Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Beijing Neurosurgical Institute, Capital Medical University, Beijing, China.
Sci Rep. 2017 Aug 16;7(1):8302. doi: 10.1038/s41598-017-08862-6.
Necrosis is a hallmark feature of glioblastoma (GBM). This study investigated the prognostic role of necrotic patterns in GBM using fractal dimension (FD) and lacunarity analyses of magnetic resonance imaging (MRI) data and evaluated the role of lacunarity in the biological processes leading to necrosis. We retrospectively reviewed clinical and MRI data of 95 patients with GBM. FD and lacunarity of the necrosis on MRI were calculated by fractal analysis and subjected to survival analysis. We also performed gene ontology analysis in 32 patients with available RNA-seq data. Univariate analysis revealed that FD < 1.56 and lacunarity > 0.46 significantly correlated with poor progression-free survival (p = 0.006 and p = 0.012, respectively) and overall survival (p = 0.008 and p = 0.005, respectively). Multivariate analysis revealed that both parameters were independent factors for unfavorable progression-free survival (p = 0.001 and p = 0.015, respectively) and overall survival (p = 0.002 and p = 0.007, respectively). Gene ontology analysis revealed that genes positively correlated with lacunarity were involved in the suppression of apoptosis and necrosis-associated biological processes. We demonstrate that the fractal parameters of necrosis in GBM can predict patient survival and are associated with the biological processes of tumor necrosis.
坏死是胶质母细胞瘤（GBM）的一个显著特征。本研究通过磁共振成像（MRI）数据的分形维数（FD）和空隙度分析，探讨了坏死模式在 GBM 中的预后作用，并评估了空隙度在导致坏死的生物学过程中的作用。我们回顾性分析了 95 例 GBM 患者的临床和 MRI 数据。通过分形分析计算 MRI 上坏死的 FD 和空隙度，并进行生存分析。我们还对 32 例有 RNA-seq 数据的患者进行了基因本体分析。单因素分析显示，FD<1.56 和空隙度>0.46 与无进展生存期（p=0.006 和 p=0.012）和总生存期（p=0.008 和 p=0.005）显著相关。多因素分析显示，这两个参数都是无进展生存期（p=0.001 和 p=0.015）和总生存期（p=0.002 和 p=0.007）的独立因素。基因本体分析显示，与空隙度呈正相关的基因参与了细胞凋亡抑制和与坏死相关的生物学过程。我们证明，GBM 中坏死的分形参数可以预测患者的生存情况，并与肿瘤坏死的生物学过程有关。
