动态对比增强 MRI 衍生的细胞内水寿命 (τ)：头颈部鳞状细胞癌患者的预后标志物。
Dynamic Contrast-Enhanced MRI-Derived Intracellular Water Lifetime (τ ): A Prognostic Marker for Patients with Head and Neck Squamous Cell Carcinomas.
机构信息
From the Departments of Radiology (S.C., L.A.L., S.G.K., S.W., G.V., S.M., H.P.).
Department of Radiology (S.G.K.), New York University, New York, New York.
出版信息
AJNR Am J Neuroradiol. 2018 Jan;39(1):138-144. doi: 10.3174/ajnr.A5440. Epub 2017 Nov 16.
BACKGROUND AND PURPOSE
Shutter-speed model analysis of dynamic contrast-enhanced MR imaging allows estimation of mean intracellular water molecule lifetime (a measure of cellular energy metabolism) and volume transfer constant (a measure of hemodynamics). The purpose of this study was to investigate the prognostic utility of pretreatment mean intracellular water molecule lifetime and volume transfer constant in predicting overall survival in patients with squamous cell carcinomas of the head and neck and to stratify p16-positive patients based upon survival outcome.
MATERIALS AND METHODS
A cohort of 60 patients underwent dynamic contrast-enhanced MR imaging before treatment. Median, mean intracellular water molecule lifetime and volume transfer constant values from metastatic nodes were computed from each patient. Kaplan-Meier analyses were performed to associate mean intracellular water molecule lifetime and volume transfer constant and their combination with overall survival for the first 2 years, 5 years, and beyond (median duration, >7 years).
RESULTS
By the last date of observation, 18 patients had died, and median follow-up for surviving patients ( = 42) was 8.32 years. Patients with high mean intracellular water molecule lifetime (4 deaths) had significantly ( = .01) prolonged overall survival by 5 years compared with those with low mean intracellular water molecule lifetime (13 deaths). Similarly, patients with high mean intracellular water molecule lifetime (4 deaths) had significantly ( = .006) longer overall survival at long-term duration than those with low mean intracellular water molecule lifetime (14 deaths). However, volume transfer constant was a significant predictor for only the 5-year follow-up period. There was some evidence ( < .10) to suggest that mean intracellular water molecule lifetime and volume transfer constant were associated with overall survival for the first 2 years. Patients with high mean intracellular water molecule lifetime and high volume transfer constant were associated with significantly ( < .01) longer overall survival compared with other groups for all follow-up periods. In addition, p16-positive patients with high mean intracellular water molecule lifetime and high volume transfer constant demonstrated a trend toward the longest overall survival.
CONCLUSIONS
A combined analysis of mean intracellular water molecule lifetime and volume transfer constant provided the best model to predict overall survival in patients with squamous cell carcinomas of the head and neck.
背景与目的
动态对比增强磁共振成像的快门速度模型分析可以估计细胞内水分子平均寿命（细胞能量代谢的一种衡量标准）和容积转移常数（血液动力学的一种衡量标准）。本研究的目的是探讨治疗前细胞内水分子平均寿命和容积转移常数对预测头颈部鳞状细胞癌患者总生存期的预后价值，并根据生存结果对头颈部鳞状细胞癌患者的 p16 阳性患者进行分层。
材料与方法
一组 60 例患者在治疗前进行了动态对比增强磁共振成像检查。从每位患者的转移性淋巴结中计算出中位数、细胞内水分子平均寿命和容积转移常数的值。通过 Kaplan-Meier 分析，将细胞内水分子平均寿命和容积转移常数及其组合与前 2 年、5 年和 5 年以上（中位时间>7 年）的总生存期相关联。
结果
截至最后观察日期，18 例患者死亡，42 例存活患者的中位随访时间为 8.32 年。高细胞内水分子平均寿命（4 例死亡）患者的总生存期显著延长（5 年），与低细胞内水分子平均寿命（13 例死亡）患者相比（=0.01）。同样，高细胞内水分子平均寿命（4 例死亡）患者的总生存期在长期（=0.006）也显著长于低细胞内水分子平均寿命（14 例死亡）患者。然而，容积转移常数仅对 5 年随访期是一个显著的预测因素。有一些证据（<0.10）表明细胞内水分子平均寿命和容积转移常数与前 2 年的总生存期相关。高细胞内水分子平均寿命和高容积转移常数的患者与其他组相比，所有随访期的总生存期均显著延长（<0.01）。此外，高细胞内水分子平均寿命和高容积转移常数的 p16 阳性患者的总生存期最长。
结论
细胞内水分子平均寿命和容积转移常数的联合分析为预测头颈部鳞状细胞癌患者的总生存期提供了最佳模型。
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