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胶质母细胞瘤中,肿瘤及肿瘤周边区域磁共振波谱值和表观扩散系数与PTEN和p53表达的相关性分析(磁共振成像)

Correlation analysis of expressions of PTEN and p53 with the value obtained by magnetic resonance spectroscopy and apparent diffusion coefficient in the tumor and the tumor-adjacent area in magnetic resonance imaging for glioblastoma.

作者信息

Li Yunyun, Ji Feng, Jiang Yuzhi, Zhao Ting, Xu Chongfu

机构信息

Department of Radiology and 2Department of Neurosurgery, Liaocheng People's Hospital, Liaocheng, Shandong 252000, China.

出版信息

J BUON. 2018 Mar-Apr;23(2):391-397.

Abstract

PURPOSE

To explore the correlation of the expression levels of phosphate and tension homology deleted on chromosome ten (PTEN) and p53 of glioblastoma multiforme (GBM) with the value obtained by magnetic resonance spectroscopy (MRS) and apparent diffusion coefficient (ADC) in the tumor and the tumor-adjacent area in magnetic resonance imaging (MRI).

METHODS

A total of 38 patients were operated for GBM. All the patients had received diffusion-weighted imaging (DWI) and MRS prior to surgery. ADC of water molecules and values of metabolite indexes of MRS, including n-acetyl aspartate (NAA), choline (Cho) and creatine (Cr), were recorded, and the ratios of Cho/NAA, Cho/Cr and NAA/Cr were calculated. Hematoxylin-eosin (H&E) staining was done to examine the morphology of tumor and of tumor-adjacent tissues; immunohistochemistry (IHC) was performed to examine the expressions of PTEN and p53 in the tumor and the tumor-adjacent area. Finally, the correlations of the expressions of PTEN and p53 with ADC, Cho/NAA, Cho/Cr and NAA/Cr of the tumor and the tumor-adjacent area were analyzed.

RESULTS

H&E staining showed that GBM tissues had disordered morphology, different sizes of cells, large cell nuclei and significant cell heterogeneity. IHC indicated that the expression level of p53 protein in the tumor was significantly higher than in the tumor-adjacent tissues (p<0.05). The expression level of PTEN protein was high in the tumor-adjacent tissues, but significantly deficient in the tumor. DWI showed that the signal of DWI in the tumor was significantly increased, but ADC was decreased compared with the tumor-adjacent area. MRS indicated that the wave band of Cho in the tumor was significantly increased, NAA was significantly lowered, and Cr section was decreased compared with the tumor-adjacent area, while NAA/Cr in the tumor was significantly decreased compared with the tumoradjacent area (p<0.05). Correlation analysis indicated that PTEN levels in the tumor and the tumor-adjacent area were positively correlated with ADC in the corresponding area, while p53 in the tumor and the tumor-adjacent area was negatively correlated with ADC in the corresponding area. Cho/NAA and Cho/Cr in the tumor were positively correlated with p53 in the tumor, but negatively correlated with PTEN in the tumor. However, NAA/Cr of the tumor was irrelevant to the levels of PTEN and p53.

CONCLUSIONS

The test results of DWI and MRS of patients with GBM can accurately reflect the inactivation or mutation of PTEN and p53.

摘要

目的

探讨多形性胶质母细胞瘤(GBM)中第10号染色体缺失的磷酸酶和张力蛋白同源物(PTEN)及p53的表达水平与磁共振波谱(MRS)所获数值以及磁共振成像(MRI)中肿瘤及其邻近区域的表观扩散系数(ADC)之间的相关性。

方法

38例GBM患者接受了手术治疗。所有患者在手术前均接受了扩散加权成像(DWI)和MRS检查。记录水分子的ADC以及MRS代谢物指标值,包括N-乙酰天门冬氨酸(NAA)、胆碱(Cho)和肌酸(Cr),并计算Cho/NAA、Cho/Cr和NAA/Cr比值。进行苏木精-伊红(H&E)染色以检查肿瘤及肿瘤邻近组织的形态;采用免疫组织化学(IHC)检测肿瘤及肿瘤邻近区域PTEN和p53的表达。最后,分析PTEN和p53表达与肿瘤及肿瘤邻近区域的ADC、Cho/NAA、Cho/Cr和NAA/Cr之间的相关性。

结果

H&E染色显示GBM组织形态紊乱,细胞大小不一,细胞核大,细胞异质性显著。IHC结果表明,肿瘤中p53蛋白的表达水平显著高于肿瘤邻近组织(p<0.05)。PTEN蛋白在肿瘤邻近组织中表达水平高,但在肿瘤中显著缺乏。DWI显示肿瘤中DWI信号显著增强,但与肿瘤邻近区域相比ADC降低。MRS表明,与肿瘤邻近区域相比,肿瘤中Cho波段显著升高,NAA显著降低,Cr区段降低,而肿瘤中NAA/Cr与肿瘤邻近区域相比显著降低(p<0.05)。相关性分析表明,肿瘤及肿瘤邻近区域的PTEN水平与相应区域的ADC呈正相关,而肿瘤及肿瘤邻近区域的p53与相应区域的ADC呈负相关。肿瘤中的Cho/NAA和Cho/Cr与肿瘤中的p53呈正相关,但与肿瘤中的PTEN呈负相关。然而,肿瘤的NAA/Cr与PTEN和p53水平无关。

结论

GBM患者的DWI和MRS检测结果可准确反映PTEN和p53的失活或突变情况。

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