Wang Rujia, Sun Zhengjun, Sun Jinghua, Ma Menhua, Wang Haiping
Department of Radiology, Tangshan Gongren Hospital, Tangshan, Hebei 063000, P.R. China.
Mol Clin Oncol. 2024 Nov 12;22(1):8. doi: 10.3892/mco.2024.2803. eCollection 2025 Jan.
O6-methylguanine DNA methyltransferase () promoter methylation is associated with the prognosis of patients with glioblastomas. With the aim of facilitating the discrimination of glioblastoma molecular phenotypes and improving the accuracy of molecular imaging diagnosis, the present retrospective study analyzed the association between promoter methylation and glioblastoma magnetic resonance imaging (MRI) texture features and prognosis. A total of 128 patients with pathologically diagnosed glioblastoma who had undergone preoperative MRI were enrolled. MRI texture features were extracted using 3D Slicer software and their relationship with promoter methylation was evaluated. In total, seven MRI texture features were significantly different between glioblastomas with methylated and unmethylated promoters-energy, entropy, uniformity, autocorrelation, and variance in gray level co-occurrence matrix, gray level non-uniformity and cluster shade. Glioblastomas with methylated and unmethylated promoters differed in tumor location, with the former predominantly located in the temporal lobe [Model I, area under the curve (AUC): 0.697]. Among MRI texture features, variance was significantly different between methylation groups (Model II, AUC: 0.838). Significant overall survival (OS) differences were noticed between patients with methylated and unmethylated promoters, between patients with preoperative Karnofsky performance status (KPS) scores ≥80 and <80, and among patients with glioblastoma who received radiotherapy, chemotherapy, or concurrent chemoradiotherapy. The seven MRI texture features may serve as independent predictors of prognosis for patients with glioblastoma with methylated promoters. MRI texture features demonstrated improved and more accurate diagnostic performance than MRI features regarding promoter methylation status prediction. For patients with glioblastoma with preoperative KPS scores ≥80, those with methylated promoters had significantly longer OS. Concurrent chemoradiotherapy had a significantly improved prognosis than either radiotherapy or chemotherapy alone. In summary, the present study provided a non-invasive, cost-effective method for detecting promoter methylation and can significantly contribute to personalized treatment planning for patients with glioblastoma, potentially improving their quality of life.
O6-甲基鸟嘌呤-DNA甲基转移酶（）启动子甲基化与胶质母细胞瘤患者的预后相关。为了便于区分胶质母细胞瘤的分子表型并提高分子影像诊断的准确性，本回顾性研究分析了启动子甲基化与胶质母细胞瘤磁共振成像（MRI）纹理特征及预后之间的关联。共纳入128例经病理诊断为胶质母细胞瘤且术前行MRI检查的患者。使用3D Slicer软件提取MRI纹理特征，并评估其与启动子甲基化的关系。总体而言，启动子甲基化和未甲基化的胶质母细胞瘤之间有七个MRI纹理特征存在显著差异，即灰度共生矩阵中的能量、熵、均匀性、自相关性和方差、灰度非均匀性和聚类阴影。启动子甲基化和未甲基化的胶质母细胞瘤在肿瘤位置上存在差异，前者主要位于颞叶[模型I，曲线下面积（AUC）：0.697]。在MRI纹理特征中，甲基化组之间的方差有显著差异（模型II，AUC：0.838）。启动子甲基化和未甲基化的患者之间、术前卡诺夫斯基表现状态（KPS）评分≥80和<80的患者之间以及接受放疗、化疗或同步放化疗的胶质母细胞瘤患者之间的总生存期（OS）存在显著差异。这七个MRI纹理特征可作为启动子甲基化的胶质母细胞瘤患者预后的独立预测指标。在预测启动子甲基化状态方面，MRI纹理特征比MRI特征表现出更好、更准确的诊断性能。对于术前KPS评分≥80的胶质母细胞瘤患者，启动子甲基化的患者OS明显更长。同步放化疗的预后明显优于单纯放疗或单纯化疗。总之，本研究提供了一种检测启动子甲基化的非侵入性、经济有效的方法，可为胶质母细胞瘤患者的个性化治疗规划做出显著贡献，有可能改善他们的生活质量。
