The Correlational Study Of Peritumoral Edema, Histological Grades And The Expression Of Ki-67 In Gliomas

Objective: In patients with preoperative brain MRI understand the peritumoral edema(PTBE) degree of glioma, HE stain recheck the level of tumor pathology, immunohistochemical method measure the expressions of Ki-67, to explore the correlation of peritumoral edemasize(PTBE), histological grades and the expression rate of Ki-67 in gliomas. Methods: Collected 74 cases surgical removal incipient, supratentorial, not intracerebroventricular glioma patients’ medical records in the neurosurgery department of People’s Hospital of Xinjiang Uygur Autonomous Region from 2010 to 2013, all patients without preoperative radiation and chemotherapy, and confirmed to be glioma by pathology later. According to two kinds of evaluation method, Schoenegger K [1] and edema index(EI) [2], to detect glioma PTBE degree, immunohistochemical method detect of all specimens on tumor expression of Ki-67, HE stain recheck level of tumor pathology, comparing the correlation between glioma PTBE degree, level of tumor pathology and the expression of Ki-67. Results:(1) In the data, 67 patients(90.54%) had PTBE, the incidence of PTBE in Ⅰ, Ⅱ, Ⅲ,Ⅳ grade glioma patients were respectively 100%(3/3), 78.95%(15/19), 83.33%(15/18) and 100%(34/34). Take the Schoenegger K peritumoral edema degree as the obvervational index, and the result through Kruskal-Wallis H test indicate that the the PTBE in Ⅰ, Ⅱ, Ⅲ and Ⅳ grade gliomas have statistically significant(H=12.039, P=0.007), Spearman rank correlation test indicate that the PTBE degree and histological grade have positive correlations(r=0.397, P=0.397); To take edema index EI as observation index, the experimental results through the Kruskal-Wallis H analysis also suggests PTBE degree has significant difference in Ⅰ, Ⅱ, Ⅲ and Ⅳ levels glioma group(H=11.169, P=11.169), Spearman level correlation analysis indicate that the PTBE degree increase with the tumor pathological level up(r=0.391, P =0.391), which had positively correlation.(2) In the data, 18 patients had negative expression(24.32%), 56 cases patients had positive expression of Ki-67(75.68%), including 10 cases of(+) expression, 9 cases(++) expression, 37 cases(+++) expression, Ⅰ, Ⅱ, Ⅲ, Ⅳ level glioma patients’ positive expression of Ki-67 number were respectively 0, 7, 17 and 32, results through Kruskal Wallis H test analysis that Ki-67 expression in Ⅰ, Ⅱ, Ⅲ, Ⅳ level glioma group have statistical significance(H=38.530, P<0.05), spearman rank correlation analysis indicate Ki-67 positive expression rate increased with the pathological grade up(r=0.692, P<0.05), which were positively correlated.(3) In the Schoenegger K peritumoral edema degree grouping variable study, no edema group of Ki-67 negative expression for 3 cases, 4 cases had positive expression, 4 cases of negative expression Ⅰ degree edema, positive expression of 6 cases, Ⅱ degree edema negative expression in 11 cases, 46 cases had positive expression, results through the Kruskal-Wallis H analysis to indicate that Ki-67 expressed in different degree of PTBE group has significant overall difference(H=6.478, P=0.039), Spearman rank correlation analysis indicate positive expression rate of Ki-67 protein and the degree of glioma PTBE have positive correlation(r=0.256, P=0.028); In study which EI index as the grouping variable, Ⅰ degree edema negative expression in 2 cases, positive expression in 2 cases, Ⅱ degree edema negative expression in 16 cases, positive expression in 29 cases, Ⅲ degree edema negative expression as 0, 12 cases had positive expression, Ⅳ degree edema negative expression also as 0, positive expression of 13 cases, results through the Kruskal-Wallis H analysis suggests that Ki-67 expressed in different degree of PTBE group has significant overall difference(H=8.690, P=0.034), and the two had positively correlation(r=0.333, P=0.004). Conclusions: Schoenegger K peritumoral edema degree judgement and EI all have practical values in the detection of glioma PTBE degree, Ki-67 can be used as one of the ideal indexes of glioma pathology classification, according to the preoperative brain MRI of patients with glioma, we may be preliminary and intuitive judge the tumor pathologic level and tumor proliferation activity, so as to provide a theoretical basis for operation and after further therapy.