statistically significant correlation existed between VEGF and MMSlop(r=0.644,P=0.000)、PH(r=0.456,P=0.015)、SSLP(r=0.635, P=0.000) and SI% (r=0.503,P=0.006) in biopsy regions.The “hotspots” were mainly in the central region of tumors and values of MMSlop (P=0.000)、PH (P=-0.000),SSLP (P=0.000) and SI% (P=0.000) in “hotspots” were higher than that of biopsy regions.CONCLUSION: The dynamic enhanced MRI may be a non-invasive method for measuring angiogenesis in nasopharyngeal carcinoma.The histopathological markers may not represent accurately the angiogenic activity of the whole tumor in vivo.更多还原