Law Meng, Brodsky Jennie E, Babb James, Rosenblum Marc, Miller Douglas C, Zagzag David, Gruber Michael L, Johnson Glyn
Department of Radiology, NYU Medical Center, New York, NY, USA.
J Magn Reson Imaging. 2007 Jun;25(6):1113-9. doi: 10.1002/jmri.20920.
To determine if increased perfusion using dynamic susceptibility contrast perfusion MRI (DSC MRI) in gliomas may be predictive of 1p19q deletions. Loss of heterozygosity of chromosomes 1p and 19q confers responsiveness to chemotherapy improving survival in gliomas.
We retrospectively reviewed 16 patients who had DSC MRI and molecular studies of their excised gliomas for 1p19q deletions. Allelic status was assessed by loss of heterozygosity using polymerase chain reaction (PCR). DNA was extracted from paraffin curls of brain tumor sections and nail clippings. Relative cerebral blood volume (rCBV) measurements were then statistically compared with the presence of 1p and 19q deletions.
Patients with 1p19q deletions (N = 7) demonstrated rCBV values of 10.54 +/- 2.93. Patients without 1p deletions (N = 9) had rCBV values of 4.84 +/- 2.4 (P = 0.012). Logistic regression demonstrated that rCBV was able to predict the presence of a 1p deletion to significance levels of 0.038 and 0.044, adjusted and not adjusted for age and sex, respectively. The kappa coefficient for the agreement between predicted deletion status using rCBV and the truedeletion status was 0.746 (P = 0.0028). Deletions of 19q alone, or together with 1p deletions, were not associated with high rCBV.
Histopathologic, molecular, and imaging evidence supports increased neovascularity in gliomas with 1p deletions in this preliminary study. We propose a diagnostic algorithm to obtain molecular studies in gliomas demonstrating high rCBV.
确定使用动态磁敏感对比灌注磁共振成像(DSC MRI)检测到的胶质瘤灌注增加是否可预测1p19q缺失。染色体1p和19q的杂合性缺失赋予胶质瘤对化疗的反应性,从而提高生存率。
我们回顾性分析了16例接受DSC MRI检查并对其切除的胶质瘤进行1p19q缺失分子研究的患者。使用聚合酶链反应(PCR)通过杂合性缺失评估等位基因状态。从脑肿瘤切片的石蜡卷和指甲剪中提取DNA。然后将相对脑血容量(rCBV)测量值与1p和19q缺失的存在进行统计学比较。
有1p19q缺失的患者(N = 7)的rCBV值为10.54±2.93。无1p缺失的患者(N = 9)的rCBV值为4.84±2.4(P = 0.012)。逻辑回归表明,rCBV能够预测1p缺失的存在,分别在调整和未调整年龄及性别时,显著水平为0.038和0.044。使用rCBV预测缺失状态与真实缺失状态之间的一致性kappa系数为0.746(P = 0.0028)。单独的19q缺失或与1p缺失一起,均与高rCBV无关。
在这项初步研究中,组织病理学、分子和影像学证据支持1p缺失的胶质瘤新生血管增多。我们提出一种诊断算法,以对显示高rCBV的胶质瘤进行分子研究。