Yuan Xuexia, Liu Deguo, Wang Yanhui, Li Xiaoxia
Medical Image Center, Affiliated Hospital of Jining Medical University, Jining, Shandong 272029, China.
J BUON. 2018 Mar-Apr;23(2):410-415.
To investigate the significance of nuclear magnetic resonance (NMR) combined with Ki-67 and vascular endothelial growth factor (VEGF) detection in the diagnosis and prognosis evaluation of brain glioma.
78 patients with brain glioma treated at the Affiliated Hospital of Jining Medical University from January 2015 to August 2017 were studied. All patients underwent the NMR diffusion tensor imaging examination. The expressions of Ki-67 and VEGF in brain glioma tissues were detected using immunohistochemistry and survival analyses were performed for patients in high apparent diffusion coefficient (ADC) group and low ADC group, high-expression Ki-67 and VEGF group and low-expression Ki-67 and VEGF group before treatment. Moreover, the value of combined diagnosis in the prognosis evaluation of patients was analyzed.
NMR diffusion tensor imaging showed that the fractional anisotropy (FA) value in the tumor enhancement region on the affected side was significantly lower than in the contralateral normal region, but ADC was significantly higher in the contralateral normal region; the FA value in grade I-II brain glioma enhancement region was higher compared with grade III-IV glioma enhancement region, but ADC was lower in the grade-III-IV glioma enhancement region (p<0.05). The low expression rates of Ki-67 and VEGF in patients with grade I-II brain glioma were significantly higher than in patients with grade III-IV glioma (p<0.05). After treatment, the 3-year survival rate of high ADC group was lower than that of low ADC group, and the 3-year survival rate of high-expression Ki-67 and VEGF group was also obviously lower than that in low-expression Ki-67 and VEGF group (p<0.05). Besides, the area under the receiver operating characteristic (ROC) curve of NMR combined with Ki-67 and VEGF detection in the prediction of patient prognosis was 0.906, the sensitivity 91.6%, and the specificity 89.5%.
NMR diffusion tensor imaging has a high application value in the diagnosis of brain glioma. The expressions of Ki-67 and VEGF are related to the pathological grade of glioma, which can be used as biological indexes for the diagnosis of glioma. Moreover, the combined detection of the three items can not only accurately determine the grade of glioma malignancy, but also effectively evaluate the prognosis of patients, thus providing a scientific basis for the selection of therapeutic regimen.
探讨核磁共振（NMR）联合Ki-67和血管内皮生长因子（VEGF）检测在脑胶质瘤诊断及预后评估中的意义。
研究2015年1月至2017年8月在济宁医学院附属医院接受治疗的78例脑胶质瘤患者。所有患者均接受NMR扩散张量成像检查。采用免疫组织化学法检测脑胶质瘤组织中Ki-67和VEGF的表达，并对治疗前高表观扩散系数（ADC）组与低ADC组、高表达Ki-67和VEGF组与低表达Ki-67和VEGF组的患者进行生存分析。此外，分析联合诊断在患者预后评估中的价值。
NMR扩散张量成像显示，患侧肿瘤强化区域的各向异性分数（FA）值明显低于对侧正常区域，但对侧正常区域的ADC值明显更高；I-II级脑胶质瘤强化区域的FA值高于III-IV级胶质瘤强化区域，但III-IV级胶质瘤强化区域的ADC值更低（p<0.05）。I-II级脑胶质瘤患者中Ki-67和VEGF的低表达率明显高于III-IV级胶质瘤患者（p<0.05）。治疗后，高ADC组的3年生存率低于低ADC组，高表达Ki-67和VEGF组的3年生存率也明显低于低表达Ki-67和VEGF组（p<0.05）。此外，NMR联合Ki-67和VEGF检测预测患者预后的受试者工作特征（ROC）曲线下面积为0.906，灵敏度为91.6%，特异性为89.5%。
NMR扩散张量成像在脑胶质瘤诊断中具有较高的应用价值。Ki-67和VEGF的表达与胶质瘤的病理分级有关，可作为胶质瘤诊断的生物学指标。此外，三项联合检测不仅能准确判断胶质瘤的恶性程度，还能有效评估患者的预后，从而为治疗方案的选择提供科学依据。
