From the Departments of Neurosurgery (A.R., M.Z., E.D., G.Z.-B., J.P.), Neuroradiology (M.E., S. Porelli, C.O), and Neuropathology (A.T.-E., P.V.), Sainte-Anne Hospital; Paris Descartes University (A.R., M.E., S. Porelli, A.T.-E., M.Z., E.D., G.Z.-B., S. Puget, P.V., C.O., J.P.), Sorbonne Paris Cité; Inserm (A.R., M.E., M.Z., E.D., P.V., C.O., J.P.), U894, IMA-Brain, Centre Psychiatrie et Neurosciences; Departments of Neuro-oncology (M.S.) and Neurosurgery (L.C.), Pitié-Salpêtrière Hospital; and Department of Pediatric Neurosurgery (S. Puget), Necker Hospital, Paris, France.
Neurology. 2019 Jan 1;92(1):e55-e62. doi: 10.1212/WNL.0000000000006690. Epub 2018 Nov 30.
To determine the prevalence of developmental venous anomaly in adult patients with diffuse glioma.
We performed a retrospective cohort study (2010-2016) of consecutive adult patients harboring a supratentorial diffuse glioma in 2 centers: Sainte-Anne Hospital (experimental and control sets) and Pitié-Salpêtrière Hospital (external validation set). We included 219 patients with diffuse glioma (experimental set), 252 patients with brain metastasis (control set), and 200 patients with diffuse glioma (validation set). The inclusion criteria were age ≥18 years at diagnosis, histopathologic diagnosis of diffuse glioma according to the 2016 World Health Organization classification of tumors of the CNS, surgery as first-line treatment without previous oncologic treatment, available presurgical MRI performed with similar acquisition protocol, and absence of a nodular-like or a ring-like pattern of contrast enhancement on MRI that may preclude the identification of a possible developmental venous anomaly within the glioma.
We found more developmental venous anomaly in the experimental set (21.5%) than in the control set (5.2%, < 0.001). Similarly, we found more developmental venous anomaly in the validation set (23.5%) than in the control set (5.2%, < 0.001). There was no difference in the developmental venous anomaly prevalence between the experimental and validation sets. The developmental venous anomaly distribution was not significantly associated with histopathologic, molecular, or imaging findings of the diffuse gliomas.
We report and replicate in an external cohort a high prevalence of developmental venous anomaly in adult patients with diffuse glioma, which suggests a potential underlying common predisposition or a causal relationship that requires deeper investigations.
确定成人弥漫性胶质瘤患者中发育性静脉畸形的患病率。
我们在 2 家中心（Sainte-Anne 医院[实验组和对照组]和 Pitié-Salpêtrière 医院[外部验证组]）进行了一项回顾性队列研究（2010-2016 年），纳入了 219 例幕上弥漫性胶质瘤患者（实验组）、252 例脑转移瘤患者（对照组）和 200 例弥漫性胶质瘤患者（验证组）。纳入标准为：诊断时年龄≥18 岁，根据 2016 年世界卫生组织中枢神经系统肿瘤分类的组织病理学诊断为弥漫性胶质瘤，一线治疗为手术，无既往肿瘤治疗史，有术前 MRI 且采集协议相似，MRI 未见结节样或环形强化模式，以免漏诊胶质瘤内可能存在的发育性静脉畸形。
实验组（21.5%）比对照组（5.2%，<0.001）更常见发育性静脉畸形。同样，验证组（23.5%）比对照组（5.2%，<0.001）更常见发育性静脉畸形。实验组和验证组之间发育性静脉畸形的患病率没有差异。发育性静脉畸形的分布与弥漫性胶质瘤的组织病理学、分子或影像学发现无显著相关性。
我们报告并在外部队列中复制了成人弥漫性胶质瘤患者中发育性静脉畸形的高患病率，这表明潜在存在共同易感性或因果关系，需要进一步深入研究。
