基于扩散张量成像参数及临床特征对胶质瘤异柠檬酸脱氢酶状态的预测研究  

Prediction of isocitrate dehydrogenase status of glioma via diffusion tensor imaging parameters and clinical features

作　　者：梁宇霞 尚宇 任雨寒 刘翔[3] 任春莹 张明[2] 牛晨[3] LIANG Yuxia;SHANG Yu;REN Yuhan;LIU Xiang;REN Chunying;ZHANG Ming;NIU Chen(Department of Health Medicine,the First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061,China;Department of Imaging,the First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061,China;PET-CT Room,the First Affiliated Hospital of Xi'an Jiaotong University,Xi'ann710061,China;Department of Neurosurgery,the First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061,China;Department of Imaging,Hospital of Stomatology Xi'an Jiaotong University,Xi'an 710004,China)

机构地区：[1]西安交通大学第一附属医院健康医学科,陕西西安710061 [2]西安交通大学第一附属医院影像科,陕西西安710061 [3]西安交通大学第一附属医院PET-CT室,陕西西安710061 [4]西安交通大学第一附属医院神经外科,陕西西安710061 [5]西安交通大学口腔医院影像科,陕西西安710004

出　　处：《实用放射学杂志》2024年第3期347-351,共5页Journal of Practical Radiology

基　　金：国家自然科学基金项目(82102014);陕西省自然科学基础研究计划项目(2022JQ792);西安市创新能力强基计划项目(21YXYJ0110);西安交通大学第一附属医院临床研究中心课题(XJTU1AF-CRF-2017-019)。

摘　　要：目的通过联合影像学及临床特征在术前无创性地对胶质瘤异柠檬酸脱氢酶(IDH)状态进行预测,为临床个体化治疗决策提供依据.方法纳入经术后病理及分子基因检测证实的胶质瘤患者47例,其中IDH突变型20例,IDH野生型27例.通过采集患者的扩散张量成像(DTI)图像,提取肿瘤实质部分的各向异性分数(FA)、平均扩散率(MD)值,联合肿瘤的MRI形态学特征、患者血液中性粒细胞/淋巴细胞计数比值(NLR)以及年龄,使用二元logistic回归方法建立模型,在术前有效预测胶质瘤患者IDH状态.结果FA平均值/正常脑白质FA比值(FAmean/FANAWM)、MD最小值(MDmin)、NLR、肿瘤位置及年龄在不同IDH状态胶质瘤患者组间存在显著差异(P<0.05).以FAmean/FANAWM、MDmin、囊变、NLR和年龄构建二元logistic回归模型预测胶质瘤IDH状态,曲线下面积(AUC)为0.961,95%置信区间(CI)为0.914~1.00.结论联合DTI、MRI形态学特征和血液NLR建立回归模型,对于胶质瘤IDH状态有较好的分类作用,可以在术前无创性地帮助预测胶质瘤IDH状态,从而为临床个体化治疗决策提供依据.Objective To noninvasively predict isocitrate dehydrogenase(IDH)status of glioma via combining imaging and clini-cal features before surgery,so as to provide basis for individualized clinical treatment decision.Methods A total of 47 patients with glioma confirmed by pathological and molecular genetic tests were included,including 20 with IDH mutant type and 27 with IDH wild type.After diffusion tensor imaging(DTI)scanning,fractional anisotropy(FA)and mean diffusivity(MD)values of tumor paren-chyma were calculated.Combining DTI parameters with MRI morphological features of tumor,blood neutrophil/lymphocyte ratio(NLR)and patient's age,binary logistic regression model was established to effectively predict IDH status of glioma patients before surgery.Results There were significant differences in FAmean/FANAWM,MDmin,NLR,tumor location and age between IDH mutant type and IDH wild type groups(P<0.05).The binary logistic regression model concluding,FAmean/FANAWM,MDmin,cystic degeneration,NLR and age,predicted IDH status of glioma with area under the curve(AUC)of 0.961 and 95%confidence interval(CI)of 0.914-1.00.Conclusion The regression model established via combining DTI,MRI morphological features and blood NLR has great performance in classifying IDH status of glioma,and can help predict IDH status noninvasively before surgery,so as to assist clinical individualized treatment.

关 键 词：胶质瘤 异柠檬酸脱氢酶 扩散张量成像 中性粒细胞/淋巴细胞计数比值 

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