作者：张利琴，刘明，曹兵

单位：

075000河北省张家口市，河北北方学院附属第一医院神经外科 通信作者：刘明，E-mail：xuzhengrong3@126.com

Units：

Departent of Neurosurgery, the First Affiliated Hospital of Hebei North University, Zhangjiakou 075000, China Corresponding author: LIU Ming, E-mail: xuzhengrong3@126.com

关键词：

脑胶质瘤; 肿瘤分级; 氢质子磁共振波谱; Survivin蛋白;

Keywords：

Glioma; Tumor grade; Hydrogen proton magnetic resonance spectroscopy; Survivin protein

CLC：

DOI：

10.12114/j.issn.1008-5971.2022.00.107

Funds：

河北省2019年度医学科学研究课题计划项目（20190883）

摘要：

目的 分析氢质子磁共振波谱(1H-MRS)在脑胶质瘤分级中的应用价值。方法 回顾性选取2019年2月至2021年5月河北北方学院附属第一医院神经外科收治的85例脑胶质瘤患者,根据术后组织病理结果并参照中枢神经系统肿瘤分级标准将其分为低级别组(Ⅰ～Ⅱ级,n=40)和高级别组(Ⅲ～Ⅳ级,n=45)。采用1H-MRS定量分析脑组织代谢产物比值,包括胆碱(Cho)/肌酸(Cr)比值、Cho/N-乙酰天冬氨酸(NAA)比值、NAA/Cr比值。比较脑胶质瘤患者瘤体区和对侧正常脑组织区代谢产物比值,两组患者瘤体区代谢产物比值及Survivin蛋白免疫活性指数(IRS)积分、阳性率;脑胶质瘤患者瘤体区代谢产物比值与Survivin蛋白IRS积分的相关性分析采用Pearson相关分析。结果 脑胶质瘤患者瘤体区Cho/Cr比值、Cho/NAA比值高于对侧正常脑组织区,NAA/Cr比值低于对侧正常脑组织区(P<0.05)。高级别组患者瘤体区Cho/Cr比值、Cho/NAA比值高于低级别组,NAA/Cr比值低于低级别组(P<0.05)。高级别组Survivin蛋白IRS积分、阳性率高于低级别组(P<0.05)。Pearson相关分析结果显示,脑胶质瘤患者瘤体区Cho/Cr比值(r=0.516,P<0.001)、Cho/NAA比值(r=0.612,P<0.001)与Survivin蛋白IRS积分呈正相关,NAA/Cr比值与Survivin蛋白IRS积分呈负相关(r=-0.476,P<0.001)。结论 采用1H-MRS定量检测的代谢产物比值与脑胶质瘤分级及Survivin蛋白表达有关,其可作为脑胶质瘤术前分级的重要影像学参考指标。

Abstract：

【Abstract】　Objective To analyze the application value of hydrogen proton magnetic resonance spectroscopy(1 H-MRS) in the grade of glioma. Methods A total of 85 patients with glioma treated in the Department of Neurosurgery of theFirst Affiliated Hospital of Hebei North University from February 2019 to May 2021 were retrospectively selected. According tothe postoperative histopathological results and the grading standard of central nervous system tumors, they were divided into lowgrade group (grade Ⅰ-Ⅱ,n=40) and high-grade group (grade Ⅲ-Ⅳ, n=45) . 1 H-MRS was used to quantitatively analyze themetabolites ratio in brain tissue, including choline (Cho) /creatine (Cr) ratio, Cho/N-acetyl aspartate (NAA) ratio and NAA/Crratio. The metabolites ratio was compared between tumor body area and contralateral normal brain tissue area, the metabolites ratioin tumor body area, immune activity index (IRS) score and positive rate of Survivin protein were compared between the two groups;Pearson correlation analysis was used to analyze the correlation between metabolites ratio in tumor body area and the IRS score ofSurvivin protein in patients with glioma. Results The Cho/Cr ratio and Cho/NAA ratio in tumor body area of patients with gliomawere higher than those in contralateral normal brain tissue area, and the NAA/Cr ratio was lower than that in contralateral normalbrain tissue area (P <0.05) . The Cho/Cr ratio and Cho/NAA ratio in tumor body area in the high-grade group were higher thanthose in the low-grade group, and the NAA/Cr ratio was lower than that in the low-grade group (P <0.05) . The IRS score andpositive rate of Survivin protein in high-grade group were higher than those in low-grade group (P <0.05) . Pearson correlationanalysis results showed that Cho/Cr ratio (r=0.516, P <0.001) and Cho/NAA ratio (r=0.612, P <0.001) were positively correlatedwith IRS score of Survivin protein, and NAA/Cr ratio was negatively correlated with IRS score of Survivin protein (r=-0.476,P <0.001) . Conclusion The metabolites ratio quantitatively detected by 1 H-MRS is related to the grade of glioma and theexpression of Survivin protein, which can be used as an important imaging reference index for the preoperative grade of glioma.

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