Department of Neurosurgery, First Medical Center, PLA General Hospital, 28 Fuxing Rd, Beijing, 100853 China.
Department of Neurosurgery, Weifang People's Hospital Brain Hospital, Weifang, Shandong Province, China.
Curr Med Imaging. 2023;19(12):1378-1386. doi: 10.2174/1573405619666230123114753.
As the largest concentration of neural stem cells in adult brain, the subventricular zone (SVZ) is considered to be a potential source of glioblastoma (GBM) occurrence in recent years.
In this study, 116 patients with glioblastoma treated at PLA General Hospital were retrospectively reviewed. The features of SVZ contacting glioblastoma were analyzed in terms of MR imaging and MGMT promoter methylation. We also evaluated the prognostic value of SVZ contacting in GBM patients.
GBM with SVZ involvement on MRI is more likely to grow across the midline (36.8% vs. 6.9%, P=0.002), more often multifocal lesion (35.6% vs. 6.9%, P=0.003) and have a lower proportion of MGMT promoter methylation (36.8% vs. 69.0%, P=0.003). The median overall survival and progression- free survival of patients in the SVZ contacting group were 12 months and 7 months, while 25 months and 17 months in the non-contacting group (P<0.001, respectively). There was no significant difference in overall survival (P=0.229) and progression-free survival (P=0.808) between patients with different SVZ contacting regions. Multivariate survival analysis indicated that patients with MRI SVZ involvement showed worse overall survival (HR=2.060, 95%CI 1.195-3.550，P=0.009) and progression- free survival (HR=3.021, 95%CI 1.788-5.104，P＜0.001).
This study suggested that MRI SVZ involvement at diagnosis is an independent risk factor for overall survival and progression-free survival in IDH wild-type glioblastoma patients. Based on MR imaging, we also found that SVZ contacting glioblastomas had a larger proportion of crossing midline tumors and multifocal lesions. In addition, patients with SVZ contact in our research presented a lower proportion of MGMT promoter methylation.
作为成人脑中最大的神经干细胞集中区，侧脑室下区（SVZ）近年来被认为是胶质母细胞瘤（GBM）发生的潜在来源。
本研究回顾性分析了 116 例在解放军总医院治疗的胶质母细胞瘤患者。根据磁共振成像（MRI）和 MGMT 启动子甲基化分析，研究了 SVZ 与胶质母细胞瘤接触的特征。我们还评估了 SVZ 接触在 GBM 患者中的预后价值。
MRI 显示 SVZ 受累的 GBM 更有可能跨中线生长（36.8%比 6.9%，P=0.002），更常为多灶性病变（35.6%比 6.9%，P=0.003），且 MGMT 启动子甲基化比例较低（36.8%比 69.0%，P=0.003）。SVZ 接触组患者的中位总生存期和无进展生存期分别为 12 个月和 7 个月，而非接触组分别为 25 个月和 17 个月（均 P＜0.001）。在不同 SVZ 接触区域的患者中，总生存期（P=0.229）和无进展生存期（P=0.808）无显著差异。多变量生存分析表明，MRI 显示 SVZ 受累的患者总生存期较差（HR=2.060，95%CI 1.195-3.550，P=0.009）和无进展生存期较差（HR=3.021，95%CI 1.788-5.104，P＜0.001）。
本研究表明，诊断时 MRI 显示 SVZ 受累是 IDH 野生型胶质母细胞瘤患者总生存期和无进展生存期的独立危险因素。基于磁共振成像，我们还发现 SVZ 接触的胶质母细胞瘤中线交叉肿瘤和多灶性病变的比例较大。此外，我们研究中的 SVZ 接触患者 MGMT 启动子甲基化比例较低。
