Correlation Among ~1H-MRS,DWI,PWI And Expression Of Nestin In Gliomas

Objective To explore the correlation among tumor cell metabolism,proliferation,tumor angiogenesis and tumor stem cells in gliomas by means of discussing the relationship among 1H-magnetic resonance spectroscopy(1H-MRS),diffusion-weighted imaging (DWI), perfusion-weighted imaging (PWI) and nestin immunohistochemistry examinations.Method Thirty-eight cases which were diagnosised pathologically with glioma after surgery were studied. According to the latest WHO glioma grading standards, all cases were categorized into two groups, the high-graded (Ⅲ-Ⅳ) and the low-graded (Ⅰ-Ⅱ),each has 19 cases.All of them underwent 1H-MRS,DWI and PWI examinations before surgery. Cho/Cr values,rADC values and rCBV values of solid regions of tumors were measured.After surgery, the expression of nestin in 38 different pathological grade gliomas tissues was detected by immunohistochemistry,and then the correlation of them was analysised.Result The Cho/Cr values (4.39±2.07) and the rCBV values (6.03±1.85) of the high-grade glioma group was significantly higher than the Cho/Cr values (1.61±0.57) and the rCBV values (1.86±0.48) of the low-grade group, while the former rADC value (1.26±0.28) was significantly lower than the latter rADC value (2.17±0.52), but the three ratio between the two groups all had significant statistical significance (P <0.01). The nestin expression (0.68±0.19) in the high-grade glioma group was significantly higher than that in the low-grade group (0.23±0.09,P<0.01). Correlation analysis showed that the nestin expression was positively correlated with the Cho/Cr values (r=0.674, P<0.01) and rCBV values (r=0.737, P<0.01), but negatively correlated with the rADC values (r=-0.688, P<0.01).Conclusion(1)The Cho/Cr values, the rADC values and the rCBV values of glioma tumor solid areas were significantly associated with the nestin, suggesting that glioma tumor cell metabolism, proliferation and tumor angiogenesis were correlated with glioma stem cells;(2) The expression of the nestin in tumor solid areas between high-grade gliomas and low-grade gliomas had significant differences;(3) The Cho/Cr values,the rADC values and the rCBV values in tumor solid areas between high-grade gliomas and low-grade gliomas were all significantly different.These findings may indicate that combining 1H-MRS,DWI and PWI with nestin immunohistochemistry could contribute to offer new evidences for clinical diagnosis, treatment and prognosis as well as better understanding the etiology,pathogenesis and biological attibutes of gliomas.