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异柠檬酸脱氢酶1(IDH1)突变型胶质瘤的磁共振成像特征及预后:中国西南地区单中心研究

The MRI Features and Prognosis of Gliomas Associated With IDH1 Mutation: A Single Center Study in Southwest China.

作者信息

Shen Guiquan, Wang Rujia, Gao Bo, Zhang Zhongwen, Wu Guipeng, Pope Whitney

机构信息

Affiliated Hospital of Guizhou Medical University, Guiyang, China.

Tangshan Gongren Hospital, Tangshan, China.

出版信息

Front Oncol. 2020 Jun 2;10:852. doi: 10.3389/fonc.2020.00852. eCollection 2020.

Abstract

To investigate the associations of MRI radiological features and prognosis of glioma with the status of isocitrate dehydrogenase 1 (IDH1). A total of 116 patients with gliomas were retrospectively recruited from January 2013 to December 2015. All patients were undergone routine MRI (T1WI, T2WI, T2-FLAIR) scanning and contrast-enhanced MRI T1WI before surgery. The following imaging features were included: tumor location, diameter, the pattern of growth, boundary, the degree of enhancement, mass effect, edema, cross the middle line, under the ependyma. χ and Fisher's exact probability tests were used to determine the significance of associations between MRI features and IDH1 mutation of glioma. The survival distributions were estimated using Kaplan-Meier compared by Log-rank test. Univariate and multivariate analyses were performed using Cox regression. Gliomas with IDH1 mutant were significantly more likely to exhibit homogeneous signal intensity ( = 0.009) on non-contrast MRI protocols and less contrast enhancement ( = 0.000) on contrast enhanced T1WI. IDH1 mutant type glioma was more inclined to cross the midline to invade contralateral hemisphere ( = 0.001). The overall survival between IDH1 mutated and wild type glioma were significantly different ( = 0.000), age ≤ 40 ( = 0.003), KPS scores > 80 before operation ( = 0.000) and low grade glioma ( = 0.000). Our results suggest IDH1 mutant in gliomas is more likely to exhibit homogeneous signal intensity, less contrast enhancement and more inclined to cross the midline. Patients with IDH1 mutated, age ≤ 40, KPS scores > 80 before operation and low-grade glioma may have a longer life and better prognosis.

摘要

探讨异柠檬酸脱氢酶1(IDH1)状态与胶质瘤MRI影像学特征及预后的相关性。回顾性纳入2013年1月至2015年12月期间的116例胶质瘤患者。所有患者在手术前行常规MRI(T1WI、T2WI、T2-FLAIR)扫描及增强MRI T1WI扫描。纳入的影像学特征包括:肿瘤位置、直径、生长方式、边界、强化程度、占位效应、水肿、是否跨越中线、是否位于室管膜下。采用χ检验和Fisher精确概率检验确定MRI特征与胶质瘤IDH1突变之间关联的显著性。采用Kaplan-Meier法估计生存分布,并通过Log-rank检验进行比较。使用Cox回归进行单因素和多因素分析。IDH1突变型胶质瘤在非增强MRI序列上更易表现为均匀信号强度(P = 0.009),在增强T1WI上强化程度更低(P = 0.000)。IDH1突变型胶质瘤更倾向于跨越中线侵犯对侧半球(P = 0.001)。IDH1突变型和野生型胶质瘤的总生存期存在显著差异(P = 0.000),年龄≤40岁(P = 0.003)、术前KPS评分>80分(P = 0.000)以及低级别胶质瘤(P = 0.000)。我们的结果表明,胶质瘤中的IDH1突变更易表现为均匀信号强度、强化程度更低且更倾向于跨越中线。IDH1突变、年龄≤40岁、术前KPS评分>80分以及低级别胶质瘤患者可能具有更长的生存期和更好的预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3a86/7280555/d9080913aa14/fonc-10-00852-g0001.jpg

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