Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU-Norwegian University of Science and Technology, Trondheim, Norway.
Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, NTNU-Norwegian University of Science and Technology, Trondheim, Norway; Department of Radiology and Nuclear Medicine, St. Olavs University Hospital, Trondheim, Norway.
World Neurosurg. 2018 Jan;109:e50-e58. doi: 10.1016/j.wneu.2017.09.102. Epub 2017 Sep 23.
Rapid growth is a well-known property of glioblastoma (GBM); however, growth rates vary among patients. Mechanisms behind such variation have not been widely studied in human patients. We sought to investigate relationships between histopathologic features and tumor growth estimated from pretreatment magnetic resonance imaging scans.
In 106 patients with GBM, 2 preoperative T1-weighted magnetic resonance imaging scans obtained at least 14 days apart were segmented to assess tumor growth. A fitted Gompertzian growth curve based on the segmented volumes divided the tumors into 2 groups: faster and slower growth than expected based on the initial tumor volume. Histopathologic features were investigated for associations with these groups, using univariable and multivariable logistic regression analyses.
The presence of high cellular density and thromboses was significantly associated with radiologic growth in the multivariable analysis (P = 0.018 and 0.019, respectively), with respective odds ratios of 3.0 (95% confidence interval, 1.2-7.4) and 4.3 (95% confidence interval, 1.3-14.5) for faster growing tumors.
Our findings show that high cellular density and thromboses are significant independent predictors of faster growth in human GBM. This finding underlines the importance of hypercellularity as a criterion in glioma grading. Furthermore, our findings are concordant with hypotheses suggesting hypoxia triggered by thromboses to be relevant for growth of GBM.
胶质母细胞瘤（GBM）的一个显著特征是快速生长，但患者间的生长速度存在差异。导致这种差异的机制在人类患者中尚未得到广泛研究。我们旨在研究术前磁共振成像扫描估计的肿瘤生长与组织病理学特征之间的关系。
在 106 名 GBM 患者中，至少相隔 14 天对 2 次术前 T1 加权磁共振成像扫描进行分割，以评估肿瘤生长。基于分割体积的拟合 Gompertz 生长曲线将肿瘤分为 2 组：生长速度快于或慢于根据初始肿瘤体积预期的生长速度。使用单变量和多变量逻辑回归分析研究组织病理学特征与这些组之间的关系。
在多变量分析中，高细胞密度和血栓的存在与影像学生长显著相关（P=0.018 和 0.019，分别），生长较快的肿瘤的优势比分别为 3.0（95%置信区间，1.2-7.4）和 4.3（95%置信区间，1.3-14.5）。
我们的研究结果表明，高细胞密度和血栓是人类 GBM 快速生长的显著独立预测因子。这一发现强调了细胞增生作为胶质瘤分级标准的重要性。此外，我们的研究结果与假设一致，即血栓引起的缺氧可能与 GBM 的生长有关。
