动态增强MRI对鼻咽癌组织内乏氧和血管生成检测的研究

目的探讨鼻咽癌MRI动态增强参数与微血管密度（MVD）和乏氧诱导因子-1α（HIF-1α）、血管内皮生长因子（VEGF）表达的相关性。方法①对14例鼻咽癌初诊患者,行MR动态增强扫描,获取该区域动态增强曲线,然后在标记处行鼻咽镜活检,测定活检部位的MVD和HIF-1α、VEGF表达水平;②观察动态增强曲线特征,测量并计算ROI的MRI动态增强参数。结果活检部位slope、MS、SImax与VEGF表达呈正相关关系（γ分别为0.889、0.882、0.619,P〈0.05）,与HIF-1α表达呈正相关关系（γ分别为0.870、0.825、0.665,P〈0.05）,与MVD也呈正相关关系（γ分别为0.627、0.755、0.693,P〈0.05）;T1 on set、TTP与VEGF表达呈负相关关系（γ分别为-0.909,-0.829,P〈0.05）,与HIF-1α表达呈负相关关系（γ分别为-0.687,-0.690,P〈0.05）,与MVD也呈负相关关系（γ分别为-0.578,-0.852,P〈0.05）。结论鼻咽癌活检部位的MRI动态增强参数与MVD、HIF-1α、VEGF表达有统计学相关性;MR动态增强扫描结果为检测鼻咽癌肿瘤组织内乏氧与血管生成提供依据。

An Study into the Role of Dynamic Contrast-Enhanced Magnetic Resonance Imaging for Detection of Intratumoral Hypoxia and Angiogenesis in Nasopharyngeal Carcinoma

Objective To investigate the relationship between the parameters of MR dynamic enhancement and microvascular density（MVD） as well as expression of hypoxia induced factor-1α（HIF-1α） and vascular endothelial growth factor（VEGF）.Methods Fifteen patients with nasopharyngeal carcinoma underwent dynamical contrast enhanced MR imaging before nasopharyngoscopy.A time-intensity curve for each ROI was obtained.The semiquantitative and quantitative dynamic parameters were calculated.Dynamic MR parameters were then correlated with histopathological results.Results Statistically significant positive correlations existed between slope,MS,and SImax of biopsy region and expression of VEGF（γ=0.889,0.882,0.619,respectively,P〈0.05）,HIF-1α（γ=0.870,0.825,0.665,respectively,P〈0.05）and MVD（γ=0.627,0.755,0.693,respectively,P〈0.05）.Statistically significant negtive correlations existed between T1 on set、TTP of biopsy region and expression of VEGF（γ=-0.909,-0.829,respectively,P〈0.05）,HIF-1α（γ=-0.687,-0.690,respectively,P〈0.05） and MVD（γ=-0.578,-0.852,respectively,P〈0.05）.Conclusion Statistically correlations exist between parameters of MR dynamic enhancement of biopsy region and MVD as well as expression of VEGF and HIF-1α.The dynamic enhanced MRI may be a non-invasive method for detection of intratumoral hypoxia and angiogenesis in nasopharyngeal carcinoma.