胶质母细胞瘤的磁共振征象与免疫组化的关系  

Relationship between magnetic resonance imaging signs and immunohistochemistry of glioblastoma

作　　者：陈铭[1] 陈加贝[1] 漆松涛[1] 刘忆[1] 石瑾[1] 彭四维[1] 唐四强[1] 

机构地区：[1]南方医科大学南方医院神经外科,广州510515

出　　处：《中华神经外科杂志》2015年第7期663-667,共5页Chinese Journal of Neurosurgery

摘　　要：目的研究胶质母细胞瘤（GBM）的磁共振（MRI）征象与异柠檬酸盐脱氢酶（IDH）1、 O（6）-甲基鸟嘌呤-DNA甲基转移酶（MGMT）免疫组化的关系。方法收集2008年1月至2013年12月病理诊断为GBM的病例，分析术前MRI与IDH1、MGMT免疫组化之间的关系。结果111例患者，术后病理均行IDH1、MGMT免疫组化检查，IDH1阳性29例（26．1％），MGMT阳性60例（54．1％）。单因素分析显示，肿瘤最大直径（χ^2=9．400，P=0．009）、MRI增强（t=2．204，P=0．030）、瘤周水肿（PTE）分度（χ^2=6．411，P=0．041）和主要侵袭部位（t=2．788，P=0．006）与IDH1的阳性表达存在相关性。Logistic多因素回归分析显示，肿瘤最大直径（P=0．015）、MRI增强（P=0．037）和主要侵袭部位（P=0．024）是预测IDH1阳性表达的主要因子，其中肿瘤最大直径是最重要的预测因子（P〈0．05）；MGMT的阳性表达与病变个数（χ^2=6．678，P=0．010）、磁共振扩散加权成像（DWI）（t=-4．320，P=0．000）、囊变（χ^2=16．185，P=0．000）、坏死（χ^2=8．325，P=0．004）和主要侵袭部位（t=2．612，P=0．010）相关。Logistic多因素回归分析显示，病变数量（P=0．008）、囊变（P=0．000）和DWI（P=0．000）是预On,0MGMT阳性表达的主要因子，其中DWI高信号是最重要的预测因子（P〈0．05）。结论：DH1、MGMT免疫组化结果与常规MRI上肿瘤表现具有一定相关性。通过分析影像和病理的相关性，有利于筛选和初步判断肿瘤的生物学行为和判断其预后。Objective To study the relationship between magnetic resonance imaging （MRI） signs of glioblastoma （GBM） and the immunohistochemistry of isocitrate dehydrogenase 1 （IDH1）, 06- methylguanine-DNA methyltransferase （MGMT）. Methods The patients pathologically diagnosed as GBM were collected from January 2008 to December 2013. The relationship between MRI and immunohistochemistry of IDH1 and MGMT before procedure was analyzed. Results A total of 111 patients performed IDH1 and MGMT immunohistochemical examinations for postoperative pathology, 29 patients （26. 1% ） were IDH1 positive and 60 （54. 1% ） were MGMT positive. Univariate analysis showed that the maximum diameter of the tumors （χ^2 = 9. 400, P = 0. 009 ） , MRI enhancement （ t = 2. 204, P = 0. 030） , peritumoral edema （PTE） indexed （χ^2 = 6. 411, P = 0. 041 ） , and main invasive sites （ t = 2. 788, P = 0. 006 ） were associated with the positive expression of IDH1. Multivariate logistic regression analysis showed that the maximum diameter of the tumors （P = O. 015 ）, MRI enhancement （P = O. 037）, and main invasive sites （P = 0. 024） were the main factors for predicting IDH1 positive expression, and the maximum diameter of the tumors was the most important predictor （ P 〈 0. 05 ）. The positive expression of MGMT was associated with the number of lesions （χ^2 = 6. 678, P = 0. 010 ）, magnetic resonance diffusion weighted imaging （DWI） （ t = - 4. 320, P = 0. 000） , cystic change （χ^2 = 16. 185, P = 0. 000） , necrosis （χ^2 = 8. 325, P = 0. 004）, and main invasion sites （t =2. 612, P =0. 010）. Multivariate logistic regression analysis showed that the number of lesions （ P = 0. 008 ）, cystic change （ P = 0. 000 ）, and DWI （ P = 0. 000 ） were the major factors for predicting MGMT positive expression, and DWI hyperintensity was the most important predictor （P 〈 0. 05）. Conclusions The results of IDH1 and MGMT immunohistochemistry have some correlations with the pe

关 键 词：胶质母细胞瘤 异柠檬酸脱氢酶 O(6)-甲基鸟嘌呤DNA甲基转移酶 磁共振成像 

分 类 号：R739.4[医药卫生—肿瘤]