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目的探讨原发性中枢神经系统淋巴瘤(PCNSL)3.0 T MRI征象及表观扩散系数(ADC)值、相对表观扩散系数(rADC)值与Ki-67、Bcl-2表达的相关性。方法分析46例经术后病理证实的PCNSL患者的MRI常规及功能成像特征,并测定其ADC、rADC值。病理采用免疫组织化学染色并检测Ki-67和bcl-2蛋白表达情况,分析肿瘤MRI征象及ADC值、rADC值与Ki-67、bcl-2表达的关系。结果 PCNSL发生的部位、是否靠近中线或脑室等与Ki-67、bcl-2的高表达水平无关(P>0.05),而肿瘤直径≥3 cm,内部囊变、坏死、出血,侵及邻近脑膜及室管膜,明显强化,边界不清晰,中或重度瘤周水肿,DWI呈稍高或高信号与Ki-67、bcl-2的高表达具有显著相关性(P<0.05)。Ki-67、bcl-2低表达组的ADC值、rADC值显著高于高表达组(P<0.05),肿瘤Ki-67、bcl-2的表达程度与ADC值、rADC值呈显著负相关。Ki-67与bcl-2表达密切相关,二者呈明显正相关(r=0.772,P=0.000)。结论 3.0 T MRI征象及ADC值、rADC值能在一定程度上反映PCNSL的生物学特性,可间接评价其相关基因的表达,有利于术前无创性评估肿瘤的恶性程度,为PCNSL的预后和治疗提供新的有价值的依据。
Objective To investigate the correlation between 3.0 T MRI features and apparent diffusion coefficient (ADC) values and relative apparent diffusion coefficient (rADC) values of Ki-67 and Bcl-2 in patients with primary central nervous system lymphoma (PCNSL). Methods The routine and functional imaging features of 46 patients with PCNSL confirmed by postoperative pathology were analyzed and their ADC and rADC values were measured. The pathological changes of Ki-67 and bcl-2 protein were detected by immunohistochemical staining. The MRI features, ADC value, rADC value and the expression of Ki-67 and bcl-2 were analyzed. Results The site of PCNSL was not related to the high expression of Ki-67 and bcl-2 (P> 0.05), such as whether it was close to the midline or the ventricle. The tumor size was ≥3 cm. The internal cystic changes, necrosis, hemorrhage, And ependymal membrane were significantly enhanced with unclear border, moderate or severe peritumoral edema, and a slightly higher or higher DWI signal correlated with the high expression of Ki-67 and bcl-2 (P <0.05). The ADC values and rADC values of Ki-67 and bcl-2 low expression group were significantly higher than those of high expression group (P <0.05). The expression of Ki-67 and bcl-2 were negatively correlated with ADC value and rADC value. Ki-67 was closely related to the expression of bcl-2, and there was a significant positive correlation between them (r = 0.772, P = 0.000). Conclusions 3.0 T MRI signs and ADC values and rADC values can reflect the biological characteristics of PCNSL to a certain extent, indirectly evaluate the expression of related genes, which is conducive to the noninvasive evaluation of the malignancy of the tumor before surgery, which is the prognosis and treatment of PCNSL Provide a new valuable basis.