CAJ | 학술논문

目的分析不同级别胶质瘤的MR氨基质子转移(APT)成像及病理特征,探讨APT成像可能的病理学基础.方法回顾性分析经手术病理证实的胶质瘤患者28例,包括11例低级别(低级别组)与17例高级别胶质瘤(高级别组),进行常规扫描及APT扫描,手术标本采用常规HE染色、CD34及细胞增殖抗原(Ki-67)免疫组织化学染色检查.采用两独立样本t检验分析高级别组与低级别组瘤核心APT值、肿瘤细胞密度、微血管密度(MVD)及肿瘤增殖标记指数的差异,采用Pearson相关性分析肿瘤核心APT值与肿瘤细胞密度、MVD及肿瘤增殖标记指数之间的相关性,多元线性回归分析APT值与三者之间的关系.结果低级别组及高级别组瘤核心的APT值分别为(2.3±0.6)％、(3.6±0.7)％,肿瘤细胞密度分别为(9.4±2.4)％、(18.4±4.7)％,MVD分别为(19.0±7.4)、(38.9±11.3)条/高倍视野,肿瘤增殖标记指数分别为(14.2±5.4)％、(31.7±4.5)％,高级别组各指标高于低级别组,差异均有统计学意义(t值分别为-4.94、-5.89、-5.13、-9.28,P值均＜0.01).高、低级别肿瘤瘤核心的APT值与肿瘤细胞密度、MVD及肿瘤增殖指数呈显著正相关(r值分别为0.904、0.598、0.750,P值均＜0.01).且瘤核心的APT值(Y)与肿瘤细胞密度(X1)、MVD(X2)及肿瘤增殖指数(xO之间呈多元线性相关,方程为Y=0.801+ 0.12X1-0.003X2+ 0.026X3 (F=46.437,P＜0.01,R2=0.853).结论脑胶质瘤APT成像能反映其病理学特征,胶质瘤瘤核心的APT值越大,肿瘤细胞密度、MVD、肿瘤增殖指数越高,肿瘤级别越高.
목적 분석불동급별효질류적MR안기질자전이(APT)성상급병리특정,탐토APT성상가능적병이학기출.방법 회고성분석경수술병리증실적효질류환자28례,포괄11례저급별(저급별조)여17례고급별효질류(고급별조),진행상규소묘급APT소묘,수술표본채용상규HE염색、CD34급세포증식항원(Ki-67)면역조직화학염색검사.채용량독립양본t검험분석고급별조여저급별조류핵심APT치、종류세포밀도、미혈관밀도(MVD)급종류증식표기지수적차이,채용Pearson상관성분석종류핵심APT치여종류세포밀도、MVD급종류증식표기지수지간적상관성,다원선성회귀분석APT치여삼자지간적관계.결과 저급별조급고급별조류핵심적APT치분별위(2.3±0.6)％、(3.6±0.7)％,종류세포밀도분별위(9.4±2.4)％、(18.4±4.7)％,MVD분별위(19.0±7.4)、(38.9±11.3)조/고배시야,종류증식표기지수분별위(14.2±5.4)％、(31.7±4.5)％,고급별조각지표고우저급별조,차이균유통계학의의(t치분별위-4.94、-5.89、-5.13、-9.28,P치균＜0.01).고、저급별종류류핵심적APT치여종류세포밀도、MVD급종류증식지수정현저정상관(r치분별위0.904、0.598、0.750,P치균＜0.01).차류핵심적APT치(Y)여종류세포밀도(X1)、MVD(X2)급종류증식지수(xO지간정다원선성상관,방정위Y=0.801+ 0.12X1-0.003X2+ 0.026X3 (F=46.437,P＜0.01,R2=0.853).결론 뇌효질류APT성상능반영기병이학특정,효질류류핵심적APT치월대,종류세포밀도、MVD、종류증식지수월고,종류급별월고.
Objective To investigate the probable pathologic basis of amido proton transfer(APT) imaging by analysing APT signal intensity and pathologic features of different grades of glioma.Methods Twenty-eight patients with glioma confirmed by postoperative pathology underwent APT scan.All the patients were divided into two groups,including 11 cases in low grade (WHO Ⅰ and Ⅱ) and 17 cases in high grade (WHO Ⅲ and Ⅳ) group.The APT rate of tumor core was measured.The specimens were processed with routine hematoxylin-eosin (HE) staining and immunohistochemistry of Ki-67 and CD34.Independent-samples t test was used to detect the difference of APT rate,cellularity,microvessel density and Ki-67 labeling indices of tumor core between low grade and high grade group.Pearson correlation analysis and multi-variable linear regression analysis were used to detect the relationship of APT rate with cellularity,microvessel density and Ki-67 labeling indices of the tumor core.Results The APT rate,cellularity and proliferation index were (2.3±0.6) ％,(9.4±2.4) ％ and (14.2±5.4) ％ in low grade group,while (3.6±0.7) ％,(18.4±4.7) ％ and (31.7±4.5) ％ in high grade group,respectively.Microvessel density was (19.0±7.4) per high-power field in low grade group and (38.9±11.3) in high grade group.There were statistical differences of the APT rate,cellularity,microvessel density and proliferation index between the low grade group and the high grade group (t=-4.94,-5.89,-5.13,and-9.28,respectively,P＜0.01).The APT rate was positive correlated with cellularity,microvessel density and proliferation index.The coefficient of correlation were 0.904,0.598,and 0.750,respectively,(P＜0.01).Multiple linear correlative analysis showed that increasing cellularity (X1),microvessel density (X2) and proliferation index (X3) were the main factors for increasing APT rate,and the correlation equation was Y=0.801 + 0.12X1-0.003X2 + 0.026X3 (F=46.437,P＜0.01,R2=0.853).Conclusions The APT signal intensity of the tumor core could reflect the pathologic features of glioma.The APT rate was positive correlated with cellularity,microvessel density and proliferation index,which indicate the higher APT rate the higher grade tumor.