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目的利用31P-MRS检测肝细胞癌(HCC),探讨各代谢参数与临床及病理特征的关系。方法对32个肝细胞癌病灶进行单体素31P-MRS扫描。根据手术及病理结果显示有无包膜、肝硬化、侵袭转移性以及恶性程度分别进行分组。根据31P-MRS扫描结果计算肝细胞内pH值(pHi)、磷酸单脂(PME)、磷酸双脂(PDE)、无机磷(Pi)、γ-ATP、β-ATP、α-ATP、PME/ATP、Pi/ATP、PME/PDE、PME/Pi、PDE/Pi、PDE/ATP和低能磷酸盐(LEP)等参数。分析以上代谢参数在各分组之间差异。结果 HCC的pHi、Pi、Pi/ATP、LEP均明显大于周围肝组织,α-ATP和PDE/Pi则相反(P<0.05)。包膜组病灶的β-ATP小于无包膜组(t=2.290,P=0.029)。肝硬化组HCC病灶pHi大于无肝硬化组,而γ-ATP则相反(P<0.05)。侵袭转移组的PME和PME/ATP均明显大于无侵袭转移组(P<0.05)。另外,在HCC高、中、低分化病理类型之间,Pi、Pi/ATP、PME/Pi、PDE/Pi均有统计学差异(P<0.05)。其余代谢参数在以上各种分组之间未见统计学差异(P>0.05)。结论 31P-MRS代谢参数与HCC临床、病理特征具有一定的关系,利用31P-MRS可对HCC的生物学行为进行无创评估。
Objective To detect hepatocellular carcinoma (HCC) by 31P-MRS and investigate the relationship between metabolic parameters and clinical and pathological features. Methods Mononuclear 31P-MRS scanning of 32 hepatocellular carcinoma lesions was performed. According to the results of surgery and pathology shows whether the capsule, cirrhosis, invasion and metastasis and malignancy were grouped. The intracellular pH (pHi), PME, PDE, Pi, γ-ATP, β-ATP, α-ATP and PME / ATP, Pi / ATP, PME / PDE, PME / Pi, PDE / Pi, PDE / ATP and low energy phosphate (LEP) and other parameters. Analysis of the above metabolic parameters in the differences between the various groups. Results The pHi, Pi, Pi / ATP and LEP of HCC were significantly higher than those of the surrounding liver tissues, while the values of α-ATP and PDE / Pi were opposite (P <0.05). Β-ATP in the lesion of the capsule group was smaller than that in the non-capsule group (t = 2.290, P = 0.029). The pH value of HCC lesions in cirrhotic patients was higher than that in patients without liver cirrhosis, while that of γ-ATP was opposite (P <0.05). The levels of PME and PME / ATP in the invasion and metastasis groups were significantly higher than those in the non-invasion and metastasis groups (P <0.05). In addition, Pi, Pi / ATP, PME / Pi and PDE / Pi were significantly different between high, moderate and poorly differentiated HCC (P <0.05). The remaining metabolic parameters in all the above groups showed no statistical difference (P> 0.05). Conclusion The metabolic parameters of 31P-MRS are related to the clinical and pathological features of HCC. 31P-MRS can be used to evaluate the biological behavior of HCC.