BRAF p.V600E野生型和突变型多形性黄色星形细胞瘤的MRI征象分析  

BRAF p.V600E-mutant and wild Type by MRI in pleomorphic xanthoastrocytoma

作　　者：王昌斌 王光彬 李娜[4] 张庆雷 庞纯伟 WANG Changbin;WANG Guangbin;LI Na;ZHANG Qinglei;PANG Chunwei(Shandong University, Cheeloo College of Medicine, Jinan 250012, China;Department of Medical Imaging,Shandong Provincial Hospital, Cheeloo College Medicine,Shandong University, Jinan 250021, China;Department of Medical Imaging,Shandong Provincial Hospital Affiliated to shandong First Medicine University, Jinan 250021, China;Deaprtment of Dermatology, Shandong University of Traditional Medicine, Jinan 250355, China;Capital Medical University, Beijing 100069, China)

机构地区：[1]山东大学齐鲁医学院,山东济南250012 [2]山东大学附属省立医院影像科,山东济南250021 [3]山东第一医科大学附属省立医院医学影像科,山东济南250021 [4]山东中医药大学附属医院皮肤科,山东济南250355 [5]首都医科大学科创中心,北京100069

出　　处：《医学影像学杂志》2022年第6期901-905,共5页Journal of Medical Imaging

摘　　要：目的回顾性分析多形性黄色星形细胞瘤(pleomorphic xanthoastrocytoma,PXA)的临床、影像及病理资料,比较鼠类肉瘤病毒癌基因同源物B1(v-raf murinesar-coma viral oncogene homolog B1,BRAF)p.V600E野生型组和突变型组MRI征象差异。方法本文为多中心回顾性分析,纳入42例经病理确诊为PXA的患者,根据肿瘤BRAF p.V600E是否突变,将患者分为BRAF p.V600E野生型组和突变型组,分析MRI征象,进行统计学分析。结果共纳入BRAF p.V600E野生型组22例(52.4%)和突变型组20例(47.6%),野生型组肿瘤直径大于突变型组(4.79±1.96)cm vs(3.18±1.08)cm,P=0.005;瘤周水肿出现率野生型组高于突变型组(18/22,81.8%vs 10/50,50.0%,P=0.029);脑室受压野生型组多于突变型组(17/22,77.3%vs 9/20,45%,P=0.031);实体瘤强化程度野生型组高于突变型组(1/22,95.5%vs 6/20,70%,P=0.027)。结论与BRAF p.V600E突变型PXA相比,野生型患者肿瘤直径更大、瘤周水肿出现的可能增高、与脑室受累的关系更密切和更低的rADCmean、rADCmin值,术前应用PXA MRI征象差异可以有助于预判相关病理类型及分子表型,为临床优化诊疗方案、指导预后提供了理论依据。Objective To investigate the differences in MRI signs of BRAF p.V600E wild type and mutant type by analyzing the clinical data and brain MR imaging characteristics of PXA.Methods A total of 42 patients diagnosed with PXA from three hospitals were selected.Clinical,imaging and pathological data were collected.According to whether the tumor BRAF p.V600E was mutated,the patients were divided into BRAF p.V600E wild-type group and mutant group,the brain MRI signs were analyzed,and statistical analysis was performed.Results There were 22 cases(52.4%)in BRAF p.V600E wild-type group and 20 cases(47.6%)in the mutant group.The wild-type group may be more inclined to the imaging manifestations of high-grade tumors.The tumor diameter in the wild-type group was greater than that in the mutant group(4.79±1.96)cm vs(3.18±1.08)cm,P=0.005;the incidence of peritumoral edema in the wild-type group was higher than that in the mutant group(18/22,81.8%vs 10/50,50.0%,P=0.029);Ventricular compression in the wild-type group was higher than that in the mutant group(17/22,77.3%vs 9/20,45%,P=0.031);the degree of solid tumor enhancement in the wild-type group was higher than that in the mutant group(1/22,95.5%vs 6/20,70%,P=0.027).Conclusion Compared with BRAF p.V600E mutant PXA,wild-type tumor tends to have a larger diameter,increased peritumoral edema,closer relationship with ventricular involvement,and lower rADCmean and rADCmin values,and differences in preoperative MRI signs of PXA It can help predict related patholog-ical types and molecular phenotypes,and provide a theoretical basis for clinical optimization of diagnosis and treatment plans and guidance for prognosis.

关 键 词：多形性黄色星形细胞瘤 磁共振成像 

分 类 号：R739.41[医药卫生—肿瘤] R445.2[医药卫生—临床医学]