Diagnostic Trial for Tumors Using ^1H-NMR Spectroscopy

用质子核磁共振波谱分析了人脑肿瘤和肺癌的核磁共振波谱与组织学类型和/或分化程度之间的关系。在正常组织和肿瘤组织的光谱中明确识别的几种物质中，胆碱、肌酸、甘氨酸和丙氨酸的峰面积及其比率可有效地用作区分不同肿瘤组织的参数。用判别因子分析评价这些参数的预测价值。通过分析发现，正常脑肿瘤和脑肿瘤的鉴别准确率为93%，三种胶质瘤类型(低级别星形细胞瘤、胶质母细胞瘤、室管膜瘤)的准确率为80%，脑膜瘤和神经鞘瘤的准确率为100%。这种准确性对应于将新病例分类为正确组织类型的概率。对正常肺癌和肺癌的区分准确率为91%，对四种肺癌类型(鳞癌、腺癌、大细胞和小细胞肺癌)的区分准确率为82%。单就鳞癌和腺癌的鉴别诊断，总正确率为95%。这些数据表明，核磁共振波谱可能产生临床有用的信息，并可能适用于肿瘤的鉴别诊断。

Proton nuclear magnetic resonance (NMR) spectroscopy was employed to examine the correlation between the NMR spectral patterns and histological types and/or the degree of differentiation of human brain tumors and lung cancers. Among several substances clearly identified in the spectra of both normal and tumor tissues, the peak areas for cholines, creatines, glycine and alanine, and the ratios thereof were Profitably applied as parameters to discriminate different tumor tissues. Discriminant factor analysis was applied to evaluate the predictive value of these parameters. By this analysis it was found that the normal brain and brain tumors could be differentiated with 93% accuracy, the three glioma types(low grade astrocytoma, glioblastoma, ependymoma) with 80% accuracy, and meningioma and neurinoma with 100% accuracy. This accuracy corresponds to the probability of classifying a new case into correct tissue type. The normal lung and lung cancer could be differentiated with 91% accuracy, and the four lung cancer types (squamous cell carcinoma, adenocarcinoma, large cell and small cell) with 82% accuracy. When focussing the differential diagnosis between squamous cell carcinoma and adenocarcinoma only, the total correct rate was 95%. These data suggested that NMR spectroscopy might yield clinically useful information and might be applicable to the differential diagnosis of tumors.