IDH mutation and 1p19q codeletion distinguish two radiological patterns of diffuse low-grade gliomas
IDH mutation and 1p19q codeletion distinguish two radiological patterns of diffuse low-grade gliomas
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DOI：
10.1007/s11060-017-2421-0
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发表时间：
2017-05-01
影响因子：
3.9
通讯作者：
Duffau, Hugues
中科院分区：
文献类型：
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作者：
Darlix, Amelie;Deverdun, Jeremy;Duffau, Hugues
弥漫性低级别胶质瘤（DLGG）的预后是可变的，取决于几个因素，包括异柠檬酸脱氢酶（IDH）突变和1 p19 q共缺失。一些研究表明，这些参数和肿瘤的放射学特征，包括地形之间的关联。我们的目的是分析IDH和1 p19 q状态与肿瘤脑内分布（在脑叶和体素水平）、体积和边界之间的相关性。我们对198例DLGG患者进行了一项回顾性、单中心研究。记录IDH和1 p19 q状态。治疗前的磁共振FLAIR成像进行了审查，以确定肺叶地形，肿瘤体积和肿瘤边界（清晰或模糊）的特点。我们进行了基于体素的病变-症状映射分析，以研究IDH和1 p19 q状态与体素水平的地形图之间的相关性。IDH突变和1 p19 q状态与使用肺叶解剖学定义的肿瘤地形图相关（分别为p < 0.001和p = 0.004）。与颞叶岛叶病变相比，额叶肿瘤更常见IDH突变（87.1 vs. 57.4%）和1 p19 q共缺失（45.2 vs. 17.0%）。在体素水平上，没有发现这些相关性，边界清晰的肿瘤更容易发生IDH突变（p = 0.001），而边界模糊的肿瘤更容易发生IDH野生型和1 p19 q非共缺失（p < 0.001）。诊断时较大的肿瘤（可能与生长速度较慢有关）更常见IDH突变（p < 0.001）。IDH野生型、1 p19 q非共缺失的颞叶岛叶肿瘤与IDH突变型、1 p19 q共缺失的额叶肿瘤不同。需要进一步的研究来确定治疗策略是否应该适应每种模式。
Diffuse low-grade gliomas (DLGG) prognosis is variable, depending on several factors, including the isocitrate dehydrogenase (IDH) mutation and the 1p19q codeletion. A few studies suggested associations between these parameters and tumor radiological characteristics including topography. Our aim was analyzing the correlations between the IDH and 1p19q statuses and the tumor intracerebral distribution (at the lobar and voxel levels), volume, and borders. We conducted a retrospective, monocentric study on a consecutive series of 198 DLGG patients. The IDH and 1p19q statuses were recorded. The pre-treatment magnetic resonance FLAIR imagings were reviewed for determination of lobar topography, tumor volume, and characterisation of tumor borders (sharp or indistinct). We conducted a voxel-based lesion-symptom mapping analysis to investigate the correlations between the IDH and 1p19q statuses and topography at the voxel level. The IDH mutation and 1p19q statuses were correlated with the tumor topography defined using lobar anatomy (p < 0.001 and p = 0.004, respectively). Frontal tumors were more frequently IDH-mutant (87.1 vs. 57.4%) and 1p19q codeleted (45.2 vs. 17.0%) than temporo-insular lesions. At the voxel level, these associations were not found. Tumors with sharp borders were more frequently IDH-mutant (p = 0.001) while tumors with indistinct borders were more frequently IDH wild-type and 1p19q non-codeleted (p < 0.001). Larger tumors at diagnosis (possibly linked to a slower growth rate) were more frequently IDH-mutant (p < 0.001). IDH wild-type, 1p19q non-codeleted temporo-insular tumors are distinct from IDH-mutant, 1p19q codeleted frontal tumors. Further studies are needed to determine whether the therapeutic strategy should be adapted to each pattern.