Hu Y, E H, Yu X, Li F, Zeng L, Lu Q, Xi X, Shen L
Department of Radiation Oncology, Hunan Cancer Hospital and the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China.
Department of Diagnostic Radiology, Hunan Cancer Hospital and the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China.
Clin Otolaryngol. 2018 Apr;43(2):425-433. doi: 10.1111/coa.12982. Epub 2017 Oct 10.
To investigate the correlation of parameters of magnetic resonance perfusion-weighted imaging (MR-PWI) with the expression of vascular endothelial growth factor (VEGF), hypoxia-inducible factor-1α (HIF-1α) and microvessel density (MVD) in nasopharyngeal carcinoma (NPC) so as to explore the value of predicting radiosensitivity.
A prospective study.
Department of Head-and-neck radiotherapy in Hunan Cancer Hospital.
Ninety-four patients of NPC were included between December 2013 and December 2014.
The expression of VEGF, MVD and HIF-1α was studied by immunohistochemistry, and magnetic resonance perfusion-weighted imaging (MR-PWI) was performed before and after undergoing radiotherapy (20 Gy dose). Parameters of MR-PWI, volume of primary tumour and rate of tumour remission were measured and calculated. Patients with primary local tumour were then divided into completely response group (CR group) and partially response group (non-CR group) according to tumour regression condition. Relevant parameters were analysed by Spearman, and diagnostic efficiency of radiosensitivity was analysed by receiver operating characteristic curve (ROC).
The expression of VEGF was positively correlated with MVD (r = .322,P < .05), but the expression of HIF-1α was no significant correlations with VEGF and MVD. The expression VEGF was in positive correlation with fractional plasma volume (fpv) (r = .339, P = .05) before radiotherapy. There was a significant difference in the quantitative parameters of MR-PWI between CR group and non-CR group during the course of radiotherapy and at the end of radiotherapy treatment. The change of blood reflux constant (Δkep20) and extravascular extracellular space volume fraction (ΔVe20) before and after treatment was positively correlated with primary local tumour remission condition after 3 month treatment; Δkep and ΔVe were negatively correlated with primary local tumour remission condition after 3 months. Tumour regression rate was only positively correlated with Ve and the average volume of primary tumour after 2 week treatment (V1). ROC curve showed that R20 ≥ 65.69%, and was considered as a threshold to predict primary local tumour remission, with a sensitivity of 0.84 and specificity of 0.69, and area under the curve was 0.819 (P = .000).
The parameters of MR-PWI with the expression of VEGF, HIF-1α and MVD could be guidance for predicting radiosensitivity in NPC.
探讨鼻咽癌（NPC）磁共振灌注加权成像（MR-PWI）参数与血管内皮生长因子（VEGF）、缺氧诱导因子-1α（HIF-1α）表达及微血管密度（MVD）的相关性，以探索预测放射敏感性的价值。
前瞻性研究。
湖南省肿瘤医院头颈放疗科。
纳入2013年12月至2014年12月的94例NPC患者。
采用免疫组织化学法研究VEGF、MVD和HIF-1α的表达，并在放疗前（20 Gy剂量）和放疗后进行磁共振灌注加权成像（MR-PWI）。测量并计算MR-PWI参数、原发肿瘤体积和肿瘤缓解率。然后根据肿瘤退缩情况将原发局部肿瘤患者分为完全缓解组（CR组）和部分缓解组（非CR组）。采用Spearman法分析相关参数，采用受试者操作特征曲线（ROC）分析放射敏感性的诊断效能。
VEGF表达与MVD呈正相关（r = 0.322，P < 0.05），但HIF-1α表达与VEGF和MVD无显著相关性。放疗前VEGF表达与血浆容积分数（fpv）呈正相关（r = 0.339，P = 0.05）。放疗过程中和放疗结束时，CR组与非CR组MR-PWI定量参数有显著差异。治疗前后血反流常数（Δkep20）和血管外细胞外间隙容积分数（ΔVe20）的变化与治疗3个月后原发局部肿瘤缓解情况呈正相关；Δkep和ΔVe与3个月后原发局部肿瘤缓解情况呈负相关。肿瘤退缩率仅与治疗2周后Ve和原发肿瘤平均体积（V1）呈正相关。ROC曲线显示，R20≥65.69%，被认为是预测原发局部肿瘤缓解的阈值，敏感性为0.84，特异性为0.69，曲线下面积为0.819（P = 0.000）。
MR-PWI参数与VEGF、HIF-1α和MVD的表达可为预测NPC放射敏感性提供指导。
