胶质瘤是颅内最常见的原发性恶性肿瘤,其分级对患者治疗方式的选择和预后至关重要。尽管目前组织病理学仍是其最为可靠的分级手段,但需通过有创性手术以获取组织样本,存在一定的风险。相较之下,磁共振成像（MRI）作为一种非侵入性影像诊断工具,在胶质瘤分级中发挥着不可或缺的作用。然而,传统MRI评估受限于医师个体主观性强和可重复性差的问题,一定程度上影响了准确的分级结果。近年来,影像组学技术的崭露头角为解决上述难题开辟了新视角,通过高通量提取影像数据特征捕捉并量化肿瘤的影像学表现,避免因主观因素而导致的不确定性,协助医师更准确地评估肿瘤的恶性程度。本文对近五年来MRI影像组学在胶质瘤术前分级预测方面的相关研究进行了简要综述,旨在为相关领域研究者提供有益的参考和借鉴,以推动MRI影像组学在临床实践中的应用。
Glioma is the most common primary malignant brain tumor,and its grading is crucial for treatment decisions and prognosis．Currently,histopathology remains the gold standard for grading,but it requires invasive procedures and carries inherent risks．In contrast,magnetic resonance imaging（MRI）,a non-invasive diagnostic tool,plays an indispensable role in glioma grading．However,traditional MRI assessment is hampered by interobserver subjectivity and limited repeatability,which compromise grading accuracy．In recent years,radiomics,a burgeoning field,has offered a promising solution to address these challenges．By extracting high-dimensional imaging data features,radiomics enables the quantification of tumor radiological characteristics and elimination of subjectivity-related discrepancies．This technology assists clinicians in more precisely assessing the malignancy of gliomas．This article summarizes relevant studies in the past five years on the application of MRI radiomics in preoperative glioma grading,aiming to provide valuable insights and guidance to researchers in the field and promote the clinician implementation of MRI radiomics．
目的 分析人脑胶质瘤组织中O6—甲基鸟嘌呤—DNA甲基转移酶(MGMT)、DNA拓扑异构酶Ⅱ(TopoⅡ)基因的表达情况及其对化疗敏感性的影响。方法 收集医院2012年4月—2018年6月期间进行开颅手术切除的新鲜人脑胶质瘤标本80例和同期经颅脑手术治疗的脑外伤或脑出血内减压切除的正常脑组织30例。采用免疫组化法检测两种标本中MGMT和TopoⅡ基因表达情况,并通过脑胶质瘤U251和U87细胞培养、体外药物(替莫唑胺)干预、Transwell体外侵袭实验分析其对化疗敏感性的影响。结果 胶质瘤标本、正常脑组织MGMT和TopoⅡ基因表达程度分布比较差异均有统计学意义(P＜0.05),且二者MGMT基因阳性表达率分别为63.75%、3.33%,TopoⅡ基因阳性表达率分别为55.00%、0.00%,差异有统计学意义(P＜0.05)。MGMT、TopoⅡ基因均在细胞核显示为阳性染色。体外药物干预的实验组、未进行药物干预的阴性对照组干预前U251、U87细胞穿膜细胞计数比较无统计学意义(P＞0.05),但干预后实验组U251、U87细胞穿膜细胞计数高于阴性对照组(P＜0.05),干预后实验组U251、U87细胞有更强的侵袭力。结论 MGMT和TopoⅡ基因在人脑胶质瘤标本中阳性表达率高,且可能参与促进脑胶质瘤细胞侵袭,影响肿瘤化疗敏感性。
Objective To analyze the expression of O6-methylguanine-DNA methyltransferase (MGMT) and DNA topoisomerase II (Topo II) genes in human brain gliomas and its influence on the chemosensitivity. Methods A total of 80 fresh human brain glioma specimens resected by craniotomy and 30 normal brain tissues resected by craniocerebral operation for traumatic brain injury or decompression for cerebral hemorrhage during the period from April 2012 to June 2017 were collected. The expression of MGMT and Topo II genes in the two kinds of specimens was detected by immunohistochemical method, and the influence on chemosensitivity was analyzed through brain glioma U251 and U87 cell culture, in vitro drug (temozolomide) intervention and Transwell invasion in vitro. Results There was a significant difference in the expression of MGMT and Topo II genes in glioma specimens and normal brain tissues (P<0.05). The positive expression rates of MGMT gene in the two kinds of specimens were 63.75% and 3.33% respectively while the positive expression rates of Topo II gene were 55.00% and 0.00%, respectively (P<0.05). Both of MGMT and Topo II genes were displayed in the nucleus as positive staining. There was no significant difference in transmembrane cell count of U251 and U87 cells between the experimental group given drug intervention in vitro and negative control group without drug intervention before the intervention (P>0.05). However, the transmembrane cell count of U251 and U87 cells in the experimental group after intervention was higher than that in the negative control group (P<0.05). After intervetion, U251 and U87 cells were with stronger invasiveness in the experimental group. Conclusion The positive expression rates of MGMT and Topo II genes are high in human brain glioma specimens. They may be involved in promoting glioma cell invasion, affecting tumor chemosensitivity.
目的 观察紫河车提取物联合顺铂对人脑胶质瘤细胞增殖与凋亡的影响。方法 把正常培养传代后的U251胶质瘤细胞按随机分配的方法分为四组,A组仅加普通培养液,B、C、D组各加紫河车提取物(400 mg/mL)2 mL、顺铂(1 mg/mL)0.01 mL、紫河车提取物(400 mg/mL)2 mL＋顺铂(1 mg/mL)0.01 mL;MTT法观察U251细胞增殖情况,流式细胞仪检测U251细胞凋亡率。结果 培养12、24、36、48、60 h,B、C、D组细胞增殖指数逐渐下降,与A组进行比较,各组P值均小于0.05;其中,将D组与B、C组进行比较,P值小于0.05。将各组培养24 h后上机,测得A、B、C、D各组细胞的凋亡率分别为(0.3±0.2)%,(10.6±1.5)%,(35.9±2.8)%,(52.1±4.1)%。其中,B、C、D各组和A组进行比较,P值均小于0.05;将D组与B、C组两组进行比较,P值也均小于0.05。结论 紫河车提取物联合顺铂可抑制人脑胶质瘤U251细胞增殖,并诱导其凋亡。
Objective To observe the effect of cisplatin combinated with the placental immunoregulating polypeptide (PIP) on proliferation and apoptosis of glioma cells. Methods Randomly we divide the normal handed U251 glioma cells into four groups. We added ordinary nutrient solution to group A, while added activated PIP(400 mg/mL)2 mL to group B, cisplatin (1 mg/ml) 0.01 ml to group C, PIP 400 mg/mL)2 mL and cisplatin (1 mg/mL) 0.01 mL to group D. We surveyed the proliferation rate of gliobma cells by MTT experimental method and analyzed the apoptosis of U251 glioma cells by flow cytometry. Results The index of cell proliferation of group B,C,D declined gradually with the training of 12 h,24 h,36 h,48 h,60 h. Compared B, C,D group with A group, P<0.05,and compared group D with group B and group C, P< 0.05. Put groups culturing of 24 hour on flow cytometer, the glioma cells apoptosis rate of each group was 0.3%±0.2%、10.6%±1.5%、35.9%±2.8%、52.1%±4.1% respectively. Compared group B,C,D with group A, P<0.05,and compared group D with group B and group C, P<0.05. Conclusion Placental immunoregulatingpPolypeptide combined with cisplatin may restrain the proliferation of human glioma cells, meanwhile increase the apoptosis of glioma cells.
目的 初步探讨可注射型载阿霉素水凝胶对胶质瘤的治疗作用。方法 使用透析法检测载阿霉素水凝胶在体外释放药物的情况。构建大鼠皮下C6胶质瘤模型，按不同给药途径分为空白对照组、经静脉注射组、水凝胶组。给药15 h后，经免疫荧光检测阿霉素在肿瘤内部的分布情况。给药7 d后，计算出各组的抑瘤率；并对肿瘤组织进行苏木精-伊红染色。结果 在体外，载阿霉素水凝胶具有缓释药物的性能。在体内，与经静脉给药相比，局部注射载阿霉素水凝胶使瘤内分布更多阿霉素，抑瘤率更高（42% vs 64%），肿瘤细胞坏死更明显。结论 载阿霉素水凝胶可为胶质瘤局部化学治提供新的载体。
Objective To investigate the therapeutic effect of injectable doxorubicin-containing hydrogel on glioma．Methods The release of doxorubicin hydrogel in vitro was detected by dialysis．The subcutaneous C6 glioma model of rats was constructed and divided into blank control group，intravenous injection group and hydrogel group according to different administration methods．The distribution of doxorubicin in the tumor was detected by immunofluorescence 15 hours after administration．After 7 days of administration，the tumor inhibition rate of each group was calculated．The tumor tissue was stained with hematoxylin eosin．Results In vitro，doxorubicin-containing hydrogels had sustained drug release properties．In vivo，compared with intravenous administration，local injection of doxorubicin-containing hydrogel resulted in more doxorubicin distribution，higher tumor inhibition rate（42% vs 64%）and more obvious tumor cell necrosis．Conclusions Doxorubicin-containing hydrogel can provide a new carrierfor local chemotherapy of glioma．
