DTI定量参数对脑胶质瘤术前分级诊断价值及与肿瘤组织中VEGF、MMP-9表达的相关性

陈程; 董磊; 黄欢

doi:10.19732/j.cnki.2096-6210.2021.06.014

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DTI定量参数对脑胶质瘤术前分级诊断价值及与肿瘤组织中VEGF、MMP-9表达的相关性

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- DTI定量参数对脑胶质瘤术前分级诊断价值及与肿瘤组织中VEGF、MMP-9表达的相关性
- The value of DTI quantitative parameters in diagnosis the preoperative grading and correlation with the expression of VEGF and MMP-9 in tumor tissues of brain glioma
- 肿瘤影像学 2021年30卷第6期页码：512-518
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- DOI：10.19732/j.cnki.2096-6210.2021.06.014
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- 网络出版：2021-12-28，
  
  纸质出版：2021-12-28
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陈程,董磊,黄欢. DTI定量参数对脑胶质瘤术前分级诊断价值及与肿瘤组织中VEGF、MMP-9表达的相关性[J]. 肿瘤影像学, 2021, 30(6): 512-518 https://doi.

org/10.19732/j.cnki.2096-6210.2021.06.014
陈程,董磊,黄欢. DTI定量参数对脑胶质瘤术前分级诊断价值及与肿瘤组织中VEGF、MMP-9表达的相关性[J]. 肿瘤影像学, 2021, 30(6): 512-518 https://doi. DOI： 10.19732/j.cnki.2096-6210.2021.06.014.

org/10.19732/j.cnki.2096-6210.2021.06.014 DOI：

摘要

目的：

探讨磁共振成像（magnetic resonance imaging，MRI）弥散张量成像（diffusion tensor imanging，DTI）定量参数与脑胶质瘤病理组织中血管内皮生长因子（vascular endothelial growth factor，VEGF）、基质金属蛋白酶-9（matrix metalloproteinase-9，MMP-9）表达的相关性及其对脑胶质瘤术前分级诊断价值。

方法：

选取2017年1月2020年10月武汉市红十字会医院收治的204例脑胶质瘤患者作为研究对象，根据世界卫生组织（World Health Organization，WHO）肿瘤病理学分级将患者分为低级别组（94例）和高级别组（110例）。所有患者术前均接受MRI和DTI检查，定量测定表观弥散系数（apparent diffusion coefficient，ADC）、各向异性分数（fractional anisotropy，FA）、相对ADC（rADC）、相对FA（rFA）及相对轴向弥散系数（relative axial diffusivity，rAD）值；免疫组织化学法检测术后肿瘤组织中VEGF、MMP-9表达情况。受试者工作特征（receiver operating characteristic，ROC）曲线分析DTI定量参数对脑胶质瘤术前分级诊断价值；Spearman分析DTI定量参数与肿瘤组织中VEGF、MMP-9表达的相关性。

结果：

高级别组DTI定量参数rADC、ADC、rAD、FA、rFA值分别为1.600.44、（1.230.32）10

-9

/s、0.980.23、0.110.03、0.210.06，均低于低级别组1.890.39、（1.470.31）10

-9

/s、1.160.28、0.170.05、0.310.11，差异有统计学意义（

＜0.05）；高级别组肿瘤组织中VEGF、MMP-9阳性表达率分别为94.55%、89.09%，均高于低级别组（38.30%、46.81%），差异有统计学意义（

＜0.05）；ROC曲线分析显示，DTI定量参数rADC、ADC、rAD、FA、rFA诊断脑胶质瘤术前分级的曲线下面积（area under curve，AUC）

分别为0.701（95% CI：0.600~0.802）、0.719（95% CI：0.619~0.820）、0.704（95% CI：0.600~0.809）、0.794（95% CI：0.701~0.888）、0.789（95% CI：0.694~0.885）。Spearman相关性分析显示，DTI定量参数rADC、ADC、rAD、FA、rFA与患者肿瘤组织中VEGF表达呈负相关（

=-0.206、-0.313、-0.281、-0.379、-0.322，

均＜0.05），与MMP-9表达呈负相关（

=-0.396、-0.235、-0.374、-0.281、-0.260，

均＜0.05）。

结论：

DTI定量参数与脑胶质瘤患者肿瘤组织中VEGF、MMP-9表达具有一定相关性，且DTI定量参数有助于脑胶质瘤术前分级诊断。

Abstract

Objective:

To investigate the value of magnetic resonance imaging (MRI) diffusion tensor imaging (DTI) quantitative parameters in diagnosis the preoperative grading and correlation with the expression of vascular endothelial growth factor (VEGF) and matrix metalloproteinase-9 (MMP-9) in pathological tissues of brain glioma.

Methods:

204 cases of brain glioma were selected as the research objects in Wuhan Red Cross Hospital from January 2017 to October 2020

and they were divided into low-grade group (94 cases) and high-grade group (110 cases) according to who tumor pathological grading. All patients were examined by MRI and DTI before operation. The value of apparent diffusion coefficient (ADC)

fractional anisotropy (FA)

relative ADC (rADC)

relative FA (rFA) and relative axial diffusivity (rAD) were measured by quantitatively. The expression of VEGF and MMP-9 in pathologicaltissues were detected by immunohistochemistry. The value of DTI quantitative parameters in diagnosis the preoperative grading of brain glioma was analyzed by receiver operating characteristic (ROC) curve. The correlation with DTI quantitative parameters and the expression of VEGF and MMP-9 in pathological tissues was analyzed by Spearman.

Results:

The value of rADC

ADC

rAD

FA and rFA in high-grade group were (1.600.44)

(1.230.32)10

-9

0.980.23

0.110.03

0.210.06

which were lower than those of low-grade group were (1.890.39)

(1.470.31)10

-9

1.160.28

0.170.05

0.310.11

the differences were statistically significant (

＜0.05). The positive expression rates of VEGF and MMP-9 in high-grade group were 94.55% and 89.09%

which were higher than those of low grade group were 38.30% and 46.81%

the difference were statistically significant (

＜0.05). ROC curve analysis showed that the AUC of rADC

ADC

rAD

FA and rFA in diagnosis the preoperative grading of brain glioma were 0.701 (95% CI: 0.600-0.802)

0.719 (95% CI: 0.619-0.820)

0.704 (95% CI: 0.600-0.809)

0.794 (95% CI: 0.701-0.888) and 0.789 (95% CI: 0.694-0.885). Spearman analysis showed that the rADC

ADC

rAD

FA and rFA were negatively correlated with the expression of VEGF (

=-0.206

-0.313

-0.281

-0.379

-0.322

all

＜0.05)

and negatively correlated with the expression of MMP-9 (

=-0.396

-0.235

-0.374

-0.281

-0.260

all

＜0.05).

Conclusion:

The quantitative parameters of DTI have a certain correlation with the expression of VEGF and MMP-9 in pathological tissues

and the quantitative parameters of DTI were helpful to diagnosis the preoperative grading of brain glioma.

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