脑星形细胞瘤磁共振波谱与肿瘤细胞Survivin、PCNA相关性研究

目的 探讨脑星形细胞瘤磁共振波谱(MRS)与肿瘤细胞的Survivin 蛋白、细胞核增殖抗原(PCNA)蛋白表达的相关性.方法 对照观察50例脑星形细胞瘤MRS检查结果与免疫组化方法测定术后标本的Survivin、PCNA蛋白表达,分析肿瘤实质内最大Cho/NAA、Cho/Cr和最小NAA/Cr值与肿瘤级别的关系,并分别与PCNA增殖指数(PI)、Survivin免疫活性指数(IRS)进行相关性分析.结果 高级别星形细胞瘤的Cho/Cr和Cho/NAA高于低级别星形细胞瘤和对照组,NAA/Cr低于低级别星形细胞瘤和对照组.Survivin的IRS和PCNA的PI随着肿瘤恶性度增加而升高.星形细胞瘤Cho/Cr与IRS显著正相关(r=0.745,P<0.01);星形细胞瘤Cho/NAA与IRS显著正相关(r=0.753,P<0.01).星形细胞瘤Cho/Cr与PI显著正相关(r=0.818,P<0.01);星形细胞瘤Cho/NAA与PI显著正相关(r=0.760,P<0.01).星形细胞瘤NAA/Cr与IRS呈负相关(r=-0.374,P<0.01),星形细胞瘤NAA/Cr与PI呈负相关(r=-0.436,P<0.01).结论 MRS基本反映着肿瘤细胞PCNA及Survivn表达情况,可在术前预测肿瘤凋亡抑制情况、增殖潜能、侵袭能力和预后,其中Cho/Cr,Cho/NAA较NAA/Cr更有意义.

MR spectroscopy of human astrocytoma and the correlation with the expression of Survivin and PCNA

Objective To investigate the relationship between the MRS and the PCNA,Survivin expression of human astrocytoma. Methods Fifty patients of astrocytoma proved by surgery and pathology were included. MRS was performed in all the patients. After surgical operation,the specimen was examined for PCNA and Survivin. The maximum of Cho/NAA,Cho/Cr and the minimum of NAA/Cr were recorded and the relationship with tumor grade was analyzed. The relationship between the above indices and the proliferative index (PI) of PCNA,immunoreactivity score (IRS) of Survivin were investigated respectively. Results The ratio of Cho/Cr and Cho/NAA in the high grade astrocytoma was higher,while NAA/Cr was lower than that of low grade astrocytoma and control group. The PI of PCNA and IRS of Survivin was higher in high grade astrocytoma than low grade astrocytoma. The ratio of Cho/Cr and Cho/NAA was strongly positively correlated with PI of PCNA (r=0.745,P<0.01; r=0.753,P<0.01 respectively). The ratio of Cho/Cr and Cho/NAA was strongly positively correlated with PI of PCNA (r=0.818,P<0.01; r=0.760,P<0.01 respectively). The NAA/Cr of astrocytoma was weakly related with IRS of Survivin (r=-0.374,P<0.01) and PI of PCNA (r=-0.436,P<0.01). Conclusion MRS can reflect the protein manifestation of PCNA and Survivin of astrocytoma noninvasively,being helpful in the preoperative assessment of apoptosis,reproductive activity,invasive activity and can predict prognosis of astrocytomas. The Cho/Cr and Cho/NAA are more useful than NAA/Cr.