Wang Y Y, Wang K, Li S W, Wang J F, Ma J, Jiang T, Dai J P
From the Departments of Neurosurgery (Y.Y.W., J.F.W., T.J.) Beijing Neurosurgical Institute (Y.Y.W., T.J., J.P.D.), Capital Medical University, Beijing, China.
Neuroradiology (K.W., S.W.L., J.M., J.P.D.), Beijing Tian Tan Hospital.
AJNR Am J Neuroradiol. 2015 Nov;36(11):2023-9. doi: 10.3174/ajnr.A4407. Epub 2015 Aug 27.
It is proposed that isocitrate dehydrogenase 1 (IDH1) mutation predicts the outcome in patients with high-grade glioma. In addition, contrast enhancement on preoperative MR imaging reflects tumor biologic features. Patients with anaplastic glioma with the IDH1 mutation were evaluated by using MR imaging to determine whether tumor enhancement is a prognostic factor and can be used to predict survival.
A cohort of 216 patients with histologically confirmed anaplastic glioma was reviewed retrospectively. Tumor contrast-enhancement patterns were classified on the basis of preoperative T1 contrast MR images. Tumor IDH1 status was examined by using RNA sequencing. We used univariate analysis and the multivariate Cox model to evaluate the prognostic value of the IDH1 mutation and tumor contrast-enhancement pattern for progression-free survival and overall survival.
In all 216 patients, IDH1 mutation was associated with longer progression-free survival (P = .004, hazard ratio = 0.439) and overall survival (P = .002, hazard ratio = 0.406). For patients with IDH1 mutant anaplastic glioma, the absence of contrast enhancement was associated with longer progression-free survival (P = .038, hazard ratio = 0.473) and overall survival (P = .043, hazard ratio = 0.436). Furthermore, we were able to stratify the progression-free survival and overall survival of patients with IDH1 mutation by using the tumor contrast-enhancement patterns (P = .022 and 0.029, respectively; log-rank).
Tumor enhancement on postcontrast MR imaging is a valuable prognostic factor for patients with anaplastic glioma and IDH1 mutation. Furthermore, the contrast-enhancement patterns could potentially be used to stratify the survival outcome of such patients.
有人提出，异柠檬酸脱氢酶1（IDH1）突变可预测高级别胶质瘤患者的预后。此外，术前磁共振成像（MR）上的对比增强反映了肿瘤的生物学特征。本研究通过MR成像对IDH1突变的间变性胶质瘤患者进行评估，以确定肿瘤增强是否为预后因素以及能否用于预测生存情况。
回顾性分析了一组216例经组织学证实为间变性胶质瘤的患者。根据术前T1加权对比增强MR图像对肿瘤的对比增强模式进行分类。采用RNA测序检测肿瘤的IDH1状态。我们使用单因素分析和多因素Cox模型评估IDH1突变和肿瘤对比增强模式对无进展生存期和总生存期的预后价值。
在全部216例患者中，IDH1突变与更长的无进展生存期（P = 0.004，风险比 = 0.439）和总生存期（P = 0.002，风险比 = 0.406）相关。对于IDH1突变的间变性胶质瘤患者，无对比增强与更长的无进展生存期（P = 0.038，风险比 = 0.473）和总生存期（P = 0.043，风险比 = 0.436）相关。此外，我们能够通过肿瘤对比增强模式对IDH1突变患者的无进展生存期和总生存期进行分层（分别为P = 0.022和0.029；对数秩检验）。
对比增强MR成像上的肿瘤增强是IDH1突变的间变性胶质瘤患者的一个有价值的预后因素。此外，对比增强模式可能有助于对此类患者的生存结果进行分层。
