Study Of Relationship Between MRI Manifestations And Clinical Prognosis Of Primary Central Nervous System Lymphoma And The Expression Of P27Factor

Objective:Compared with intracranial astrocytoma, to discuss the MRI manifestations of orimary central nervous system lymphoma and its pathological basis. To study the relationship between the image and clinical prognosis of PCNSL and the expression of p27.Methods:19cases of PCNSL and19cases of astrocytoma, which confirmed by surgical or biopsy were reviewed, including MR imaging and pathological date. To find paraffin block of PCNSL for immunohistochemical staining of p27factor. The relationship between MRI manifestations and prognosis of PCNSL and expression of p27were statistically analyzed by SPSS17.0software.Results:①All19cases of PCNSL,13cases had single lesion,6cases had multiple lesions. ALL lesions were located in the supratentorial, nearly the midline or ventricle except1case of multiple lesions. The corpus callosum were violated in7cases, and2cases with necrosis. The majority cases were with light-moderate edema. Most of the lesions were slightly hypointense or isointense on T1W1and isointense or hyperintense on T2WI relative to grey matter; lesions of hyperintense on DWI.4cases received the H-MRS and solid components of tumor showed typical NAA peaks with moderate decrease and Cho peaks with obviously increased;3cases appeared prominent peak of Lip. Enhanced scan showed that the lesions presented obviously mass like or nodular enhancement with the typical appearance of "gap and sharp feature".①19cases of astrocytoma all had single lesion, and where the lesions located were no obvious characteristic. These were given priority to with moderate or severe edema. The majority of lesions were slight hypointense on1l W1and uneven slight hyperintense on T2WI; lesions of isointense or mixed hyperintense signal on DWI. Most of lesions enhanced scan showed nonuniform circular enhancement, and more often found necrosis and haemorrhage.③All cases of PCNSL are diffuse large B cell lymphoma.The cells of tumor were diffusely distributed around the vessel,which with almost the same size, had a little cytoplasm and large nucleus. In19cases of astrocytoma.8cases were the WHO Ⅲ level and Ⅱ cases were the WHO IV level.④9cases of PCNSL were low p27expression and highly expressed in10cases. It was found that p27expression level, the deep lesion,60years old or more having the correlation with survival time of patients.Conclusions:①Typical PCNSL had significantly different from astrocytoma about MRI imaging, with tended to locate at near the midline or ventricle, and the majority cases with light-moderate edema. Most of the lesions were slightly hypointense or isointense on T1WI and isointense or hyperintense on T2WI; lesions of hyperintense on DWI. The solid components of tumor showed specific peak of Lip On the’H-MRS. Enhanced scan showed that the lesions presented obviously mass like or nodular enhancement with the typical appearance of "gap and sharp feature". Capsule and necrosis were rare.②p27lower expression of PCNSL was associated with poor prognosis, could be used as biological indicator to estimate of the prognosis of PCNSL.③Lesions near the center line and (or) ventricle not only associated with the survival time of patients, but also associated with the expression levels of p27.It is used to predict the biological behavior and prognosis of PCNSL were helpful.