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目的评价透明细胞肾癌(CRCC)R_2~*值变化与肿瘤组织内缺氧诱导因子(HIF-1α、HIF-2α)表达的相关性。方法回顾性分析26例经手术病理证实的CRCC患者血氧水平依赖MRI与HIF-1α、HIF-2α的结果。使用Furhman法划分肿瘤的病理级别,并将所有患者分成低级别和高级别两个亚组。测量所有患者肿瘤实质的R_2~*值。比较高低级别组CRCC之间HIF-1α、HIF-2α表达情况的差异。使用Pearson相关分析法评价R_2~*值与HIF-α阳性表达率之间的关系。结果低级别组(Ⅰ+Ⅱ)17例,高级别组(Ⅲ+Ⅳ)9例。高级别组R_2~*值明显高于低级别组(P<0.005)。高级别组HIF-α阳性表达率值明显高于低级别组(P<0.05)。CRCC的R_2~*值与HIF-2α表达与组织的R_2~*值呈正相关(P<0.05)。结论 R_2~*值作为一种无创的评价指标有助于CRCC的病理核分级,且R_2~*值与HIF-2α表达水平存在相关性。
Objective To evaluate the relationship between the change of R_2 ~ * value and the expression of hypoxia inducible factor (HIF-1α, HIF-2α) in clear cell renal cell carcinoma (CRCC). Methods We retrospectively analyzed the results of blood oxygenation level in MRI and HIF-1α and HIF-2α in 26 CRCC patients confirmed by surgery and pathology. Furhman’s method was used to classify the pathological grade of the tumor, and all patients were divided into two subgroups: low-grade and high-grade. The R_2 ~ * values of all patients’ tumors were measured. The difference between the expression of HIF-1α and HIF-2α in high and low grade CRCC was compared. Pearson correlation analysis was used to evaluate the relationship between R_2 ~ * value and HIF-α positive rate. Results Low-grade group (Ⅰ + Ⅱ) in 17 cases, high-grade group (Ⅲ + Ⅳ) in 9 cases. R_2 ~ * values in the high-grade group were significantly higher than those in the low-grade group (P <0.005). The positive rate of HIF-α in high-grade group was significantly higher than that in lower-grade group (P <0.05). The R_2 ~ * value of CRCC was positively correlated with the expression of HIF-2α and the R_2 ~ * value (P <0.05). Conclusion R_2 ~ * value as a noninvasive evaluation index contributes to the pathological nuclear grade of CRCC, and there is a correlation between R_2 ~ * value and HIF-2α expression level.