摘要目的 探讨人脑胶质瘤~(18)F-脱氧葡萄糖(FDG)摄取水平与乏氧诱导因子-1α(HIF-1α)表达及微血管密度(MVD)之间的相关性.方法 对41例脑胶质瘤(其中高级别肿瘤23例,低级别肿瘤18例)患者术前行~(18)F-FDG PET检查,计算肿瘤与对侧正常脑白质的最大标准摄取值(SUV_(max))比值(T/WM).肿瘤标本采用免疫组织化学染色,观察HIF-1α表达及定量研究肿瘤MVD,评价T/WM与HIF-1α表达及MVD的相关性.用SPSS 11.5软件进行t检验、单因素方差分析及Spearman相关分析、Wilcoxon秩和检验.结果 (1)高、低级别肿瘤的T/WM、HIF-1α阳性表达率及MVD分别为3.39 ±1.43,95.7%,44.13±16.1和1.46±0.55,55.6%,18.83±7.07,2组间T/WM、HIF-1α表达及MVD差异均有统计学意义(t=-5.921,z=-3.938,t=-6.745,P均＜0.05).(2)所有病例中HIF-1α强表达8例,中度表达9例,弱表达15例,阴性表达9例.T/WM及MVD均随HIF1α表达水平升高而增加,组间差异有统计学意义(F=7.41,P＜0.05).(3)Spearman相关分析表明,41例胶质瘤的T/WM与MVD呈明显正相关(r=0.759,P＜0.05).结论 脑胶质瘤的~(18)F-FDG摄取水平与HIF-1α表达及MVD之间存在良好相关性,可在术前一定程度上间接评估肿瘤的乏氧状态及血管生成情况,有助于全面评估病变的生物学特征及预后.

abstractsObjective To investigate the correlation between ~(18)F-fluorodeoxyglucose (FDG) uptake and hypoxia inducible factor1α (HIF-1α) level,microvessel density (MVD) in human gliomas.Methods ~(18)F-FDG PET scan was performed preoperatively in 41 patients with gliomas (including 23 highgrade and 18 low-grade tumors).The ratios of maximum standardized uptake value(SUV_(max))between tumor (T)and contralateral white matter (WM) were calculated (T/WM).Immunohistochemical stain methods were used to evaluate the level of HIF-1α and measure the MVD in tumors.Correlation analysis between SUV_(max) of T/WM and HIF-1α level,MVD wag performed.The t-test,one-way ANOVA test,Spearman rank correlation and Wilcoxon signed-rank test were calculated using SPSS 11.5 software.Results (1)The SUV_(max) of T/WM,HIF-1α level and MVD in high-grade and low-grade tumors groups were 3.39±1.43,95.7% and 44.13±16.1 vs 1.46±0.55.55.6% and 18.83±7.07,respectively.The difierences of SUV_(max) of T/WM,HIF-1α level and MVD between two groups were statistically significant (t=-5.921,z=-3.938,t=-6.745,all P＜0.05).(2)Among 41 gliomas,the strong positive expression of HIF-1α was observed in 8,mederate in 9,weak in 15 and negative expression was found in 9,SUV_(max) of T/WM and MVD increased with increasing HIF-1α level.The differences of SUV_(max) of T/WM and MVD among 4 different groups were statistically significant (F=7.41,P＜0.05).(3) The MVD of all gliomas was ranged from 9.76 to 94.52,which correlated with SUV_(max) of T/WM(r=0.759,P＜0.05).Conclusions The SUV_(max) of T/WM correlates with HIF-1α level and MVD in gliomas.Therefore,~(18)F-FDG PET provides preoperatively a noninvasive assessment of hypoxia or angiogenesis in human glionma.