Yoo Jihwan, Cha Yoon Jin, Park Hun Ho, Park Mina, Joo Bio, Suh Sang Hyun, Ahn Sung Jun
Department of Neurosurgery, Brain Tumor Center, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06230, Korea.
Department of Pathology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06230, Korea.
Cancers (Basel). 2022 Mar 26;14(7):1694. doi: 10.3390/cancers14071694.
Although necrosis is common in brain metastasis (BM), its biological and clinical significances remain unknown. We evaluated necrosis extent differences by primary cancer subtype and correlated BM necrosis to overall survival post-craniotomy. We analyzed 145 BMs of patients receiving craniotomy. Necrosis to tumor ratio (NTR) was measured. Patients were divided into two groups by NTR: BMs with sparse necrosis and with abundant necrosis. Clinical features were compared. To investigate factor relevance for BM necrosis, multivariate logistic regression, random forests, and gradient boosting machine analyses were performed. Kaplan−Meier analysis and log-rank tests were performed to evaluate the effect of BM necrosis on overall survival. Lung cancer was a more common origin for BMs with abundant necrosis (42/72, 58.33%) versus sparse necrosis (23/73, 31.51%, p < 0.01). Primary cancer subtype and tumor volume were the most relevant factors for BM necrosis (p < 0.01). BMs harboring moderately abundant necrosis showed longer survival, versus sparse or highly abundant necrosis (p = 0.04). Lung cancer BM may carry larger necrosis than BMs from other cancers. Further, moderately abundant necrosis in BM may predict a good prognosis post-craniotomy.
尽管坏死在脑转移瘤（BM）中很常见，但其生物学和临床意义仍不清楚。我们评估了不同原发癌亚型的坏死程度差异，并将BM坏死与开颅术后的总生存期相关联。我们分析了145例接受开颅手术的患者的BM。测量坏死与肿瘤比率（NTR）。根据NTR将患者分为两组：坏死稀疏的BM和坏死丰富的BM。比较临床特征。为了研究与BM坏死相关的因素，进行了多因素逻辑回归、随机森林和梯度提升机器分析。进行Kaplan-Meier分析和对数秩检验以评估BM坏死对总生存期的影响。与坏死稀疏的BM（23/73，31.51%）相比，坏死丰富的BM中肺癌是更常见的起源（42/72，58.33%，p<0.01）。原发癌亚型和肿瘤体积是与BM坏死最相关的因素（p<0.01）。与坏死稀疏或高度丰富的BM相比，坏死程度中等丰富的BM生存期更长（p=0.04）。肺癌BM可能比其他癌症的BM坏死更大。此外，BM中坏死程度中等丰富可能预示开颅术后预后良好。
