初发性和复发性脑胶母细胞瘤的启动子甲基化状态：与 DWI 和 DSC PWI 特征的相关性研究。
Promoter Methylation Status in Initial and Recurrent Glioblastoma: Correlation Study with DWI and DSC PWI Features.
机构信息
From the Department of Radiology (H.J.C.), Cha Bundang Medical Center, Cha University, Seongnam, Korea.
Department of Radiology (S.H.C., R.-E.Y., K.M.K., T.J.Y., J.-h.K., C.-H.S.), Seoul National University Hospital, Seoul, Korea
出版信息
AJNR Am J Neuroradiol. 2021 May;42(5):853-860. doi: 10.3174/ajnr.A7004. Epub 2021 Feb 25.
BACKGROUND AND PURPOSE
() promoter methylation status in primary and recurrent glioblastoma may change during treatment. The purpose of this study was to correlate promoter methylation status changes with DWI and DSC PWI features in patients with recurrent glioblastoma after standard treatment.
MATERIALS AND METHODS
Between January 2008 and November 2016, forty patients with histologically confirmed recurrent glioblastoma were enrolled. Patients were divided into 3 groups according to the promoter methylation status for the initial and recurrent tumors: 2 groups whose promoter methylation status remained, group methylated ( = 13) or group unmethylated ( = 18), and 1 group whose promoter methylation status changed from methylated to unmethylated ( = 9). Normalized ADC and normalized relative CBV values were obtained from both the enhancing and nonenhancing regions, from which histogram parameters were calculated. The ANOVA and the Kruskal-Wallis test followed by post hoc tests were performed to compare histogram parameters among the 3 groups. The test and Mann-Whitney test were used to compare parameters between group methylated and group methylated to unmethylated. Receiver operating characteristic curve analysis was used to measure the predictive performance of the normalized relative CBV values between the 2 groups.
RESULTS
Group methylated to unmethylated showed significantly higher means and 90th and 95th percentiles of the cumulative normalized relative CBV values of the nonenhancing region of the initial tumor than group methylated and group unmethylated (all < .05). The mean normalized relative CBV value of the nonenhancing region of the initial tumor was the best predictor of methylation status change ( < .001), with a sensitivity of 77.78% and specificity of 92.31% at a cutoff value of 2.594.
CONCLUSIONS
promoter methylation status might change in recurrent glioblastoma after standard treatment. The normalized relative CBV values of the nonenhancing region at the first preoperative MR imaging were higher in the promoter methylation change group from methylation to unmethylation in recurrent glioblastoma.
背景与目的
原发性和复发性脑胶质瘤中 启动子甲基化状态在治疗过程中可能发生变化。本研究旨在探讨复发性脑胶质瘤患者在标准治疗后， 启动子甲基化状态变化与 DWI 和 DSC PWI 特征的相关性。
材料与方法
2008 年 1 月至 2016 年 11 月，纳入 40 例经组织学证实的复发性脑胶质瘤患者。根据初始和复发性肿瘤 启动子甲基化状态，患者分为 3 组：组甲基化（ = 13）、组未甲基化（ = 18）和组甲基化状态由甲基化变为未甲基化（ = 9）。从增强和非增强区域获得归一化 ADC 和归一化相对 CBV 值，并计算直方图参数。采用方差分析和 Kruskal-Wallis 检验，随后进行事后检验，比较 3 组间直方图参数。采用 检验和 Mann-Whitney 检验比较组甲基化和组甲基化变为未甲基化之间的参数。采用受试者工作特征曲线分析评估 2 组间归一化相对 CBV 值的预测性能。
结果
组甲基化变为未甲基化的初始肿瘤非增强区的累积归一化相对 CBV 值的均值、90 百分位数和 95 百分位数均显著高于组甲基化和组未甲基化（均<0.05）。初始肿瘤非增强区的平均归一化相对 CBV 值是甲基化状态变化的最佳预测指标（<0.001），其截断值为 2.594 时，敏感性为 77.78%，特异性为 92.31%。
结论
标准治疗后复发性脑胶质瘤中 启动子甲基化状态可能发生变化。在复发性脑胶质瘤中，从甲基化到非甲基化的 启动子甲基化变化组，其初次术前 MRI 非增强区的归一化相对 CBV 值较高。
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