作为成人大脑中最大的神经干细胞集中区域,脑室下区(SVZ)被认为与胶质瘤的起源有密切关系。深入研究SVZ累及脑胶质瘤的特征性表现,可能为该致命性疾病的个体化诊治提供新的思路。
纳入2016年1月至2021年12月在我科接受手术治疗的所有279例胶质瘤患者。收集临床和影像学资料,并进行电话随访以分析总生存期和无进展生存期.分析了包括SVZ参与对胶质母细胞瘤患者生存的预后因素。接下来,SVZ参与之间的关系,分别确定了一组独特的影像学特征和基因状态。卡方检验,物流回归,采用Cox回归进行统计学分析。
将患者分为SVZ受累组(n=198,70.97%)和SVZ未受累组(n=81,29.03%)。SVZ组的中位总生存期和无进展生存期分别为13个月和7个月。但对于SVZ非参与组,25个月和17个月,分别。在多变量Cox生存分析中,MRISVZ受累被证明是胶质母细胞瘤患者生存的独立危险因素。具有SVZ受累征的患者囊性病变的发生率较低(32.32%vs.48.48%,p=0.029),和较大的平均最大直径(5.88±1.28vs.3.28±1.65cm)。与高级别胶质瘤(HGG)相比,T1增强(25.25%vs.10.42%,p=0.041)和T2WI上的均匀信号(14.14%vs.43.75%,p=0.025)与SVZ参与WHO2级胶质瘤(LGG)独立相关。在基因状态分析中,SVZ受累组MGMT启动子甲基化率较低(57.58%vs.79.17%,p=0.017)。
SVZ参与MRI诊断是胶质母细胞瘤患者生存的独立阴性预后指标。一些图像标志分别与SVZ参与HGG和LGG相关。SVZ累及的胶质瘤独特的影像学和基因特征表明,这类肿瘤可能是胶质瘤的一个独特亚组。
As the largest concentrated region of neural stem cells in the adult brain, the subventricular zone (SVZ) is considered to have a close relationship with the origin of gliomas. An in-depth study of the characteristic manifestations associated with SVZ involvement in glioma may provide new ideas for individualized diagnosis and treatment of this fatal disease.
All 279 patients with glioma who underwent surgical treatment in our department from January 2016 to December 2021 were included. Clinical and imaging data were collected, and telephonic follow-up was conducted to analyze the overall survival and progression-free survival. Prognostic factors including SVZ involvement on glioblastoma patients\' survival were analyzed. Next, the relationship between SVZ involvement, a set of unique imaging features and gene status were determined respectively. The chi-squared test, logistics regression, and Cox regression were used for statistical analysis.
The patients were divided into the SVZ involvement group (n = 198, 70.97 %) and SVZ non-involvement group (n = 81, 29.03 %). The median overall survival and progression-free survival were 13 months and 7 months for the SVZ involvement group, but 25 months and 17 months for the SVZ non-involvement group, respectively. In multivariate Cox survival analysis, MRI SVZ involvement proved an independent risk factor for the survival of patients with glioblastoma. The patients with SVZ involvement sign had a lower rate of cystic lesion (32.32 % vs. 48.48 %, p = 0.029), and a larger mean maximum diameter (5.88 ± 1.28 vs. 3.28 ± 1.65 cm). Compared with high grade gliomas (HGG), T1 enhancement (25.25 % vs. 10.42 %, p = 0.041) and homogeneous signal on T2WI (14.14 % vs. 43.75 %, p = 0.025) were independently associated with SVZ involvement in WHO grade 2 gliomas(LGG). In the gene status analysis, the SVZ involvement group showed the lower rate of MGMT promoter methylation (57.58 % vs. 79.17 %, p = 0.017).
SVZ involvement in MRI at diagnosis is an independent negative prognostic indicator for the survival of glioblastoma patients. Some image signs are associated with SVZ involvement in HGG and LGG respectively. The unique imaging and gene features of gliomas with SVZ involvement indicate that this kind of tumor maybe a unique subgroup of gliomas.