| MRS联合Ki-67鉴别脑转移瘤与高级别胶质瘤的作用 |
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| 引用本文： | 胡平,邓钢,叶立果,徐阳,江洪祥,高论,陈谦学.MRS联合Ki-67鉴别脑转移瘤与高级别胶质瘤的作用[J].中国临床神经外科杂志,2021,26(3):159-161. |
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| 作者姓名： | 胡平 邓钢 叶立果 徐阳 江洪祥 高论 陈谦学 |
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| 作者单位： | 430060 武汉，武汉大学人民医院神经外科（胡 平、邓 钢、叶立果、徐 阳、江洪祥、高 论、陈谦学） |
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| 摘 要： | 目的 探讨磁共振波谱（MRS）参数联合Ki-67指数在鉴别脑转移瘤（BM）与原发性高级别胶质瘤（HGG）中的作用。方法 回顾性分析2018年1月至2020年8月手术及病理证实的30例原发性HGG（HGG组）和13例BM（BM组）的临床资料。所有病人术前均行MRS检查，术后均行Ki-67检测。MRS参数包括N-乙酰天冬氨酸（NAA）、肌酸（Cr）、胆碱（Cho），并计算Cho/NAA、Cho/Cr、NAA/Cr比值。结果 HGG组Ki-67指数及Cho/NAA明显低于BM组（P<0.05），但是两组Cho/Cr、NAA/Cr无统计学差异（P>0.05）。ROC曲线分析鉴别BM与HGG的结果显示，Cho/NAA曲线下面积（AUC）为0.809（P<0.05），最佳截断值为3.245，灵敏度为0.615，特异度为0.967；Ki-67指数AUC为0.774（P<0.05），最佳截断值为0.45，敏感度为0.769，特异度为0.633；Cho/NAA联合Ki-67指数的AUC为0.871（P<0.05），敏感度为0.769，特异度为0.933。结论 Cho/NAA和Ki-67指数都有助于鉴别BM和原发性HGG，但Cho/NAA联合Ki-67指数可提高鉴别能力，诊断更加准确。如果病人Cho/NAA≥3.245、Ki-67指数≥0.45，诊断BM更准确。
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| 关 键 词： | 原发性高级别胶质瘤 脑转移瘤 鉴别诊断 磁共振波谱（MRS） Ki-67 |
Role of MRS parameters combined with Ki-67 index in differentiating brain metastases from primary high-grade gliomas |
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| HU Ping,DENG Gang,YE Li-guo,XU Yang,JIANG Hong-xiang,GAO Lun,CHEN Qian-xue.Role of MRS parameters combined with Ki-67 index in differentiating brain metastases from primary high-grade gliomas[J].Chinese Journal of Clinical Neurosurgery,2021,26(3):159-161. |
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| Authors: | HU Ping DENG Gang YE Li-guo XU Yang JIANG Hong-xiang GAO Lun CHEN Qian-xue |
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| Affiliation: | Department of Neurosurgery, Renmin Hospital of Wuhan University, Wuhan 430010, China |
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| Abstract: | Objective To explore the role of MRS parameters combined with Ki-67 index in differentiating the brain metastases(BM)from primary high-grade glioma(HGG).Methods A retrospective analysis was performed on the clinical data of 30 patients with primary HGG(HGG group)and 13 patients with BM(BM group)who underwent surgery from January 2018 to August 2020.All the patients received MRS examination before the operation and the MRS parameters included N-acetylaspartate(NAA),creatine(Cr),choline(Cho),and the ratios of Cho/NAA,Cho/Cr and NAA/Cr.The tissue samples were detected by pathological examination and Ki-67 immunohistochemistry.Results The Ki-67 index and ratio of Cho/NAA of HGG group were significantly lower than those of BM group(P<0.05).There was no significant difference in the ratios of Cho/Cr and NAA/Cr between the two groups(P>0.05).ROC curve analysis showed that,for differential diagnosis of BM and HGG,the area under curve(AUC)of the ratio of Cho/NAA was 0.809(P<0.05),the cutoff value was 3.245,and the sensitivity and specificity were 0.615 and 0.967,respectively;the AUC of Ki-67 index was 0.774(P<0.05),the cut-off value was 0.45,and the sensitivity and specificity were 0.769 and 0.633,respectively;the AUC of the ratio of Cho/NAA combined with Ki-67 index was 0.871(P<0.05),and the sensitivity and specificity were 0.769 and 0.933,respectively.Conclusions Both the ratio of Cho/NAA and Ki-67 index are helpful to the differential diagnosis of BM and HGG,and the ratio Cho/NAA combined with Ki-67 index can improve the differential diagnostic power and make the diagnosis more accurate.The patients with the ratio of Cho/NAA≥3.245 and Ki-67 index≥0.45 are more acurate to make the diagnossis of BM. |
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| Keywords: | Primary high-grade glioma Brain metastases MRS Ki-67 Differential diagnosis |
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