胶质瘤脑浸润程度与病理级别的相关性研究.docVIP

胶质瘤脑浸润程度与病理级别的相关性研究 晏怡1 唐文渊1 邓朝霞2 谢兵吕发金刘斌5 （1重庆医科大学附属第一医院神经外科 400016； 2 第三军医大学西南医院急救部ICU； 3第三军医大学西南医院放射科； 4重庆医科大学附属第一医院放射科； 5重庆医科大学病理） 目的：运用病理和影像的方法研究胶质瘤脑浸润程度与其病理级别的关系。 方法：1. 选择需作内减压的脑胶质瘤30例，通过手术获取肿瘤区和瘤周水肿区组织标本；2肿瘤区组织通过病理检查确定肿瘤分级，瘤周水肿区通过病理检查作肿瘤细胞计数和细胞密度分析，确定肿瘤脑浸润程度，将两者作相关分析；3. 利用DTI成像测量5个兴趣区（肿瘤实体区、瘤周水肿区、水肿外区、相对正常白质区和对侧白质区）的FA值，将不同兴趣区的FA值与肿瘤的病理脑浸润程度和病理级别分别作相关分析。 结果：1. 脑胶质瘤脑浸润程度和病理级别间无显著相关性；2. 瘤周水肿区的FA值与胶质瘤病理脑浸润程度呈负相关性；3. 瘤周水肿区的FA值与胶质瘤病理级别间无显著相关性。 结论：从病理和影像分析的角度来看，传统脑胶质瘤病理分级与肿瘤脑浸润程度无相关系，高级别的胶质瘤并不一定具有更高的侵袭性。 关键词：胶质瘤 病理 侵袭 磁共振成像 弥散张量成像 R730.264 [文献标识码]A Correlative analysis between the brain invasive potentials and pathological grading of gilomas YAN Yi 1, TANG Wenyuan 1, DENG Zhaoxia 2, XIEBin 3, LU Fajin 4, LIU Bin 5 （1 Department of Neurosurgery, The first Affiliated Hospital of Chongqing Medical University, 400016; 2 Department of Intensive Care Unit, Xi’nan Hostpital of The Third Military Medical University; 3 Department of Radiology, Xi’nan Hostpital of The Third Military Medical University; 4 Department of Radiology, The first Affiliated Hospital of Chongqing Medical University; 5 Department of Pathology, Chongqing University of Medical Sciences） Objective: To correlation analyze the relationship between pathological grading of gliomas and degree of brain invasion (density of tumor cells present in peritumoral area) by means of diffusion tensor imaging (DTI) and pathology. Methods: 1. 30 histologically confirmed gilomas, which all need internal decompression according to neurosurgery experts, were included to our study and biopsy of tumoral and peritumoral edema region. 2. Pathological grading was determined according to WHO standard, and degree of brain invasion was recorded by calculating the density of tumor cells in the peritumoral edema region; correlation analysis was done. 3. Five regions of interest (ROIs)-- tumor, peritumoral edema region, outer region of edema, white matter region and contralateral white matter region --were drawn within the tumo