前列腺癌多模态MRI参数与P504s蛋白表达的相关性分析
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摘要
目的:评估前列腺癌(PCa)组织中P504s、34β-E12、P63表达情况,并探讨PCa多模态MRI参数与P504s的相关性。方法:对43例PCa患者和64例非PCa患者(均经前列腺穿刺活检或根治性前列腺切除术后病理证实)的多模态MRI影像资料(常规MRI、扩散加权成像DWI、动态增强磁共振成像DCE-MRI)进行回顾性分析,获取时间-信号强度(SI-T)曲线,计算Tmax(s)、SImax%、Rmax%和自动生成ADC值;运用免疫组化方法检测前列腺组织中P504s、34β-E12、P63表达情况。结果:PCa组P504s、34β-E12、P63阳性表达率分别为83.7%、25.6%、25.6%,非PCa组分别为0%、91.0%、86.0%,两组间差异有统计学意义(P<0.05);PCa组和非PCa组ADC值、Tmax(s)、SImax%、Rmax%分别为:(0.83±0.22)×10~(-3)mm~2/s、(21.30±10.78)s、(1.75±0.39)%、(20.20±15.50)%和(1.34±0.28)×10~(-3)mm~2/s、(50.22±36.31)s、(1.24±0.41)%、(7.98±6.25)%,组间比较差异有统计学意义(P<0.05);ADC值、Tmax(s)与P504s表达呈负相关(r=-0.60、-0.37,P<0.01);而SImax%、Rmax%与P504s表达呈正相关(r=0.50、0.45,P<0.01)。结论:PCa多模态MRI各参数与P504s表达有相关性,可作为预测肿瘤恶性程度的影像生物学标志物。
Objective: To evaluate the expressions of P504s, 34β-E12, and P63 proteins in PCa and the correlation between the parameters of multi-modality MRI and the expression of P504s. Methods: We retrospectively analyzed the multi-modality MRI data on 43 PCa and 64 non-PCa patients. We obtained the signal intensity-time(SI-T) curves, maximum SI(SImax), time to SImax(Tmax), rate of maximum enhancement(Rmax), and automatically generated apparent diffusion coefficient(ADC) values by conventional, diffusion-weighted and dynamic contrast-enhanced MRI, and determined the expressions of P504s, 34β-E12 and P63 in the prostatic tissues of the patients by immunohistochemistry. Results: Statistically significant differences were observed between the PCa and non-PCa groups in the positive expressions of P504s(83.7% vs 0%, P < 0.05), 34β-E12(25.6% vs 91.0%, P < 0.05) and P63(25.6% vs 86.0%, P < 0.05) in the prostatic tissue, the ADC value([0.83 ± 0.22] vs [1.34 ± 0.28] ×10~(-3)mm~2/s, P < 0.05), Tmax([21.30 ± 10.78] vs [50.22 ± 36.31] s, P < 0.05), SImax([1.75 ± 0.39]% vs [1.24 ± 0.41]%, P < 0.05), and Rmax([20.20 ± 15.50]% vs [7.98 ± 6.25]%, P < 0.05). The expression of P504s was correlated negatively with the ADC value and Tmax(r =-0.60 and-0.37, P < 0.01) but positively with SImax and Rmax(r = 0.50 and 0.45, P < 0.01). Conclusion: The parameters of multi-modality MRI are correlated with the expression of P504s in PCa and can be used as imaging biomarkers for predicting the degrees of its malignancy.
Objective: To evaluate the expressions of P504s, 34β-E12, and P63 proteins in PCa and the correlation between the parameters of multi-modality MRI and the expression of P504s. Methods: We retrospectively analyzed the multi-modality MRI data on 43 PCa and 64 non-PCa patients. We obtained the signal intensity-time(SI-T) curves, maximum SI(SImax), time to SImax(Tmax), rate of maximum enhancement(Rmax), and automatically generated apparent diffusion coefficient(ADC) values by conventional, diffusion-weighted and dynamic contrast-enhanced MRI, and determined the expressions of P504s, 34β-E12 and P63 in the prostatic tissues of the patients by immunohistochemistry. Results: Statistically significant differences were observed between the PCa and non-PCa groups in the positive expressions of P504s(83.7% vs 0%, P < 0.05), 34β-E12(25.6% vs 91.0%, P < 0.05) and P63(25.6% vs 86.0%, P < 0.05) in the prostatic tissue, the ADC value([0.83 ± 0.22] vs [1.34 ± 0.28] ×10~(-3)mm~2/s, P < 0.05), Tmax([21.30 ± 10.78] vs [50.22 ± 36.31] s, P < 0.05), SImax([1.75 ± 0.39]% vs [1.24 ± 0.41]%, P < 0.05), and Rmax([20.20 ± 15.50]% vs [7.98 ± 6.25]%, P < 0.05). The expression of P504s was correlated negatively with the ADC value and Tmax(r =-0.60 and-0.37, P < 0.01) but positively with SImax and Rmax(r = 0.50 and 0.45, P < 0.01). Conclusion: The parameters of multi-modality MRI are correlated with the expression of P504s in PCa and can be used as imaging biomarkers for predicting the degrees of its malignancy.
引文
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[3] 张敏,刘明辉.经直肠超声造影诊断前列腺癌的临床价值.中南大学学报(医学版),2018,43(8):882-885.
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[15] Anwar SS,Anwar Khan Z,Shoaib Hamid R,et al.Assessment of apparent diffusion coefficient values as predictor of aggressiveness in peripheral zone prostate cancer:Comparison with Gleason score.ISRN Radiol,2014,2014:1-7.
[16] Sun NN,Liu C,Gex L,et al.Dynamic contrast-enhanced MRI for advanced esophageal cancer response assessment after concurrent chemoradiotherapy.Diagn Interv Radiol,2018,24(4):195-202.
[17] 孙静,敖炜群,耿和,等.DWI结合DCE-MRI在前列腺癌分期诊断中的应用.中国临床医学影像杂志,2014,25(12):870-873.
[18] Scialpi M,Rondoni V.Is contrast enhancement needed for diagnostic prostate MRI?Transl Androl Urol,2017,6(3):499-509.
[19] 龚德霖,李铮,万志成,等.P504s、34βE12与p65联合CK5/6对前列腺良恶性病变鉴别诊断的临床意义.中国地方病防治杂志,2017,32(5):564,566.
[20] Bill-Axelson A,Holmberg L,Garmo H,et al.Radical prostatectomy or watchful waiting in early prostate cancer.N Engl J Med,2014,370(10):932-942.
[21] 姚世文,蔡亚琴,倪建.DCE-MRI定量参数和ADC值对前列腺癌的临床诊断价值及ADC值与血清PSA、P504s的相关性.现代医学,2017,45(9):1266-1270.
[22] 谭敬安,陈焱君,陈瑞燕,等.良性前列腺增生及前列腺癌的ADC值与PAP、P504S、PSA表达的相关性研究.癌症进展,2015,13(5):529-532.
[2] 陆殿元,沈理,蔡建荣,等.超声造影对于不同PSA含量前列腺癌诊断的临床价值.中华男科学杂志,2018,24(1):50-54.
[3] 张敏,刘明辉.经直肠超声造影诊断前列腺癌的临床价值.中南大学学报(医学版),2018,43(8):882-885.
[4] Bloom JB,Gold SA,Hale JR,et al."Super-active surveillance":MRI ultrasound fusion biopsy and ablation for less invasive management of prostate cancer.Gland Surg,2018,7(2):166-187.
[5] Murray NP,Reyes E,Fuenteacba IC,et al.Extended use of P504S positive primary circulating prostate cell detection to determine the need for initial prostate biopsy in a prostate cancer screening program in Chile.Asian Pac J Cancer Prew,2014,15(21):9335-9339.
[6] Ockner RK,Kaikaus RM,Bass NM.Fatty-acid metabolism and the pathogenesis of hepatocellular carcinoma:Review and hypothesis.Hepatocellular,1993,18(3):669-76.
[7] Kuefer R,Varambally S,Zhou M,et al.Alpha-methylacyl-CoA racemase:Expression levels of this novel cancer biomarker depend on tumor differentiation.Am J Pathol,2002,161(3):841-848.
[8] Yeldandi AV,Rao MS,Reddy JK,et al.Hydrogen peroxide generation in peroxisome proliferator-induced oncogenesis.Mutat Res,2000,448(2):159-177.
[9] Saez E,Tantonoz P,Nelson MC,et al.Activators of the nuclear receptor PPAR gamma enhance colon polyp formation.Nat Med,1998,4(9):1058-1061.
[10] Zheng S,Chang B,Faith DA,et al.Sequence variants of alpha-methylacyl-CoA racemase associated with prostate cancer risk.Cancer Res,2002,62(22):6485-6488.
[11] 吕艳,朱润庆,常伟,等.P504S、P63和CK34β-E12联合检测在前列腺癌病理诊断中的价值.中国血液流变学杂志,2010,20 (3):424-426.
[12] 邵志红,王培军.多模态磁共振成像在前列腺癌主动监测中的应用进展.中华临床医师杂志(电子版),2015,9(23):4417-4420.
[13] Ueno YR,Tamada T,Takahashi S,et al.Computed diffusion-weighted imaging in prostate cancer:Basics,advantages,cautions,and future prospects.Korean J Radiol,2018,19(5):832-837.
[14] 李鹏,杨文君,陈志强,等.前列腺癌动态对比增强MRI与扩散加权成像的相关性.中国医学影像技术,2013,29(2):264-268.
[15] Anwar SS,Anwar Khan Z,Shoaib Hamid R,et al.Assessment of apparent diffusion coefficient values as predictor of aggressiveness in peripheral zone prostate cancer:Comparison with Gleason score.ISRN Radiol,2014,2014:1-7.
[16] Sun NN,Liu C,Gex L,et al.Dynamic contrast-enhanced MRI for advanced esophageal cancer response assessment after concurrent chemoradiotherapy.Diagn Interv Radiol,2018,24(4):195-202.
[17] 孙静,敖炜群,耿和,等.DWI结合DCE-MRI在前列腺癌分期诊断中的应用.中国临床医学影像杂志,2014,25(12):870-873.
[18] Scialpi M,Rondoni V.Is contrast enhancement needed for diagnostic prostate MRI?Transl Androl Urol,2017,6(3):499-509.
[19] 龚德霖,李铮,万志成,等.P504s、34βE12与p65联合CK5/6对前列腺良恶性病变鉴别诊断的临床意义.中国地方病防治杂志,2017,32(5):564,566.
[20] Bill-Axelson A,Holmberg L,Garmo H,et al.Radical prostatectomy or watchful waiting in early prostate cancer.N Engl J Med,2014,370(10):932-942.
[21] 姚世文,蔡亚琴,倪建.DCE-MRI定量参数和ADC值对前列腺癌的临床诊断价值及ADC值与血清PSA、P504s的相关性.现代医学,2017,45(9):1266-1270.
[22] 谭敬安,陈焱君,陈瑞燕,等.良性前列腺增生及前列腺癌的ADC值与PAP、P504S、PSA表达的相关性研究.癌症进展,2015,13(5):529-532.