2-羟戊二酸在神经胶质瘤中的积累与生存相关：一项由 3.0 特斯拉磁共振波谱仪进行的研究。

Accumulation of 2-hydroxyglutarate in gliomas correlates with survival: a study by 3.0-tesla magnetic resonance spectroscopy.

机构信息

Department of Neurosurgery, Brain Research Institute, University of Niigata, Niigata, Japan.

Center for Integrated Brain Sciences, Brain Research Institute, University of Niigata, Niigata, Japan.

出版信息

Acta Neuropathol Commun. 2014 Nov 7;2:158. doi: 10.1186/s40478-014-0158-y.

INTRODUCTION

Previous magnetic resonance spectroscopy (MRS) and mass spectroscopy studies have shown accumulation of 2-hydroxyglutarate (2HG) in mutant isocitrate dehydrogenase (IDH) gliomas. IDH mutation is known to be a powerful positive prognostic marker in malignant gliomas. Hence, 2HG accumulation in gliomas was assumed to be a positive prognostic factor in gliomas, but this has not yet been proven. Here, we analyzed 52 patients harboring World Health Organization (WHO) grade II and III gliomas utilizing 3.0-tesla MRS.

RESULTS

Mutant IDH gliomas showed significantly higher accumulation of 2HG (median 5.077 vs. 0.000, p =0.0002, Mann-Whitney test). 2HG was detectable in all mutant IDH gliomas, whereas in 10 out of 27 (37.0%) wild-type IDH gliomas, 2HG was below the detectable range (2HG =0) (p =0.0003, chi-squared test). Screening for IDH mutation by 2HG analysis was highly sensitive (cutoff 2HG =1.489 mM, sensitivity 100.0%, specificity 72.2%). Gliomas with high 2HG accumulation had better overall survival than gliomas with low 2HG accumulation (p =0.0401, Kaplan-Meier analysis).

DISCUSSION

2HG accumulation detected by 3.0-tesla MRS not only correlates well with IDH status, but also positively correlates with survival in WHO grade II and III gliomas.

简介

先前的磁共振波谱（MRS）和质谱研究表明，2-羟戊二酸（2HG）在突变型异柠檬酸脱氢酶（IDH）胶质瘤中积累。IDH 突变已知是恶性胶质瘤强有力的阳性预后标志物。因此，胶质瘤中 2HG 的积累被认为是胶质瘤的一个阳性预后因素，但这尚未得到证实。在这里，我们利用 3.0 特斯拉 MRS 分析了 52 例携带世界卫生组织（WHO）二级和三级胶质瘤的患者。

结果

突变型 IDH 胶质瘤中 2HG 的积累明显更高（中位数 5.077 与 0.000，p =0.0002，Mann-Whitney 检验）。所有突变型 IDH 胶质瘤中均可检测到 2HG，而在 27 例野生型 IDH 胶质瘤中有 10 例（37.0%）低于检测范围（2HG =0）（p =0.0003，卡方检验）。通过 2HG 分析筛查 IDH 突变具有很高的敏感性（截断值 2HG =1.489 mM，敏感性 100.0%，特异性 72.2%）。2HG 积累较高的胶质瘤总生存时间优于 2HG 积累较低的胶质瘤（p =0.0401，Kaplan-Meier 分析）。