幕上IDH突变型与野生型胶质细胞瘤MRI强化特征分析
|
摘要
目的分析对比幕上异柠檬酸脱氢酶(IDH)突变型及野生型在高低不同级别胶质细胞瘤的MRI强化特征。方法经手术及病理证实101例胶质细胞瘤,其中低级别(WHOⅡ级)胶质细胞瘤58例,IDH突变型26例,IDH野生型32例;高级别(WHOⅢ级)胶质细胞瘤43例,IDH突变型20例,IDH野生型23例。术前全部行核磁共振影像(MRI)增强扫描,按照无或轻度强化、中度强化、重度强化组分别进行统计。结果低级别胶质细胞瘤以轻中度强化为主,IDH突变型和野生型之间强化程度无明显差别(P> 0. 05),高级别胶质细胞瘤的中重度强化明显增多,IDH野生型重度强化明显多于IDH突变型胶质细胞瘤,两组间有统计学差异(P <0. 01)。结论低级别胶质细胞瘤IDH突变型与野生型间强化程度无明显差别,高级别胶质细胞瘤IDH野生型重度强化明显多于IDH突变型,提示在不同级别胶质细胞瘤中IDH突变的促血管生成作用存在区别。
Objective The MR contrast imaging features between the isocitrate dehydrogenase( IDH)mutation group and wild-type group in human superatentorial high and low grade gliomas were studied and analyzed. Methods A total of 101 cases of gliomas confirmed by surgery and pathology were involved,including 26 cases of IDH mutation and 32 cases of IDH wild type in WHO Grade Ⅱ gliomas,20 cases of IDH mutation and 23 cases of IDH wild type in WHO Grade Ⅲ gliomas. All cases were performed contrast enhanced MRI before operation. Degrees of tumor enhancement including none/slight,medium and severe enhancement were recorded respectively and analyzed. Results Most low grade gliomas showed slight or medium enhancement and there were no significant differences in enhancement degree between IDH mutation type and IDH wild type( P > 0. 05). High grade gliomas showed much more medium and severe enhancement than that of low grade gliomas,and there were more severe enhancement of IDH mutation type than that of IDH wild type with significant difference( P < 0. 01). Conclusion There is statistically no significant difference of enhancement degree between IDH mutation group and IDH wild type group in low grade gliomas,while there are more severe enhancements in IDH wild type than that of IDH mutation type in high grade gliomas,which suggests different values of IDH in promoting angiogenesis in different grade gliomas.
Objective The MR contrast imaging features between the isocitrate dehydrogenase( IDH)mutation group and wild-type group in human superatentorial high and low grade gliomas were studied and analyzed. Methods A total of 101 cases of gliomas confirmed by surgery and pathology were involved,including 26 cases of IDH mutation and 32 cases of IDH wild type in WHO Grade Ⅱ gliomas,20 cases of IDH mutation and 23 cases of IDH wild type in WHO Grade Ⅲ gliomas. All cases were performed contrast enhanced MRI before operation. Degrees of tumor enhancement including none/slight,medium and severe enhancement were recorded respectively and analyzed. Results Most low grade gliomas showed slight or medium enhancement and there were no significant differences in enhancement degree between IDH mutation type and IDH wild type( P > 0. 05). High grade gliomas showed much more medium and severe enhancement than that of low grade gliomas,and there were more severe enhancement of IDH mutation type than that of IDH wild type with significant difference( P < 0. 01). Conclusion There is statistically no significant difference of enhancement degree between IDH mutation group and IDH wild type group in low grade gliomas,while there are more severe enhancements in IDH wild type than that of IDH mutation type in high grade gliomas,which suggests different values of IDH in promoting angiogenesis in different grade gliomas.
引文
1 HENDRICKS B K, COHEN-GADOL A A, MILLER J C. Novel delivery methods bypassing the blood-brain and blood-tumor barriers[J]. Neurosurg Focus,2015,38(3):E10.
2 PARSONS D W,JONES S,ZHANG X,et al. An integrated genomic analysis of human glioblastoma multiforme[J]. Science,2008,321(5897):1807-1812.
3 ANDRONESI O C,KIM G S,GERSTNER E A,et al. Detection of 2-Hydroxyglutarate in IDH-Mutated glioma patients by in vivo SpectralEditing and 2D correlation magnetic resonance spectroscopy[J]. Sci Transl Med,2012,4(116):116ra4.
4 PRENSNER J R,CHINNAIYAN A M. Metabolism unhinged:IDH mutations in cancer[J]. Nat Med,2011,17(3):291-293.
5 BIRNER P,PUSCH S,CHRISTOV C,et al. Mutant IDH1 inhibits PI3K/Akt signaling in human glioma[J]. Cancer,2014,120(16):2440-2447.
6 张劲松,尚磊,叶菁,等.幕上IDH突变型低级别胶质瘤MRI特征与病理相关研究[J].中华神经外科疾病研究杂志,2016,15(2):140-143.
7 YAN H,PARSONS D W,JIN G,et al. Idh1 and idh2 mutations in gliomas[J]. N Engl J Med,2009,360(8):765-773.
8 QI S T,YU L,LU Y T,et al. Idh mutations occur frequently in Chinese glioma patients and predict longer survival but not response to concomitant chemoradiotherapy in anaplastic gliomas[J]. Oncol Rep,2011,26(6):1479-1485.
9 HARTMANN C,MEYER J,BALSS J,et al. Type and frequency of IDH1 and IDH2 mutations are related to astrocytic and oligodendroglial differentiation and age:a study of 1,010 diffuse gliomas[J]. Acta Neuropathol,2009,118(4):469-474.
10 KIM W,LIAU L M. IDH mutations in human glioma[J]. Neurosurg Clin N Am,2012,23(3):471-480.
11 METELLUS P,COULIBALY B,COLIN C,et al. Absence of IDH mutation identifies a novel radiologic and molecular subtype of WHO Grade II gliomas with dismal prognosis[J]. Acta Neuropathol,2010,120(6):719-729.
12 ZHAO S,LIN Y,XU W,et al. Glioma-derived mutations in IDH1dominantly inhibit IDH1 catalytic activity and induce HIF-1alpha[J].Science,2009,324(5924):261-265.
13 CHESNELONG C,CHAUMEIL M M,BLOUGH M D,et al. Lactate dehydrogenase A silencing in IDH mutant gliomas[J]. Neuro Oncol,2014,16(5):686-695.
14 KICKINGEREDER P,SAHM F,RADBRUCH A,et al. IDH mutation status is associated with a distinct hypoxia/angiogenesis transcriptome signature which is non-invasively predictable with r CBV imaging in human glioma[J]. Sci Rep,2015,5:16238.
15 LAW M,YOUNG R J,BABB J S,et al. Gliomas:predicting time to progression or survival with cerebral blood volume measurements at dynamic susceptibility-weighted contrast-enhanced perfusion MR imaging[J]. Radiology,2008,247(2):490-498.
2 PARSONS D W,JONES S,ZHANG X,et al. An integrated genomic analysis of human glioblastoma multiforme[J]. Science,2008,321(5897):1807-1812.
3 ANDRONESI O C,KIM G S,GERSTNER E A,et al. Detection of 2-Hydroxyglutarate in IDH-Mutated glioma patients by in vivo SpectralEditing and 2D correlation magnetic resonance spectroscopy[J]. Sci Transl Med,2012,4(116):116ra4.
4 PRENSNER J R,CHINNAIYAN A M. Metabolism unhinged:IDH mutations in cancer[J]. Nat Med,2011,17(3):291-293.
5 BIRNER P,PUSCH S,CHRISTOV C,et al. Mutant IDH1 inhibits PI3K/Akt signaling in human glioma[J]. Cancer,2014,120(16):2440-2447.
6 张劲松,尚磊,叶菁,等.幕上IDH突变型低级别胶质瘤MRI特征与病理相关研究[J].中华神经外科疾病研究杂志,2016,15(2):140-143.
7 YAN H,PARSONS D W,JIN G,et al. Idh1 and idh2 mutations in gliomas[J]. N Engl J Med,2009,360(8):765-773.
8 QI S T,YU L,LU Y T,et al. Idh mutations occur frequently in Chinese glioma patients and predict longer survival but not response to concomitant chemoradiotherapy in anaplastic gliomas[J]. Oncol Rep,2011,26(6):1479-1485.
9 HARTMANN C,MEYER J,BALSS J,et al. Type and frequency of IDH1 and IDH2 mutations are related to astrocytic and oligodendroglial differentiation and age:a study of 1,010 diffuse gliomas[J]. Acta Neuropathol,2009,118(4):469-474.
10 KIM W,LIAU L M. IDH mutations in human glioma[J]. Neurosurg Clin N Am,2012,23(3):471-480.
11 METELLUS P,COULIBALY B,COLIN C,et al. Absence of IDH mutation identifies a novel radiologic and molecular subtype of WHO Grade II gliomas with dismal prognosis[J]. Acta Neuropathol,2010,120(6):719-729.
12 ZHAO S,LIN Y,XU W,et al. Glioma-derived mutations in IDH1dominantly inhibit IDH1 catalytic activity and induce HIF-1alpha[J].Science,2009,324(5924):261-265.
13 CHESNELONG C,CHAUMEIL M M,BLOUGH M D,et al. Lactate dehydrogenase A silencing in IDH mutant gliomas[J]. Neuro Oncol,2014,16(5):686-695.
14 KICKINGEREDER P,SAHM F,RADBRUCH A,et al. IDH mutation status is associated with a distinct hypoxia/angiogenesis transcriptome signature which is non-invasively predictable with r CBV imaging in human glioma[J]. Sci Rep,2015,5:16238.
15 LAW M,YOUNG R J,BABB J S,et al. Gliomas:predicting time to progression or survival with cerebral blood volume measurements at dynamic susceptibility-weighted contrast-enhanced perfusion MR imaging[J]. Radiology,2008,247(2):490-498.