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目的评估表观扩散系数(ADC)值是否可以预测多形性胶质母细胞瘤(GBM)的甲基鸟嘌呤-DNA-甲基转移酶(MGMT)启动子的甲基化状态,并判断其与总生存率、生存期的相关性。材料与方法回顾性分析经病理证实为胶质母细胞瘤的47例病人。所有病人在外科手术前均进行MR扩散加权成像(平均间隔1周),在术前对病人的MGMT启动子的甲基化状态进行检测。对最小的ADC值进行评估。应用Student’st检验、Kaplan-Meier曲线、线性与Cox回归曲线对总生存率和生存期参数进行评估。结果 25例病人的MGMT启动子的甲基化为阳性。MGMT启动子的甲基化阳性的病人具有较高的ADC值,他们的生存率比MGMT启动子的甲基化阴性的病人更长。ADCmin值的中位数为0.8,将其作为截断值可以鉴别甲基化与非甲基化的病人。ADCmin值高于0.8的病人比低于0.8的病人生存期更长。ADCmin值与总生存率、生存期呈线性相关。结论多形性胶质母细胞瘤的ADCmin值可作为外科术前MGMT启动子甲基化状态评估的参数,并可以预测病人的生存率。要点①MR扩散加权成像(DWI)提供了解GBM的新视角。②DWI的ADCmin值可以预测MGMT启动子的甲基化状态。③MGMT启动子的甲基化组比非甲基化组具有更长的生存期。④具有高ADCmin值的病人比较低者具有更长的生存期。
Objectives To assess whether the apparent diffusion coefficient (ADC) value predicts the methylation status of the MGMT promoter in GBM, Correlation with overall survival and survival. Materials and Methods Retrospective analysis of 47 patients with pathologically confirmed glioblastoma. All patients underwent MR diffusion weighted imaging (one week apart on average) before surgery, and the methylation status of MGMT promoter in the patient was detected preoperatively. The smallest ADC value is evaluated. The overall survival and survival parameters were assessed using Student’s t test, Kaplan-Meier curves, linear and Cox regression curves. Results 25 cases of MGMT promoter methylation was positive. Methylation-positive patients with the MGMT promoter have higher ADC values and their survival rate is longer than methylation-negative patients with the MGMT promoter. The median ADCmin value was 0.8, which was used as a cutoff to identify both methylated and unmethylated patients. Patients with ADCmin values above 0.8 have longer survival than patients below 0.8. The ADCmin value was linearly correlated with overall survival and survival. Conclusion The ADCmin value of glioblastoma multiforme can be used as a parameter to evaluate the methylation status of MGMT promoter before surgery, and can predict the survival rate of patients. Key Points ① MR diffusion-weighted imaging (DWI) provides a new perspective on understanding GBM. The ADCmin value of DWI can predict the methylation status of MGMT promoter. ③MGMT promoter methylation group than non-methylation group has a longer survival. ④ patients with high ADCmin values have a lower survival time longer.