摘要
目的探讨脑干胶质瘤患者^(11)C-蛋氨酸PET表现与分子标志物及总体生存率(OS)的关系。方法回顾性分析86例经手术病理证实的脑干胶质瘤患者(男51例,女35例),术前均行11 C-蛋氨酸PET检查。计算并记录PET图像的半定量参数,包括SUVmax、SUVmean、肿瘤摄取比(TBR),以及反映体积的参数代谢肿瘤体积(MTV)。记录并分析患者的分子病理诊断情况(包括p53、ATRX、H3K27M和lDH1的突变状态以及MGMT启动子甲基化)。评估PET影像学表现与肿瘤分级、分子生物标志物和总生存率之间的关系。结果在86例患者中,TBRmax(P=0. 007)和TBRmean(P=0. 032)与肿瘤分级具有显著的相关性。MTV与H3K27M突变(P=0.003)和MGMT启动子甲基化(P=0.021)呈显著负相关。但其他PET参数与分子病理之间没有显著关系。Cox回归分析显示TBRmax、TBRmean和H3K27M突变状态与OS显著相关。TBRmax可以作为一个独立的预后因素,具有重要的预测意义。结论 ^(11)C-蛋氨酸PET的一些参数与脑干胶质瘤的级别、分子病理以及生存期具有明显的关系,因此可以用于评估患者的预后情况。
Objective To explore the relation between 11C-methionine PET(11C-MET PET) findings,molecular biomarkers,and overall survival( OS) in patients with brainstem glioma. Method A total of 86 patients(51 men and 35 women) with histologically verified brainstem glioma were retrspectively analyzed,and all of them underwent 11C-MET PET examination preoperatively. Semiquantitative parameters of the PET images including SUVmax,SUVmean,and region of tumor-to-background ratio( TBR) were calculated and recorded. Metabolic tumor volume(MTV), which is a volume-based measurement calculated as the total volume within the boundary,was also investigated. The relationship between imaging findings,tumor grade,molecular biomarkers(including mutation status of P53,ATRX,H3 K27 M,and IDH1 as well as MGMT promoter methylation) and the overall survival(OS) were evaluated using Nonparametric Tests, Rank Correlation analysis, and Cox proportional hazard model. Result Regarding the 86 patients, significant differences in TBRmax(P = 0.007) and TBRmean( P=0.032) were observed in relation to tumor grade. H3 K27 M mutation was detected in 25 patients,IDH1 mutation in 8 patients,ATRX mutation in 29 patients,and MGMT promoter methylation in 25 patients. MTV was significantly inversely correlated with the presence of H3 K27 M mutation(P =0. 003) and MGMT promoter methylation(P = 0. 021). None of the parameters were corelated with the mutation of P53, ATRX, and IDH1. Cox regression analysis showed that TBR and H3 K27 M mutation status were significantly associated with OS. TBR was found to be an independent prognostic factor using multivariate analysis. Conclusion 11CMET PET parameters were significantly correlated with the pathological grade,H3 K27 M mutation status, and MGMT promoter methylation in brainstem glioma patients. H3 K27 M mutation, TBRmean and TBRmax were associated with OS. TBRmax was an independent factor for OS in this cohort of patients.
作者
李欢
孔鲁
赵晓斌
泮长存
张鹏
肖雄
艾林
张力伟
LI Huan;KONG Lu;ZHAO Xiao-bin;PAN Chang-cun;ZHANG Peng;XIAO Xiong;AI Lin;ZHANG Li-wei(Department of Neurosurgery, Beijing Tiantan Hospital Affiliated to Capital Medical University, Beijing100050,China;Department of Nuclear Medicine,Beijing Tiantan Hospital Affiliated to Capital Medical University,Beijing 100050,China)
出处
《中国临床医生杂志》
2019年第1期16-20,共5页
Chinese Journal For Clinicians
基金
北京市2016年度科技创新基地培育与发展工程子专项(206028)
吴阶平医学基金会临床科研专项资助基金
