动态增强磁共振与HIF-1a预测食管鳞癌放化疗敏感性

发布时间：2018-09-01 16:50

【摘要】：目的:探讨动态增强磁共振(DCE-MRI)定量参数与乏氧诱导因子-1a(HIF-1a)预测食管鳞癌放化疗敏感性的价值。方法:对22例食管鳞癌患者行常规MRI、DWI、DCE-MRI检查及免疫组化染色。根据免疫组化结果分为HIF-1a阴性组(n=13)及HIF-1a阳性组(n=9),比较治疗前两组间DCE-MRI定量参数值之间的差异及治疗前后各参数值、肿块体积的差异。并以ROC曲线来评价治疗前Ktrans值区分HIF-1a阴性/阳性表达的效能。结果:1治疗前HIF-1a阴性组与阳性组间Ktrans值有显著差异(P=0.001);2治疗前后HIF-1a阴性组Ktrans值、肿块体积(V)有显著差异(P=0.002,P=0.001),而阳性组DCEMRI定量参数、肿块体积(V)无明显差异;3采用ROC曲线评价治疗前Ktrans值对判断食管鳞癌HIF-1a阴性/阳性表达的效能,曲线下面积为0.932,敏感性为100%,特异性为86.4%。结论:食管鳞癌HIF-1a阴性表达患者可能对放化疗更为敏感,治疗前Ktrans值对判断食管鳞癌HIF-1a阴性/阳性表达及对其放化疗敏感性的预测可能有一定的价值。
[Abstract]:Objective: to investigate the value of quantitative parameters of dynamic enhanced magnetic resonance (DCE-MRI) and hypoxia inducible factor-1a (HIF-1a) in predicting radio-chemosensitivity of esophageal squamous cell carcinoma. Methods: 22 cases of esophageal squamous cell carcinoma were examined by routine MRI,DWI,DCE-MRI and immunohistochemical staining. According to the immunohistochemical results, the patients were divided into HIF-1a negative group (nm13) and HIF-1a positive group (NN9). The difference of DCE-MRI quantitative parameters before and after treatment and the difference of mass volume between the two groups before and after treatment were compared. ROC curve was used to evaluate the efficacy of Ktrans value in differentiating negative and positive HIF-1a expression before treatment. Results there was significant difference in Ktrans value between HIF-1a negative group and positive group before and after treatment (P0. 001), and there was significant difference in mass volume (V) between HIF-1a negative group and positive group before and after treatment (P0. 002 + P0. 001), but DCEMRI quantitative parameters in positive group were significantly different before and after treatment. There was no significant difference in tumor volume (V). The ROC curve was used to evaluate the effectiveness of Ktrans value in judging the negative / positive expression of HIF-1a in esophageal squamous cell carcinoma before treatment. The area under the curve was 0.932, the sensitivity was 100 and the specificity was 86.4%. Conclusion: patients with negative expression of HIF-1a in esophageal squamous cell carcinoma may be more sensitive to radiotherapy and chemotherapy. The Ktrans value before treatment may be valuable in predicting the negative / positive expression of HIF-1a and its sensitivity to radiotherapy and chemotherapy in esophageal squamous cell carcinoma.
【作者单位】：湖南省肿瘤医院放诊科;湖南省肿瘤医院胸部放疗科;湖南省肿瘤医院胸外科;
【基金】：湖南省科技厅(2014SR3131) 湖南省临床重点专科(医学影像)建设项目(2015/43) 国家临床重点专科建设项目单位基金项目(2013/544)~~
【分类号】：R735.1;R445.2

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