胶质瘤脑浸润程度与病理级别的相关性研究

目的运用病理和影像学的方法研究胶质瘤脑浸润程度与其病理级别的关系。方法选择需作内减压的脑胶质瘤患者30例，通过手术获取肿瘤区和瘤周水肿区组织标本；肿瘤区组织通过病理检查确定肿瘤分级，瘤周水肿区通过病理检查作肿瘤细胞计数和细胞密度分析，确定肿瘤脑浸润程度，将两者作相关分析；利用磁共振弥散张量成像（DTI）测量5个兴趣区（肿瘤实体区、瘤周水肿区、水肿外区、相对正常白质区和对侧白质区）的分量各向异性（FA）值，将瘤周水肿区的FA值与肿瘤的病理脑浸润程度和病理级别分别作相关分析。结果胶质瘤脑浸润程度和病理级别间无显著相关性；瘤周水肿区的FA值与胶质瘤病理脑浸润程度呈负相关性；瘤周水肿区的FA值与胶质瘤病理级别间无显著相关性。结论从病理和影像学分析的角度来看，传统脑胶质瘤病理分级与肿瘤脑浸润程度无显著相关性，高级别的胶质瘤并不一定具有更高的侵袭性。

Correlative analysis between the potential of invasion to brain and pathological grading of gliomas

Objective To analyze the relationship between the potential of tumor invasion to brain and pathological grades of gliomas by moans of imaging and pathology. Methods A total of 30 histologically confirmed gliomas were included in our study. The tumor tissue and peritumor tissue were obtained for further analysis. Pathological grades of tumor tissue were determined according to WHO standard, and degree of invasion of gliomas was recorded by calculating the density of tumor cells in the peritumoral region. Correlation between pathological grades and the degree of invasion was analyzed. Five regions of interest （ROls） （tumor, peritumoral edema region, region around edema zone, normal white matter region and contralateral white matter region） were chosen and the fractional anisotropy （FA） values of ROIs were measured by diffusion tensor imaging （DTI）. The correlation either between FA values of peritumoral edema region and the potential of tumor invasion to brain or pathological grades of glioma was analyzed respectively. Results There was no significant correlation between tumor invasion potential and pathological grades of gliomas. FA values of peritumoral edema region were negatively correlated with brain invasive potential. However, no correlation between FA values of peritumoral edema region and pathological grading was found. Conclusion There is no significant correlation between pathological grades of gliomas and the tomor invasive potential from the perspective of pathologogy and imaging.