Cui Yong, Ma Li, Chen Xuzhu, Zhang Zhe, Jiang Haihui, Lin Song
Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing, People's Republic of China.
J Neurooncol. 2014 Sep;119(2):377-85. doi: 10.1007/s11060-014-1490-6. Epub 2014 May 30.
Tumor grade and molecular variants influence the survival of patients with glioma. The apparent diffusion coefficient (ADC) map is a non-invasive tool for evaluating the outcomes and response to therapy in glioma. In this study, we investigated the correlation between the tumor grade and prognostic biomarkers with the ADC in glioma patients. Eighty-two patients with supratentorial glioma were identified via analysis of surgical specimens and neuroradiological data. Using the World Health Organization grade, histological subtype, and molecular variants (1p/19q codeletion, isocitrate dehydrogenase 1/2 mutation, Ki-67 index, O6-methylguanine DNA methyltransferase, P53, and vascular endothelial growth factor immunoactivity) as prognostic biomarkers, we performed receiver operating characteristic analysis and multiple linear regression to assess the association between the magnetic resonance diffusion parameter and mean ADC and the prognostic factors of glioma pathology. Univariate analysis and multiple linear regression revealed inverse correlations between the ADC values and the tumor grade, oligodendrocytoma histology, and 1p/19q codeletion. A threshold mean ADC value could predict the 1p/19q chromosomal status in WHO II gliomas with 72 % sensitivity and 88 % specificity (area under the curve 0.82, 95 % confidence interval 0.68-0.97) and could distinguish low-grade glioma with low-risk factors from the high-risk group (P < 0.01). The mean ADC value could be used as a non-invasive tool to evaluate the prognosis of supratentorial glioma patients. A threshold mean ADC value could be used to predict the 1p/19q codeletion and to identify low-risk low-grade gliomas (LGGs). Lower ADC values are indicative of a favorable prognosis in LGGs.
肿瘤分级和分子变异影响神经胶质瘤患者的生存。表观扩散系数（ADC）图是评估神经胶质瘤治疗效果和反应的一种非侵入性工具。在本研究中，我们调查了神经胶质瘤患者的肿瘤分级和预后生物标志物与ADC之间的相关性。通过分析手术标本和神经放射学数据，确定了82例幕上神经胶质瘤患者。使用世界卫生组织分级、组织学亚型和分子变异（1p/19q共缺失、异柠檬酸脱氢酶1/2突变、Ki-67指数、O6-甲基鸟嘌呤-DNA甲基转移酶、P53和血管内皮生长因子免疫活性）作为预后生物标志物，我们进行了受试者工作特征分析和多元线性回归，以评估磁共振扩散参数和平均ADC与神经胶质瘤病理学预后因素之间的关联。单因素分析和多元线性回归显示，ADC值与肿瘤分级、少突胶质细胞瘤组织学和1p/19q共缺失呈负相关。一个平均ADC阈值可以预测WHO II级神经胶质瘤中1p/19q染色体状态，灵敏度为72%，特异性为88%（曲线下面积为0.82，95%置信区间为0.68-0.97），并且可以区分低风险因素的低级别神经胶质瘤和高风险组（P<0.01）。平均ADC值可作为评估幕上神经胶质瘤患者预后的非侵入性工具。一个平均ADC阈值可用于预测1p/19q共缺失并识别低风险的低级别神经胶质瘤（LGG）。较低的ADC值表明LGG预后良好。
