MR扩散加权成像(单、双指数模型)参数直方图预测宫颈癌淋巴脉管、嗜神经侵犯及与PD-1/PD-L1相关性的研究

Cervical cancer seriously threatens the health of women. In recent years, the resected gross specimens from patients with cervical cancer were stained with immunohistochemistry of CD-34, D2-40 and S-100, and the detection rates of lymphovascular invasion (LVI) and perineural invasion (PNI) were significantly increased. As important prognostic factors, the both have attracted increasing attention. However, preoperative accurate prediction of LVI or PNI is extremely difficult. Conventional imaging techniques and H&E staining in biopsy are not sensitive to them. In addition, postoperative pathology has hysteresis. Diffusion-weighted (DW) magnetic resonance (MR) imaging is a functional imaging modality based on the thermally-driven motion of water molecules constrained by tissue ultrastructure. The apparent diffusion coefficient(ADC) is a quantitative parameter of DW MR imaging that may provide useful information regarding tumor cellularity. Our previous studies have confirmed that ADC values can predict the aggressiveness of cervical cancer. The tumor cells are in a highly immunosuppressed microenvironment, anti-PD-1/PD-L1immunotherapy targets has shown good potential. The purpose of the current study is to investigate the diagnostic performance of various diffusion parameters for predicting LVI and PNI in invasive cervical cancer and the correlation of various diffusion parameters with PD-1/PD-L1 by using monoexponential and biexponential DW MRI with histogram Analysis, and funther provide evidences of immunotherapy targets for cervical cancer.

宫颈癌威胁女性生命健康。免疫组化检查通过特异性抗原蛋白（CD-34、D2-40、S-100）对肿瘤血管、淋巴管、神经染色标识，淋巴脉管侵犯（LVI）和神经侵犯（PNI）的检出率明显升高。两者作为重要的预后因素备受关注。然而术前准确预测LVI、PNI困难。常规影像方法，活检H&E染色不敏感，术后病理具有滞后性。MR扩散加权成像（DWI）通过监测组织内水分子的扩散运动，对病变敏感。ADC值作为定量参数，与细胞构成相关。我们的前期研究证实ADC值可以预测宫颈癌的侵袭性。肿瘤细胞处于一个高度免疫抑制的微环境中，以PD-1/PD-L1为靶点的肿瘤免疫治疗显示出良好前景。本课题将通过DW MRI(单、双指数模型）直方图分析阐明不同扩散参数预测宫颈癌LVI及PNI的价值及与PD-1/PD-L1的相关性，以及能否作为筛选抗PD-1/PD-L1治疗敏感人群的影像生物标记物，为宫颈癌的免疫靶向治疗提供依据。

宫颈癌威胁女性生命健康。免疫组化检查通过特异性抗原蛋白（CD-34、D2-40、S-100）对肿瘤血管、淋巴管、神经染色标识，淋巴脉管侵犯（LVI）和神经侵（PNI）的检出率明显升高。两者作为重要的预后因素备受关注。然而术前准确预测LVI、PNI困难。常规影像方法，活检H&E染色不敏感，术后病理具有滞后性。MR扩散加权成像（DWI）通过监测组织内水分子的扩散运动，对病变敏感。ADC值作为定量参数，与细胞构成相关。我们的研究证实ADC值可以预测宫颈癌的侵袭性。肿瘤细胞处于一个高度免疫抑制的微环境中，以PD-1/PD-L1为靶点的肿瘤免疫治疗显示出良好前景。本课题通过DWI MRI (单、双指数模型）分析阐明了不同扩散参数预测宫颈癌LVI及PNI的价值及与PD-1/PD-L1的相关性，以及能否作为筛选抗PD-1/PDL1治疗敏感人群的影像生物标记物，为宫颈癌的免疫靶向治疗提供理论依据。

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