用MRS评价前列腺癌内分泌治疗后的代谢变化：癌区与非癌区外周带的比较

目的用MRS定量评价前列腺癌内分泌治疗后的代谢变化,观察癌组织与非癌区外周带的代谢差别.方法 21例内分泌治疗后的前列腺癌患者与19例未经任何治疗的前列腺癌患者,行MRS检查.将前列腺分为左、右两侧,每侧由上到下分为底部、中部和尖部三部分,共六分区.根据手术或穿刺病理结果将这六分区归类为癌区和非癌区.在MRS代谢图上测量前列腺癌区和非癌区外周带内分泌治疗后的胆碱(choline,Cho)、肌酸(creatine,Cre)和枸橼酸盐(citrate,Cit)的代谢水平.结果内分泌治疗后前列腺的Cho、Cre和Cit均下降,Cit下降较明显(P<0.01).内分泌治疗组非癌区(Cho Cre)/Cit的比值高于未治疗组(分别为0.82±0.12和0.59±0.20),差异有统计学意义(P<0.01).内分泌治疗组有Cho,Cre和Cit代谢的癌区(Cho Cre)/Cit的比值与未治疗组相比差异无显著性(分别为2.62±0.31和2.26±0.73,P>0.05).结论 MRS可以定量分析前列腺癌内分泌治疗后的代谢变化,前列腺内分泌治疗后癌区与非癌区外周带的代谢改变不同.

Metabolic changes of prostate cancer after endocrine therapy by MR spectroscopy: comparison of cancerous and noncancerous regions in the peripheral zone

Objective Using magnetic resonance spectroscopy (MRS) to investigate the metabolic changes of prostate cancer after endocrine therapy. MethodsTwenty one patients with pathologically confirmed prostate cancer who underwent endocrine therapy and 19 cases of untreated prostate cancer (as control group) were quantitatively assessed by MRS. The prostate was divided into 6 regions (left/right bottom, middle and tip). The cancerous and noncancerous regions were marked and enrolled in a region, and the (choline+creatine)/citrate (CC/C) value of each region was measured. ResultsAfter endocrine therapy, prostatic metabolites of Cho, Cre and Cit reduced significantly. Cit levels decreased greater than Cho and Cre levels (P<0.01). The (Cho+Cre)/Cit ratio of noncancerouss prostate peripheral zone increased and was statistically higher than that of control group(0.82±0.12 and 0.59±0.20, respectively, P<0.01). The (Cho+Cre)/Cit ratio of cancerous regions with detectable Cho, Cre and Cit peaks was also increased slightly with no statistically difference comparing to untreated prostate cancer (2.62±0.31 and 2.26±0.73, respectively, P>0.05). Conclusion MRS can be used to evaluate the metabolic changes of prostate after endocrine therapy. The metabolites in cancerous and noncancerous regions in the peripheral zone of the prostate vary differently.