基于影像的形态学特征与胶质母细胞瘤特征分子表达的相关性研究

Correlations Between Morphological Characteristics and Expression Levels of Specific Molecular Biomarkers in Glioblastoma

本文探讨了磁共振成像(MRI)形态学指标与胶质母细胞瘤(GBM)特征分子表达率的相关性,为GBM的临床评估、个性化治疗方案的选择及预后评价提供了影像学参考依据.首先回顾性分析了我院60例经手术病理证实的GBM的MRI数据,测量计算出肿瘤区最长径(TLD)、水肿区最长径(ELD)、强化与肿瘤长径比例(CTE/TLD)3个形态学指标.同时,进行免疫组化染色,得到GBM的表皮生长因子受体(EGFR)、异柠檬酸脱氢酶-1(IDH-1)、抑癌基因TP53、磷酸酶-张力蛋白(PTEN)和神经丝轻链(NEFL)特征性变化,根据染色程度与瘤细胞阳性细胞的比率的乘积进行评分.然后,对TLD、ELD和CTE/TLD与上述分子表达分别进行Pearson相关分析和多元logistic回归分析.结果标明TLD与EGFR、PTEN表达呈正相关(r=0.796、r=0.533),与IDH-1表达呈负相关(r=-0.672).CTE/TLD与EGFR、PTEN表达呈正相关(r=0.622、r=0.638),与IDH-1表达呈负相关(r=-0.493).ELD与5个特征分子的表达均无显著相关性.因此,基于MRI的肿瘤形态学分析能够在一定程度上反应肿瘤特征分子的差异,对GBM的分子分级和预后判断可提供直观的影像学参考依据.本文结果显示常规MRI测量肿瘤形态学指标有可能成为一种较为简便直观的胶质瘤分级与预后评估手段.

To provide guidance to clinical diagnosis and develop individual-based treatment/prognostic evaluation, this study explored the correlations between morphological characteristics of glioblastoma （GBM） measured by conventional MRI and expression levels of GBM-specific molecular biomarkers. MRI data of 60 patients with histopathologically confirmed GBM were analyzed retrospectively, from which the morphological characteristics of GMB （i.e., TLD, ELD and CTE/TLD ratio） were measured. Histochemical staining was used to measure the levels of GBM-specific molecular biomarkers （i.e., EGFR, IDH-1, TP53, PTEN and NEFL）, which were calculated as the product of staining index and stained area. Correlations among the morphological characteristics and the levels of molecular biomarkers were assessed using multivariate logistic regression analyses. There was a significant correlation between TLD and EGFR level （r = - 0.796）. The correlation between TLD and PTEN level was positive （r =- 0.533）, while the correlation between TLD and IDH-1 level was negative （r = -0.672）. CTE/TLD had a positive correlation with EGFR （r = -0.622） and PTEN （r = -0.638） levels, along with a negative correlation with IDH-1 level （r = -0.493）. ELD had no significant correlation with the levels of all five molecular biomarkers. It was concluded that the morphological characteristics of GBM derived from conventional MRI had correlations with the expression levels of EGFR, IDH-1 and PTEN, and it was possible to derive heterogeneity, molecular classification and prognosis of GBM using conventional MRI.