Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA.
NMR Biomed. 2011 Jul;24(6):691-9. doi: 10.1002/nbm.1738.
This study investigates the relationship between phospholipid metabolite concentrations, Gleason score, rate of cellular proliferation and surgical stage in malignant prostatectomy samples by performing one- and two-dimensional, high-resolution magic angle spinning, total correlation spectroscopy, pathology and Ki-67 staining on the same surgical samples. At radical prostatectomy, surgical samples were obtained from 49 patients [41 with localized TNM stage T1 and T2, and eight with local cancer spread (TNM stage T3)]. Thirteen of the tissue samples were high-grade prostate cancer [Gleason score: 4 + 3 (n = 7); 4 + 4 (n = 6)], 22 low-grade prostate cancer [Gleason score: 3 + 3 (n = 17); 3 + 4 (n = 5)] and 14 benign prostate tissues. This study demonstrates that high-grade prostate cancer shows significantly higher Ki-67 staining and concentrations of phosphocholine (PC) and glycerophosphocholine (GPC) than does low-grade prostate cancer (2.4 ± 2.8% versus 7.6 ± 3.5%, p < 0.005, and 0.671 ± 0.461 versus 1.87 ± 2.15 mmolal, p < 0.005, respectively). In patients with local cancer spread, increases in [PC + GPC + PE + GPE] (PE, phosphoethanolamine; GPE, glycerophosphoethanolamine] and Ki-67 index approached significance (4.2 ± 2.5 versus 2.7 ± 2.4 mmolal, p = 0.07, and 5.3 ± 3.8% versus 2.9 ± 3.8%, p = 0.07, respectively). PC and Ki-67 were significantly lower and GPC higher in prostate tissues when compared with cell cultures, presumably because of a lack of important stromal-epithelial interactions in cell cultures. The findings of this study will need to be validated in a larger cohort of surgical patients with clinical outcome data, but support the role of in vivo (1)H MRSI in discriminating between low- and high-grade prostate cancer based on the magnitude of elevation of the in vivo total choline resonance.
这项研究通过对同一手术样本进行一维和二维、高分辨率魔角旋转、全相关光谱、病理和 Ki-67 染色，研究了磷脂代谢物浓度、Gleason 评分、细胞增殖率与恶性前列腺切除样本中外科分期之间的关系。在根治性前列腺切除术时，从 49 名患者中获得手术样本[41 名局部 TNM 分期 T1 和 T2，8 名局部癌症扩散（TNM 分期 T3）]。13 份组织样本为高级别前列腺癌[Gleason 评分：4+3（n=7）；4+4（n=6）]，22 份为低级别前列腺癌[Gleason 评分：3+3（n=17）；3+4（n=5）]，14 份为良性前列腺组织。本研究表明，高级别前列腺癌的 Ki-67 染色和磷酸胆碱（PC）和甘油磷酸胆碱（GPC）浓度明显高于低级别前列腺癌（2.4±2.8%比 7.6±3.5%，p<0.005 和 0.671±0.461 比 1.87±2.15mmolal，p<0.005）。在局部癌症扩散的患者中，[PC+GPC+PE+GPE]（PE，磷酸乙醇胺；GPE，甘油磷酸乙醇胺）和 Ki-67 指数的增加接近显著（4.2±2.5 比 2.7±2.4mmolal，p=0.07 和 5.3±3.8%比 2.9±3.8%，p=0.07）。与细胞培养物相比，前列腺组织中的 PC 和 Ki-67 显著降低，GPC 升高，可能是因为细胞培养物中缺乏重要的基质-上皮相互作用。需要在具有临床结果数据的更大手术患者队列中验证本研究的结果，但支持基于体内总胆碱共振升高幅度区分低级别和高级别前列腺癌的体内（1）H MRSI 的作用。
