Bezabeh Tedros, Odlum Olva, Nason Richard, Kerr Paul, Sutherland Donna, Patel Rakesh, Smith Ian C P
Institute for Biodiagnostics, National Research Council, University of Manitoba, Canada.
AJNR Am J Neuroradiol. 2005 Sep;26(8):2108-13.
Poor treatment outcome remains high in patients with squamous cell carcinoma (SCC) of the head and neck region. Treatment of head and neck cancer could be improved and perhaps standardized if reliable markers for tumor progression and poor prognosis could be developed. MR spectroscopy has been used previously to differentiate between malignant and adjacent normal specimen in these cancers. This study explores the capability of MR spectroscopy in providing an indication of the aggressiveness of a tumor and its response to treatment.
Thirty-six SCC patients with treatment failure, and 22 other patients who were treated concurrently at the same center but with no indication of failure for a period of 3 years, were selected for the study. Tumor specimens were kept frozen at -70 degrees C, and later subjected to 1H-MR spectroscopy at 25 degrees C. The resonance areas for 6 spectral regions were determined, and their ratio calculated. The mean values of the ratios were then compared between the 2 groups by using the Student t test.
The choline-to-creatine (3.2/3.0 parts per million [ppm]) and the 1.3/0.9 ppm spectral intensity ratios (signal due to lipid or lactic acid) were the 2 most notable ones to be significantly elevated in the group with poor response. Using these ratios, a sensitivity of 83% and a specificity of 82% were obtained in predicting which head and neck cancer patients would fail treatment.
These preliminary results suggest that MR spectroscopy has the potential to contribute to an accurate and early prediction of tumor behavior and response to treatment in squamous cell carcinoma of the head and neck region.
头颈部鳞状细胞癌（SCC）患者的治疗效果不佳率仍然很高。如果能够开发出可靠的肿瘤进展和预后不良标志物，头颈部癌症的治疗可能会得到改善，甚至实现标准化。此前，磁共振波谱已被用于区分这些癌症中的恶性标本和相邻正常标本。本研究探讨了磁共振波谱在指示肿瘤侵袭性及其对治疗反应方面的能力。
本研究选取了36例治疗失败的SCC患者，以及另外22例在同一中心同时接受治疗且3年内无失败迹象的患者。将肿瘤标本保存在-70℃的冷冻状态，随后在25℃下进行1H-磁共振波谱分析。测定6个光谱区域的共振面积，并计算其比值。然后使用学生t检验比较两组的比值平均值。
胆碱与肌酸的比值（3.2/3.0百万分之一[ppm]）以及1.3/0.9 ppm的光谱强度比值（脂质或乳酸产生的信号）是反应不佳组中显著升高的两个最明显的比值。使用这些比值，在预测哪些头颈部癌症患者治疗会失败时，灵敏度为83%，特异性为82%。
这些初步结果表明，磁共振波谱有潜力对头颈部鳞状细胞癌的肿瘤行为和治疗反应做出准确且早期的预测。
