脑胶质瘤1H-MRS的应用与VEGF、MMP-9及uPA表达的相关性研究

目的 探讨脑胶质瘤氢质子磁共振波谱(1H-MRS)特征与肿瘤病理级别和侵袭性的关系及与血管内皮生长因子(VEGF)、基质金属蛋白酶(MMP)-9和尿激酶型纤溶酶原激活剂(uPA)表达的相关性.方法 55例术后病理证实的脑胶质瘤患者分为高、低级别2组,并对肿瘤实质1H-MRS比值进行组间和组内差异性分析.检测脑胶质瘤中的MMP-9、VEGF及uPA的表达情况,探讨三者与1H-MRS比值变化的相关性.结果 高、低级别脑胶质瘤实质区胆碱/肌酸(Cho/Cr)、胆碱/N-乙酰天门冬氨酸(Cho/NAA)两者比值有显著差异及相关性(P<0.01),VEGF、MMP-9肿瘤表达具有显著差异(P<0.01),与前者存在显著相关性(P<0.01),而NAA/Cr比值及uPA表达均无明显差异及相关性(P>0.05).结论 VEGF、MMP-9在脑胶质瘤发生发展中具有重要促进作用,Cho/Cr、Cho/NAA比值为术前脑胶质瘤分级提供重要参考价值,间接反映了VEGF、MMP-9的表达.

Correlation between 1H-MRS and the expression of VEGF,MMP-9 and uPA in brain glioma

Objective To evaluate the relationship between 1H-MRS features of brain glioma and its pathological grade and invasiveness, and the correlation between those features and the expression of VEGF, MMP-9 and uPA.Methods The brain gliomas in 55 patients confirmed by pathology were divided into two groups: high grade and low one.An analysis of intragroup and intergroup differences in some metabolite ratios of 1H-MRS in the tumor parenchyma was conducted.The expression of MMP-9,VEGF and uPA in brain glioma was detected,and the correlation between the above three parameters and changes in metabolite ratios of 1H-MRS were explored.Results There was significant difference and correlation in Cho/Cr and Cho/NAA ratio in the tumor parenchyma between high and low grade(P<0.01).The expression of VEGF and MMP-9 in tumor was significantly different(P<0.01) but with significant correlation(P<0.01),and there was no significant difference and correlation in NAA/Cr ratio and uPA expression(P>0.05).Conclusion VEGF and MMP-9 play an important role in the development of brain glioma.Cho/Cr and Cho/NAA ratios provide an important reference for preoperative grading of brain gliomas and indirectly reflect the expression of VEGF and MMP-9.