Department of Neurosurgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan.
Department of Neurosurgery, Hokkaido Ohno Memorial Hospital, Hokkaido, Japan.
Sci Rep. 2022 Jan 11;12(1):546. doi: 10.1038/s41598-021-04216-5.
This study aimed whether the uptake of amino tracer positron emission tomography (PET) can be used as an additional imaging biomarker to estimate the prognosis of glioma. Participants comprised 56 adult patients with newly diagnosed and untreated World Health Organization (WHO) grade II-IV astrocytic glioma who underwent surgical excision and were evaluated by 11C-methionine PET prior to the surgical excision at Osaka City University Hospital from July 2011 to March 2018. Clinical and imaging studies were retrospectively reviewed based on medical records at our institution. Preoperative Karnofsky Performance Status (KPS) only influenced progression-free survival (hazard ratio [HR] 0.20; 95% confidence interval [CI] 0.10-0.41, p < 0.0001), whereas histology (anaplastic astrocytoma: HR 5.30, 95% CI 1.23-22.8, p = 0.025; glioblastoma: HR 11.52, 95% CI 2.27-58.47, p = 0.0032), preoperative KPS ≥ 80 (HR 0.23, 95% CI 0.09-0.62, p = 0.004), maximum lesion-to-contralateral normal brain tissue (LN max) ≥ 4.03 (HR 0.24, 95% CI 0.08-0.71, p = 0.01), and isocitrate dehydrogenase (IDH) status (HR 14.06, 95% CI 1.81-109.2, p = 0.011) were factors influencing overall survival (OS) in multivariate Cox regression. OS was shorter in patients with LN max ≥ 4.03 (29.3 months) than in patients with LN max < 4.03 (not reached; p = 0.03). OS differed significantly between patients with IDH mutant/LN max < 4.03 and patients with IDH mutant/LN max ≥ 4.03. LN max using 11C-methionine PET may be used in prognostic markers for newly identified and untreated WHO grade II-IV astrocytic glioma.
本研究旨在探讨氨基酸示踪剂正电子发射断层扫描（PET）摄取是否可用作额外的影像学生物标志物，以评估胶质瘤的预后。研究对象为 2011 年 7 月至 2018 年 3 月期间在大阪市立大学医院接受手术切除且术前接受 11C-蛋氨酸 PET 评估的 56 例新诊断和未经治疗的世界卫生组织（WHO）II-IV 级星形细胞瘤成人患者。我们根据我院的病历对临床和影像学研究进行了回顾性分析。术前卡氏功能状态（KPS）仅影响无进展生存期（风险比[HR]0.20；95%置信区间[CI]0.10-0.41，p<0.0001），而组织学（间变性星形细胞瘤：HR5.30，95%CI1.23-22.8，p=0.025；胶质母细胞瘤：HR11.52，95%CI2.27-58.47，p=0.0032）、术前 KPS≥80（HR0.23，95%CI0.09-0.62，p=0.004）、最大病变与对侧正常脑组织（LNmax）比值≥4.03（HR0.24，95%CI0.08-0.71，p=0.01）和异柠檬酸脱氢酶（IDH）状态（HR14.06，95%CI1.81-109.2，p=0.011）是多变量 Cox 回归中影响总生存期（OS）的因素。LNmax≥4.03 的患者 OS 更短（29.3 个月），而 LNmax<4.03 的患者 OS 未达到（p=0.03）。IDH 突变/LNmax<4.03 患者和 IDH 突变/LNmax≥4.03 患者的 OS 有显著差异。使用 11C-蛋氨酸 PET 的 LNmax 可能用于预测新诊断和未经治疗的 WHO II-IV 级星形细胞瘤的预后标志物。
