非小细胞肺癌脑转移患者MRI表现与原发灶病理类型的关系
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摘要
目的探讨非小细胞肺癌脑转移患者MRI表现与原发灶病理类型的关系。方法回顾性分析2016年3月——2017年4月我院收治的108例经临床病理及影像学证实的非小细胞肺癌脑转移患者影像学资料。依照病理类型分为腺癌、鳞癌、腺鳞癌三组。所有患者均行MRI扫描,观察并记录脑转移瘤大小、数目、转移部位、病灶实质信号、病灶周围水肿程度;采用免疫组化法观察非小细胞肺癌脑转移瘤的Ki-67标记指数,分析rADC值与Ki-67的关系。结果单发、多发脑转移瘤在腺癌组、鳞癌组和腺鳞癌组间分布存在差异(P<0.05)。鳞癌脑转移瘤单发较腺癌及腺鳞癌多见。腺癌组、鳞癌组和腺鳞癌组在脑转移瘤转移部位、脑转移病灶水肿程度、脑转移病灶内部出血发生率及病灶强化类型方面比较,差异均无统计学意义(P>0.05)。脑转移病灶大小在腺癌、鳞癌、腺鳞癌之间差异有统计学意义(P<0.05)。腺癌患者脑转移瘤体积小者居多,而鳞癌及腺鳞癌脑转移瘤体积大者居多。腺鳞癌组、鳞癌组和腺癌组脑转移瘤实质rADC值分别为(1.44±0.32)、(1.23±0.35)和(0.84±0.23),组间比较差异均有统计学意义(P<0.05)。腺癌组、鳞癌组和腺鳞癌组脑转移瘤囊变发生率比较,差异有统计学意义(P<0.05)。Ki-67标记指数与非小细胞肺癌脑转移瘤rADC值呈负相关。结论非小细胞肺癌脑转移病灶大小、数目、内部囊变、实质rADC值与原发病灶类型存在联系,分析Ki-67表达与rADC的关系,可有助于对肿瘤增殖程度的评估。
Objective To investigate the relationship between MRI findings and pathological types of primary brain metastases in non-small cell lung cancer.Methods From March 2016 to April 2017,one hundred and eight patients with brain metastasis from non-small cell lung cancer confirmed by clinical pathology and imaging were retrospectively analyzed.According to pathological types,they were divided into three groups:aenocarcinoma,squamous cell carcinoma and adenosquamous cell carcinoma.All patients underwent MRI scanning to observe and record the size,number,location,parenchymal signal and edema degree around the brain metastases.Ki-67 marker index of brain metastases from non-small cell lung cancer was observed by immunohistochemical method,and the relationship between rADC value and Ki-67 was analyzed.Results There were differences in the distribution of single and multiple brain metastases among adenocarcinoma group,squamous cell carcinoma group and adenosquamous cell carcinoma group(P<0.05).Brain metastases from squamous cell carcinoma group were more common than adenocarcinoma group and adenosine carcinoma group.There was no significant difference in the location of metastasis,the degree of edema,the incidence of intracerebral hemorrhage and the type of enhancement between adenocarcinoma group,squamous cell carcinoma group and adenosquamous cell carcinoma group(P>0.05).The size of brain metastases was significantly different between adenocarcinoma group,squamous cell carcinoma and adenosine carcinomagroup(P<0.05).In patients with adenocarcinoma,most of the metastatic brain tumors are small,while those with squamous cell carcinoma and adenosine squamous cell carcinoma have larger brain metastases.The rADC values of brain metastases in adenosquamous carcinoma group,squamous cell carcinoma group and adenocarcinoma group were(1.44±0.32),(1.23 ± 0.35)and(0.84 ± 0.23),respectively,there were significant differences between the two groups(P<0.05).The incidence of brain metastases in adenocarcinoma group,squamous cell carcinoma group and adenosquamous cell carcinoma group was significantly different(P<0.05).The Ki-67 marker index was negatively correlated with the rADC value of brain metastases in non-small cell lung cancer.Conclusion The size,number,internal cystic degeneration and rADC value of brain metastases in non-small cell lung cancer are related to the type of primary lesions.The analysis of the relationship between Ki-67 expression and rADC can help to evaluate the degree of tumor proliferation.
Objective To investigate the relationship between MRI findings and pathological types of primary brain metastases in non-small cell lung cancer.Methods From March 2016 to April 2017,one hundred and eight patients with brain metastasis from non-small cell lung cancer confirmed by clinical pathology and imaging were retrospectively analyzed.According to pathological types,they were divided into three groups:aenocarcinoma,squamous cell carcinoma and adenosquamous cell carcinoma.All patients underwent MRI scanning to observe and record the size,number,location,parenchymal signal and edema degree around the brain metastases.Ki-67 marker index of brain metastases from non-small cell lung cancer was observed by immunohistochemical method,and the relationship between rADC value and Ki-67 was analyzed.Results There were differences in the distribution of single and multiple brain metastases among adenocarcinoma group,squamous cell carcinoma group and adenosquamous cell carcinoma group(P<0.05).Brain metastases from squamous cell carcinoma group were more common than adenocarcinoma group and adenosine carcinoma group.There was no significant difference in the location of metastasis,the degree of edema,the incidence of intracerebral hemorrhage and the type of enhancement between adenocarcinoma group,squamous cell carcinoma group and adenosquamous cell carcinoma group(P>0.05).The size of brain metastases was significantly different between adenocarcinoma group,squamous cell carcinoma and adenosine carcinomagroup(P<0.05).In patients with adenocarcinoma,most of the metastatic brain tumors are small,while those with squamous cell carcinoma and adenosine squamous cell carcinoma have larger brain metastases.The rADC values of brain metastases in adenosquamous carcinoma group,squamous cell carcinoma group and adenocarcinoma group were(1.44±0.32),(1.23 ± 0.35)and(0.84 ± 0.23),respectively,there were significant differences between the two groups(P<0.05).The incidence of brain metastases in adenocarcinoma group,squamous cell carcinoma group and adenosquamous cell carcinoma group was significantly different(P<0.05).The Ki-67 marker index was negatively correlated with the rADC value of brain metastases in non-small cell lung cancer.Conclusion The size,number,internal cystic degeneration and rADC value of brain metastases in non-small cell lung cancer are related to the type of primary lesions.The analysis of the relationship between Ki-67 expression and rADC can help to evaluate the degree of tumor proliferation.
引文
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[3]Patel CK,Vemaraju R,Glasbey J,et al.Trends in peri-operative performance status following resection of high grade glioma and brain metastases:The impact on survival[J].Clin Neurol Neurosurg,2018,164:67-71
[4]Neumann R,Abu-Isa J,Stamou S,et al.Papilledema as a diagnostic sign of cerebral edema on postmortem magnetic resonance imaging[J].Am J Forensic Med Pathol,2016,37(4):264-269
[5]Duchnowska R,Sperinde J,Chenna A,et al.Quantitative HER2 and p95HER2 levels in primary breast cancers and matched brain metastases[J].Neuro Oncol,2015,17(9):1241-1249
[6]Hjorthaug K,Hjbjerg J A,Knap M M,et al.Accuracy of 18F-FDG PET-CT in triaging lung cancer patients with suspected brain metastases for MRI[J].Nucl Med Commun,2015,36(11):1084-1090
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[9]Majchrzak E,Szybiak B,Wegner A,et al.Oral cavity and oropharyngeal squamous cell carcinoma in young adults:a review of the literature[J].Radiol Oncol,2014,48(1):1-10
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[15]杨翠翠.探讨肺癌脑转移瘤的MRI表现与原发灶病理类型的相关性[D].济南大学,2016
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