Dynamic contrast-enhanced magnetic resonance imaging biomarkers predict chemotherapeutic responses and survival in primary central-nervous-system lymphoma
Dynamic contrast-enhanced magnetic resonance imaging biomarkers predict chemotherapeutic responses and survival in primary central-nervous-system lymphoma
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DOI：
10.1007/s00330-020-07296-5
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发表时间：
2020-09-30
影响因子：
5.9
通讯作者：
Sun, Shengjun
中科院分区：
文献类型：
--
作者：
Fu, Fan;Sun, Xuefei;Sun, Shengjun
目的评价动态对比增强磁共振成像（DCE-MRI）在预测原发性中枢神经系统淋巴瘤（PCNSL）患者化疗反应和临床结果中的应用价值。方法在2016年至2019年期间，对56例纳入前瞻性研究的患者在基线和治疗后30天进行DCE-MRI检查。进行多因素logistic回归分析以评估肿瘤反应的危险因素。通过受试者工作特征（ROC）曲线分析DCE相关参数的预测值。为评价预后因素，采用Kaplan-Meier生存分析、log-rank检验和Cox回归检验进行分析。结果无反应组K（trans）、v (e)高于反应组（p< 0.05）。治疗30天后k（反式）和k（反式）下降百分比是化疗反应的独立预测因子（p= 0.034和p= 0.019）。ROC分析显示，预测化疗反应的k （trans）截断点为0.353 min(-1)(AUC, 0.941, 95% CI, 0.87-1, p< 0.001)，治疗30天后k （trans）下降的百分比为15.2% （AUC, 0.858, 95% CI, 0.742-0.970, p< 0.001）。inK（trans）降低越多，无进展生存期（PFS）越长（chi(2)= 13.203,p< 0.001）。较高的k （trans）是较短PFS的独立预测因子（风险比，10.182;95% CI, 2.510-41.300;p= 0.001）。结论DCE-MRI测量的K（trans）和K（trans）变化是预测PCNSL患者化疗反应的可靠生物标志物。
Objectives To evaluate the utility of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in predicting the response of chemotherapy and clinical outcomes in primary central-nervous-system lymphoma (PCNSL) patients. Methods DCE-MRI in 56 patients enrolled in a prospective study was performed at baseline and 30 days after treatment from 2016 to 2019. Multivariate logistic regression analyses were performed to assess risk factors for tumor responses. The predictive values of related parameters derived from DCE were analyzed via receiver operating characteristic (ROC) curve analysis. To evaluate prognostic factors, the Kaplan-Meier survival analysis with log-rank tests and Cox regression tests were analyzed. Results K(trans)andV(e)were higher in the non-response group than in the response group (p< 0.05). TheK(trans)and the percentage ofK(trans)decreased after 30 days of treatment were independent predictors of chemotherapy responses (p= 0.034 andp= 0.019). ROC analysis indicated that the cut-off point ofK(trans)for predicting chemotherapeutic responses was 0.353 min(-1)(AUC, 0.941; 95% CI, 0.87-1;p< 0.001) and percentage ofK(trans)decreased after 30 days of treatment was 15.2% (AUC, 0.858; 95% CI, 0.742-0.970;p< 0.001). The greater decrease inK(trans)correlated with a longer progression-free survival (PFS) (chi(2)= 13.203,p< 0.001). The higherK(trans)was an independent predictor for shorter PFS (hazard ratio, 10.182; 95% CI, 2.510-41.300;p= 0.001). Conclusions K(trans)andK(trans)change measured by DCE-MRI were reliable biomarkers for predicting chemotherapy responses in PCNSL patients.