1
|
Setyawan NH, Choridah L, Nugroho HA, Malueka RG, Dwianingsih EK, Supriatna Y, Supriyadi B, Hartanto RA. Glioma Grade and Molecular Markers: Comparing Machine-Learning Approaches Using VASARI (Visually AcceSAble Rembrandt Images) Radiological Assessment. Cureus 2024; 16:e63873. [PMID: 39100020 PMCID: PMC11298015 DOI: 10.7759/cureus.63873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/04/2024] [Indexed: 08/06/2024] Open
Abstract
OBJECTIVES This study aimed to leverage Visually AcceSAble Rembrandt Images (VASARI) radiological features, extracted from magnetic resonance imaging (MRI) scans, and machine-learning techniques to predict glioma grade, isocitrate dehydrogenase (IDH) mutation status, and O6-methylguanine-DNA methyltransferase (MGMT) methylation. METHODOLOGY A retrospective evaluation was undertaken, analyzing MRI and molecular data from 107 glioma patients treated at a tertiary hospital. Patients underwent MRI scans using established protocols and were evaluated based on VASARI criteria. Tissue samples were assessed for glioma grade and underwent molecular testing for IDH mutations and MGMT methylation. Four machine learning models, namely, Random Forest, Elastic-Net, multivariate adaptive regression spline (MARS), and eXtreme Gradient Boosting (XGBoost), were trained on 27 VASARI features using fivefold internal cross-validation. The models' predictive performances were assessed using the area under the curve (AUC), sensitivity, and specificity. RESULTS For glioma grade prediction, XGBoost exhibited the highest AUC (0.978), sensitivity (0.879), and specificity (0.964), with f6 (proportion of non-enhancing) and f12 (definition of enhancing margin) as the most important predictors. In predicting IDH mutation status, XGBoost achieved an AUC of 0.806, sensitivity of 0.364, and specificity of 0.880, with f1 (tumor location), f12, and f30 (perpendicular diameter to f29) as primary predictors. For MGMT methylation, XGBoost displayed an AUC of 0.580, sensitivity of 0.372, and specificity of 0.759, highlighting f29 (longest diameter) as the key predictor. CONCLUSIONS This study underscores the robust potential of combining VASARI radiological features with machine learning models in predicting glioma grade, IDH mutation status, and MGMT methylation. The best and most balanced performance was achieved using the XGBoost model. While the prediction of glioma grade showed promising results, the sensitivity in discerning IDH mutations and MGMT methylation still leaves room for improvement. Follow-up studies with larger datasets and more advanced artificial intelligence techniques can further refine our understanding and management of gliomas.
Collapse
Affiliation(s)
- Nurhuda H Setyawan
- Department of Radiology, Faculty of Medicine, Public Health, and Nursing, Dr. Sardjito General Hospital, Universitas Gadjah Mada, Yogyakarta, IDN
| | - Lina Choridah
- Department of Radiology, Faculty of Medicine, Public Health, and Nursing, Dr. Sardjito General Hospital, Universitas Gadjah Mada, Yogyakarta, IDN
| | - Hanung A Nugroho
- Department of Electrical and Information Engineering, Faculty of Engineering, Universitas Gadjah Mada, Yogyakarta, IDN
| | - Rusdy G Malueka
- Department of Neurology, Faculty of Medicine, Public Health, and Nursing, Dr. Sardjito General Hospital, Universitas Gadjah Mada, Yogyakarta, IDN
| | - Ery K Dwianingsih
- Department of Anatomical Pathology, Faculty of Medicine, Public Health, and Nursing, Dr. Sardjito General Hospital, Universitas Gadjah Mada, Yogyakarta, IDN
| | - Yana Supriatna
- Department of Radiology, Faculty of Medicine, Public Health, and Nursing,Dr. Sardjito General Hospital, Universitas Gadjah Mada, Yogyakarta, IDN
| | - Bambang Supriyadi
- Department of Radiology, Faculty of Medicine, Public Health, and Nursing, Dr. Sardjito General Hospital, Universitas Gadjah Mada, Yogyakarta, IDN
| | - Rachmat A Hartanto
- Department of Surgery, Faculty of Medicine, Public Health, and Nursing, Dr. Sardjito General Hospital, Universitas Gadjah Mada, Yogyakarta, IDN
| |
Collapse
|
2
|
Setyawan NH, Choridah L, Nugroho HA, Malueka RG, Dwianingsih EK. Beyond invasive biopsies: using VASARI MRI features to predict grade and molecular parameters in gliomas. Cancer Imaging 2024; 24:3. [PMID: 38167551 PMCID: PMC10759759 DOI: 10.1186/s40644-023-00638-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Accepted: 11/22/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Gliomas present a significant economic burden and patient management challenge. The 2021 WHO classification incorporates molecular parameters, which guide treatment decisions. However, acquiring these molecular data involves invasive biopsies, prompting a need for non-invasive diagnostic methods. This study aims to assess the potential of Visually AcceSAble Rembrandt Images (VASARI) MRI features to predict glioma characteristics such as grade, IDH mutation, and MGMT methylation status. METHODS This study enrolled 107 glioma patients treated between 2017 and 2022, meeting specific criteria including the absence of prior chemotherapy/radiation therapy, and the presence of molecular and MRI data. Images were assessed using the 27 VASARI MRI features by two blinded radiologists. Pathological and molecular assessments were conducted according to WHO 2021 CNS Tumor classification. Cross-validation Least Absolute Shrinkage and Selection Operator (CV-LASSO) logistic regression was applied for statistical analysis to identify significant VASARI features in determining glioma grade, IDH mutation, and MGMT methylation status. RESULTS The study demonstrated substantial observer agreement in VASARI feature evaluation (inter- and intra-observer κ = 0.714 - 0.831 and 0.910, respectively). Patient imaging characteristics varied significantly with glioma grade, IDH mutation, and MGMT methylation. A predictive model was established using VASARI features for glioma grade prediction, exhibiting an AUC of 0.995 (95% CI = 0.986 - 0.998), 100% sensitivity, and 92.86% specificity. IDH mutation status was predicted with AUC 0.930 (95% CI = 0.882 - 0.977), and improved slightly to 0.933 with 'age-at-diagnosis' added. A model predicting MGMT methylation had a satisfactory performance (AUC 0.757, 95% CI = 0.645 - 0.868), improving to 0.791 when 'age-at-diagnosis' was added. CONCLUSIONS The T1/FLAIR ratio, enhancement quality, hemorrhage, and proportion enhancing predict glioma grade with excellent accuracy. The proportion enhancing, thickness of enhancing margin, and T1/FLAIR ratio are significant predictors for IDH mutation status. Lastly, MGMT methylation is related to the longest diameter of the lesion, edema crossing the midline, and the proportion of the non-enhancing lesion. VASARI MRI features offer non-invasive and accurate predictive models for glioma grade, IDH mutation, and MGMT methylation status, enhancing glioma patient management.
Collapse
Affiliation(s)
- Nurhuda Hendra Setyawan
- Department of Radiology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Jl. Farmako, Kabupaten Sleman, Daerah Istimewa Yogyakarta, 55281, Indonesia.
| | - Lina Choridah
- Department of Radiology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Jl. Farmako, Kabupaten Sleman, Daerah Istimewa Yogyakarta, 55281, Indonesia
| | - Hanung Adi Nugroho
- Department of Electrical and Information Engineering, Faculty of Engineering, Universitas Gadjah Mada, Jl. Grafika No.2, Kabupaten Sleman, Daerah Istimewa Yogyakarta, 55281, Indonesia
| | - Rusdy Ghazali Malueka
- Department of Neurology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Jl. Farmako, Kabupaten Sleman, Daerah Istimewa Yogyakarta, 55281, Indonesia
| | - Ery Kus Dwianingsih
- Department of Anatomical Pathology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Jl. Farmako, Kabupaten Sleman, Daerah Istimewa Yogyakarta, 55281, Indonesia
| |
Collapse
|
3
|
Campos LG, de Oliveira FH, Antunes ÁCM, Duarte JÁ. Evaluation of glial tumors: correlation between magnetic resonance imaging and histopathological analysis. Radiol Bras 2024; 57:e20240025. [PMID: 39290827 PMCID: PMC11406976 DOI: 10.1590/0100-3984.2024.0025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 06/01/2024] [Accepted: 06/22/2024] [Indexed: 09/19/2024] Open
Abstract
Objective To determine the correlation of conventional and diffusion-weighted imaging findings on magnetic resonance imaging (MRI) of the brain, based on Visually AcceSAble Rembrandt Images (VASARI) criteria, with the histopathological grading of gliomas: low-grade or high-grade. Materials and Methods Preoperative MRI scans of 178 patients with brain gliomas and pathological confirmation were rated by two neuroradiologists for tumor size, location, and tumor morphology, using a standardized imaging feature set based on the VASARI criteria. Results In the univariate analysis, more than half of the MRI characteristics evaluated showed a significant association with the tumor grade. The characteristics most significantly associated with the tumor grade were hemorrhage; restricted diffusion; pial invasion; enhancement; and a non-contrast-enhancing tumor crossing the midline. In a multivariable regression model, the presence of enhancement and hemorrhage maintained a significant association with high tumor grade. The absence of contrast enhancement and restricted diffusion were associated with the presence of an isocitrate dehydrogenase gene mutation. Conclusion Our data illustrate that VASARI MRI features, especially intratumoral hemorrhage, contrast enhancement, and multicentricity, correlate strongly with glial tumor grade.
Collapse
Affiliation(s)
| | - Francine Hehn de Oliveira
- Department of Radiology, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil
- Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Ápio Cláudio Martins Antunes
- Department of Radiology, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil
- Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Juliana Ávila Duarte
- Department of Radiology, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil
- Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| |
Collapse
|
4
|
Li B, Gao B, Zhu HJ, Luwor RB, Lu J, Zhang L, Kong B. The Prognostic Value of Preoperative Inflammatory Markers for Pathological Grading of Glioma Patients. Technol Cancer Res Treat 2024; 23:15330338241273160. [PMID: 39099463 DOI: 10.1177/15330338241273160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/06/2024] Open
Abstract
Introduction: The independent diagnostic value of inflammatory markers neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) and the diagnostic efficacy of NLR, derived neutrophil to lymphocyte ratio (dNLR), PLR, and lymphocyte-to-monocyte ratio (LMR) in glioma cases remain unclear. We investigated the correlation of preoperative peripheral blood inflammatory markers with pathological grade, Ki-67 Proliferation Index, and IDH-1 gene phenotype in patients with glioma, focusing on tumor grade and prognosis. Methods: We retrospectively analyzed the clinical, pathological, and laboratory data of 334 patients with glioma with varying grades and 345 with World Health Organization (WHO I) meningioma who underwent initial surgery at the Affiliated Hospital of Jining Medical University from December 2019 to December 2021. The diagnostic value of peripheral blood inflammatory markers for glioma was investigated. Results: The proportion of men smoking and drinking was significantly higher in the glioma group than in the meningioma group (P < .05); in contrast, the age and body mass index (Kg/m2) were significantly lower in the glioma group (P = .01). Significant differences were noted in the pathological grade (WHO II, III, and IV), Ki-67 Proliferation Index, and peripheral blood inflammatory markers such as lymphocyte median, NLR, dNLR, and PLR between the groups (P < .05). No significant correlation existed between peripheral blood inflammatory factors and IDH-1 gene mutation status or tumor location in patients with glioma (P > .05). LMR, NLR, dNLR, and PLR, varied significantly among different glioma types (P < .05). White blood cell (WBC) count, neutrophil, NLR, and dNLR correlated positively with glioma risk. Further, WBC, neutrophil, NLR, dNLR, and LMR had a high diagnostic efficiency. Conclusion: Peripheral blood inflammatory markers, serving as noninvasive biomarkers, offer high sensitivity and specificity for diagnosing glioma, differentiating it from meningioma, diagnosing GBM, and distinguishing GBM from low-grade glioma. These markers may be implemented as routine screening tools.
Collapse
Affiliation(s)
- Bo Li
- Department of Neurosurgery, Affiliated Hospital of Jining Medical University, Jining, Shangdong, China
| | - Bo Gao
- Department of Neurosurgery, Affiliated Hospital of Jining Medical University, Jining, Shangdong, China
| | - Hong-Jian Zhu
- Department of Surgery, The University of Melbourne, The Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Rodney B Luwor
- Department of Surgery, The University of Melbourne, The Royal Melbourne Hospital, Parkville, VIC, Australia
- Fiona Elsey Cancer Research Institute, Ballarat, Victoria, Australia
- federation University, Ballarat, Victoria, Australia
| | - Jing Lu
- Department of Surgery, The University of Melbourne, The Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Lu Zhang
- Department of Neurosurgery, Affiliated Hospital of Jining Medical University, Jining, Shangdong, China
| | - Bo Kong
- Department of Neurosurgery, Affiliated Hospital of Jining Medical University, Jining, Shangdong, China
| |
Collapse
|
5
|
Yang X, Hu C, Xing Z, Lin Y, Su Y, Wang X, Cao D. Prediction of Ki-67 labeling index, ATRX mutation, and MGMT promoter methylation status in IDH-mutant astrocytoma by morphological MRI, SWI, DWI, and DSC-PWI. Eur Radiol 2023; 33:7003-7014. [PMID: 37133522 DOI: 10.1007/s00330-023-09695-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 02/19/2023] [Accepted: 03/09/2023] [Indexed: 05/04/2023]
Abstract
OBJECTIVE Noninvasive detection of molecular status of astrocytoma is of great clinical significance for predicting therapeutic response and prognosis. We aimed to evaluate whether morphological MRI (mMRI), SWI, DWI, and DSC-PWI could predict Ki-67 labeling index (LI), ATRX mutation, and MGMT promoter methylation status in IDH mutant (IDH-mut) astrocytoma. METHODS We retrospectively analyzed mMRI, SWI, DWI, and DSC-PWI in 136 patients with IDH-mut astrocytoma.The features of mMRI and intratumoral susceptibility signals (ITSS) were compared using Fisher exact test or chi-square tests. Wilcoxon rank sum test was used to compare the minimum ADC (ADCmin), and minimum relative ADC (rADCmin) of IDH-mut astrocytoma in different molecular markers status. Mann-Whitney U test was used to compare the rCBVmax of IDH-mut astrocytoma with different molecular markers status. Receiver operating characteristic curves was performed to evaluate their diagnostic performances. RESULTS ITSS, ADCmin, rADCmin, and rCBVmax were significantly different between high and low Ki-67 LI groups. ITSS, ADCmin, and rADCmin were significantly different between ATRX mutant and wild-type groups. Necrosis, edema, enhancement, and margin pattern were significantly different between low and high Ki-67 LI groups. Peritumoral edema was significantly different between ATRX mutant and wild-type groups. Grade 3 IDH-mut astrocytoma with unmethylated MGMT promoter was more likely to show enhancement compared to the methylated group. CONCLUSIONS mMRI, SWI, DWI, and DSC-PWI were shown to have the potential to predict Ki-67 LI and ATRX mutation status in IDH-mut astrocytoma. A combination of mMRI and SWI may improve diagnostic performance for predicting Ki-67 LI and ATRX mutation status. CLINICAL RELEVANCE STATEMENT Conventional MRI and functional MRI (SWI, DWI, and DSC-PWI) can predict Ki-67 expression and ATRX mutation status of IDH mutant astrocytoma, which may help clinicians determine personalized treatment plans and predict patient outcomes. KEY POINTS • A combination of multimodal MRI may improve the diagnostic performance to predict Ki-67 LI and ATRX mutation status. • Compared with IDH-mutant astrocytoma with low Ki-67 LI, IDH-mutant astrocytoma with high Ki-67 LI was more likely to show necrosis, edema, enhancement, poorly defined margin, higher ITSS levels, lower ADC, and higher rCBV. • ATRX wild-type IDH-mutant astrocytoma was more likely to show edema, higher ITSS levels, and lower ADC compared to ATRX mutant IDH-mutant astrocytoma.
Collapse
Affiliation(s)
- Xiefeng Yang
- Department of Radiology, First Affiliated Hospital of Fujian Medical University, Fuzhou, 350005, People's Republic of China
| | - Chengcong Hu
- Department of Pathology, First Affiliated Hospital of Fujian Medical University, 20 Cha-Zhong Road, 20 Cha-Zhong Road, Fuzhou, 350005, People's Republic of China
| | - Zhen Xing
- Department of Radiology, First Affiliated Hospital of Fujian Medical University, Fuzhou, 350005, People's Republic of China
| | - Yu Lin
- Department of Radiology, First Affiliated Hospital of Fujian Medical University, Fuzhou, 350005, People's Republic of China
| | - Yan Su
- Department of Radiology, First Affiliated Hospital of Fujian Medical University, Fuzhou, 350005, People's Republic of China
| | - Xingfu Wang
- Department of Pathology, First Affiliated Hospital of Fujian Medical University, 20 Cha-Zhong Road, 20 Cha-Zhong Road, Fuzhou, 350005, People's Republic of China.
| | - Dairong Cao
- Department of Radiology, First Affiliated Hospital of Fujian Medical University, Fuzhou, 350005, People's Republic of China.
- Fujian Key Laboratory of Precision Medicine for Cancer, The First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, People's Republic of China.
- Key Laboratory of Radiation Biology of Fujian Higher Education Institutions, The First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, People's Republic of China.
| |
Collapse
|
6
|
Du N, Shu W, Li K, Deng Y, Xu X, Ye Y, Tang F, Mao R, Lin G, Li S, Fang X. An initial study on the predictive value using multiple MRI characteristics for Ki-67 labeling index in glioma. J Transl Med 2023; 21:119. [PMID: 36774480 PMCID: PMC9922464 DOI: 10.1186/s12967-023-03950-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 02/01/2023] [Indexed: 02/13/2023] Open
Abstract
BACKGROUND AND PURPOSE Ki-67 labeling index (LI) is an important indicator of tumor cell proliferation in glioma, which can only be obtained by postoperative biopsy at present. This study aimed to explore the correlation between Ki-67 LI and apparent diffusion coefficient (ADC) parameters and to predict the level of Ki-67 LI noninvasively before surgery by multiple MRI characteristics. METHODS Preoperative MRI data of 166 patients with pathologically confirmed glioma in our hospital from 2016 to 2020 were retrospectively analyzed. The cut-off point of Ki-67 LI for glioma grading was defined. The differences in MRI characteristics were compared between the low and high Ki-67 LI groups. The receiver operating characteristic (ROC) curve was used to estimate the accuracy of each ADC parameter in predicting the Ki-67 level, and finally a multivariate logistic regression model was constructed based on the results of ROC analysis. RESULTS ADCmin, ADCmean, rADCmin, rADCmean and Ki-67 LI showed a negative correlation (r = - 0.478, r = - 0.369, r = - 0.488, r = - 0.388, all P < 0.001). The Ki-67 LI of low-grade gliomas (LGGs) was different from that of high-grade gliomas (HGGs), and the cut-off point of Ki-67 LI for distinguishing LGGs from HGGs was 9.5%, with an area under the ROC curve (AUROC) of 0.962 (95%CI 0.933-0.990). The ADC parameters in the high Ki-67 group were significantly lower than those in the low Ki-67 group (all P < 0.05). The peritumoral edema (PTE) of gliomas in the high Ki-67 LI group was higher than that in the low Ki-67 LI group (P < 0.05). The AUROC of Ki-67 LI level assessed by the multivariate logistic regression model was 0.800 (95%CI 0.721-0.879). CONCLUSIONS There was a negative correlation between ADC parameters and Ki-67 LI, and the multivariate logistic regression model combined with peritumoral edema and ADC parameters could improve the prediction ability of Ki-67 LI.
Collapse
Affiliation(s)
- Ningfang Du
- grid.8547.e0000 0001 0125 2443Department of Radiology, Huadong Hospital, Fudan University, Shanghai, China
| | - Weiquan Shu
- grid.8547.e0000 0001 0125 2443Department of Neurosurgery, Huadong Hospital, Fudan University, Shanghai, China
| | - Kefeng Li
- grid.266100.30000 0001 2107 4242School of Medicine, University of California, San Diego, CA USA ,Faculty of Health Sciences and Sports, Macao Polytechnic University, Macao SAR, China
| | - Yao Deng
- grid.8547.e0000 0001 0125 2443Department of Neurosurgery, Huadong Hospital, Fudan University, Shanghai, China
| | - Xinxin Xu
- grid.8547.e0000 0001 0125 2443Clinical Research Center for Gerontology, Huadong Hospital, Fudan University, Shanghai, China
| | - Yao Ye
- grid.8547.e0000 0001 0125 2443Department of Pathology, Huadong Hospital, Fudan University, Shanghai, China
| | - Feng Tang
- grid.8547.e0000 0001 0125 2443Department of Neurosurgery, Huadong Hospital, Fudan University, Shanghai, China
| | - Renling Mao
- grid.8547.e0000 0001 0125 2443Department of Neurosurgery, Huadong Hospital, Fudan University, Shanghai, China
| | - Guangwu Lin
- Department of Radiology, Huadong Hospital, Fudan University, Shanghai, China.
| | - Shihong Li
- Department of Radiology, Huadong Hospital, Fudan University, Shanghai, China.
| | - Xuhao Fang
- Department of Neurosurgery, Huadong Hospital, Fudan University, Shanghai, China.
| |
Collapse
|
7
|
Obukhova L, Kopytova T, Murach E, Shchelchkova N, Kontorshchikova C, Medyanik I, Orlinskaya N, Grishin A, Kontorshchikov M, Badanina D. Relationship between Glutathione-Dependent Enzymes and the Immunohistochemical Profile of Glial Neoplasms. Biomedicines 2022; 10:biomedicines10102393. [PMID: 36289655 PMCID: PMC9598304 DOI: 10.3390/biomedicines10102393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 09/15/2022] [Accepted: 09/20/2022] [Indexed: 11/25/2022] Open
Abstract
This research aimed to investigate the relationships between the parameters of glutathione metabolism and the immunohistochemical characteristics of glial tumors. Postoperative material from 20 patients with gliomas of different grades of anaplasia was analyzed. Bioinformatic analysis of the interactions between the gliomas’ immunohistochemical markers and their glutathione-dependent enzymes was carried out using the STRING, BioGrid, while Signor databases revealed interactions between such glioma markers as IDH and p53 and the glutathione exchange enzymes (glutathione peroxidase, glutathione reductase, glutathione S-transferase). The most pronounced relationship with glutathione metabolism was demonstrated by the level of the nuclear protein Ki67 as a marker of proliferative activity, and the presence of the IDH1 mutation as one of the key genetic events of gliomagenesis. The glutathione system is an active participant in the body’s antioxidant defense, involving the p53 markers and MGMT promoter methylation. It allows characterization of the gliomal cells’ status at different stages of tumor development.
Collapse
|
8
|
Obukhova LM, Evdokimov II, Medyanik IA, Orlinskaya NY, Grishin AS, Babintsev VE, Barinov YA, Kontorshchikov MM, Gorshkova TN, Lazukin VF. Prospects for the use of blood elemental status to assess the molecular genetic profile of gliomas. Klin Lab Diagn 2022; 67:497-503. [PMID: 36099457 DOI: 10.51620/0869-2084-2022-67-9-497-503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
It has been established that blood element homeostasis is related to gliomagenesis which increases the attractiveness of the analysis of its components as a promising preoperative mediated characteristics of the molecular genetic profile of gliomas. The aim of this work is to analyze the relationship between mineral metabolism parameters and immunohistochemical characteristics of glial tumors and evaluate the clinical significance of blood element homeostasis analysis for preoperative assessment of the molecular profile of gliomas. The levels of cancer specific markers MGMT, Ki-67, p-53, IDH1 were determined immunohistochemically using the corresponding antibody clones. Micronutrient levels were analyzed by inductively coupled plasma atomic emission spectrometry recalculating the results per 1 g of protein which was determined by the Lowry method. The data on cancer-specific marker levels obtained in primary brain tumors (20) and in blood plasma of gliomas patients (20) and practically healthy subjects (5) were compared using a number of statistical programs. We found significant differences in the levels of sodium, potassium, zinc and copper depending on the value of the mitotic index Ki-67 and IDH1 isocitrate dehydrogenase gene mutation. For the first time, a significant correlation showing the consistency between the level of glial tumor cancer-specific markers and blood mineral metabolism was observed. The revealed correlations provide new insights into understanding of gliomagenesis mechanisms and can be used as a predictive preoperative assessment of molecular genetic markers of gliomas.
Collapse
Affiliation(s)
- Larisa Mikhailovna Obukhova
- Federal State Budgetary Educational Institution of Higher Educational "Privolzhsky Research Medical University" of the Ministry of Health of the Russian Federation
| | - I I Evdokimov
- Federal Budgetary Scientific Institution G.G. Devyatykh Institute of Chemistry High-Purity Chemistry of the Russian Academy of Sciences
| | - I A Medyanik
- Federal State Budgetary Educational Institution of Higher Educational "Privolzhsky Research Medical University" of the Ministry of Health of the Russian Federation
| | - N Yu Orlinskaya
- Federal State Budgetary Educational Institution of Higher Educational "Privolzhsky Research Medical University" of the Ministry of Health of the Russian Federation
| | - A S Grishin
- Federal State Budgetary Educational Institution of Higher Educational "Privolzhsky Research Medical University" of the Ministry of Health of the Russian Federation
| | - V E Babintsev
- Federal State Budgetary Educational Institution of Higher Educational "Privolzhsky Research Medical University" of the Ministry of Health of the Russian Federation
| | - Yu A Barinov
- Federal State Budgetary Educational Institution of Higher Educational "Privolzhsky Research Medical University" of the Ministry of Health of the Russian Federation
| | - M M Kontorshchikov
- Federal State Budgetary Educational Institution of Higher Educational "Privolzhsky Research Medical University" of the Ministry of Health of the Russian Federation
| | - T N Gorshkova
- Federal State-Funded Healthcare Institution "Privolzhsky District Medical Center" of Federal and Biological Agency of Russia
| | - V F Lazukin
- Federal State Budgetary Educational Institution of Higher Educational "Privolzhsky Research Medical University" of the Ministry of Health of the Russian Federation
| |
Collapse
|
9
|
Zhang Z, Gu W, Hu M, Zhang G, Yu F, Xu J, Deng J, Xu L, Mei J, Wang C, Qiu F. Based on clinical Ki-67 expression and serum infiltrating lymphocytes related nomogram for predicting the diagnosis of glioma-grading. Front Oncol 2022; 12:696037. [PMID: 36147928 PMCID: PMC9488114 DOI: 10.3389/fonc.2022.696037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 07/12/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundCompelling evidence indicates that elevated peripheral serum lymphocytes are associated with a favorable prognosis in various cancers. However, the association between serum lymphocytes and glioma is contradictory. In this study, a nomogram was established to predict the diagnosis of glioma-grading through Ki-67 expression and serum lymphocytes.MethodsWe performed a retrospective analysis of 239 patients diagnosed with LGG and 178 patients with HGG. Immunohistochemistry was used to determine the Ki-67 expression. Following multivariate logistic regression analysis, a nomogram was established and used to identify the most related factors associated with HGG. The consistency index (C-index), decision curve analysis (DCA), and a calibration curve were used to validate the model.ResultsThe number of LGG patients with more IDH1/2 mutations and 1p19q co-deletion was greater than that of HGG patients. The multivariate logistic analysis identified Ki-67 expression, serum lymphocyte count, and serum albumin (ALU) as independent risk factors associated with HGG, and these factors were included in a nomogram in the training cohort. In the validation cohort, the nomogram demonstrated good calibration and high consistency (C-index = 0.794). The Spearman correlation analysis revealed a significant association between HGG and serum lymphocyte count (r = −0.238, P <0.001), ALU (r = −0.232, P <0.001), and Ki-67 expression (r = 0.457, P <0.001). Furthermore, the Ki-67 expression was negatively correlated with the serum lymphocyte count (r = −0.244, P <0.05). LGG patients had lower Ki-67 expression and higher serum lymphocytes compared with HGG patients, and a combination of these two variables was significantly higher in HGG patients.ConclusionThe constructed nomogram is capable of predicting the diagnosis of glioma-grade. A decrease in the level of serum lymphocyte count and increased Ki-67 expression in HGG patients indicate that their immunological function is diminished and the tumor is more aggressive.
Collapse
Affiliation(s)
- Zhi Zhang
- Department of Neurosurgery, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Weiguo Gu
- Department of Oncology, The First Affiliated Hospital of Nanchang University, Nanchang, China
- Nanchang Key Laboratory of Tumor Gene Diagnosis and Innovative Treatment Research, Nanchang, China
| | - Mingbin Hu
- Department of Oncology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Guohua Zhang
- Nanchang Key Laboratory of Tumor Gene Diagnosis and Innovative Treatment Research, Nanchang, China
| | - Feng Yu
- Department of Oncology, The First Affiliated Hospital of Nanchang University, Nanchang, China
- Department of Oncology, Gaoxin Branch of the First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Jinbiao Xu
- Department of Oncology, Gaoxin Branch of the First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Jianxiong Deng
- Department of Oncology, Gaoxin Branch of the First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Linlin Xu
- Department of Pathology, The First Affiliated Hospital of Nanchang University, Nanchang, China
- Molecular Pathology Center, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Jinhong Mei
- Department of Pathology, The First Affiliated Hospital of Nanchang University, Nanchang, China
- Molecular Pathology Center, The First Affiliated Hospital of Nanchang University, Nanchang, China
- *Correspondence: Feng Qiu, ; Jinhong Mei, ; Chunliang Wang,
| | - Chunliang Wang
- Department of Neurosurgery, The First Affiliated Hospital of Nanchang University, Nanchang, China
- *Correspondence: Feng Qiu, ; Jinhong Mei, ; Chunliang Wang,
| | - Feng Qiu
- Nanchang Key Laboratory of Tumor Gene Diagnosis and Innovative Treatment Research, Nanchang, China
- Department of Oncology, Gaoxin Branch of the First Affiliated Hospital of Nanchang University, Nanchang, China
- *Correspondence: Feng Qiu, ; Jinhong Mei, ; Chunliang Wang,
| |
Collapse
|
10
|
Effect of High-Quality Nursing Based on Comprehensive Nursing on the Postoperative Quality of Life and Satisfaction of Patients with Malignant Glioma. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:9345099. [PMID: 35529933 PMCID: PMC9068302 DOI: 10.1155/2022/9345099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 04/10/2022] [Accepted: 04/18/2022] [Indexed: 11/29/2022]
Abstract
Objective To explore the effect of high-quality nursing based on comprehensive nursing on postoperative quality of life and satisfaction of patients with malignant glioma. Methods From September 2017 to May 2020, 86 patients with malignant glioma treated in our hospital were recruited and assigned (1 : 1) to receive either comprehensive nursing (comprehensive group) or high-quality nursing plus comprehensive nursing (high-quality group). Outcome measures included preoperative and postoperative self-rating anxiety scale (SAS) scores, self-rating depression scale (SDS) scores, quality of life, and nursing satisfaction. Results High-quality nursing plus comprehensive nursing was associated with significantly lower SAS and SDS scores versus comprehensive nursing alone (P < 0.05). Patients receiving high-quality nursing plus comprehensive nursing showed higher quality of life scores versus those only given comprehensive nursing (P < 0.05). High-quality nursing plus comprehensive nursing resulted in higher nursing satisfaction of the patients versus comprehensive nursing alone (P < 0.05). Conclusion High-quality nursing can relieve the negative emotions of patients with malignant glioma and significantly enhance their quality of life, thereby improving the nursing satisfaction of patients with nursing, so it is worthy of clinical application.
Collapse
|
11
|
Obukhova L, Nikiforova O, Kontorshchikova C, Medyanik I, Orlinskaya N, Grishin A, Kontorshchikov M, Shchelchkova N. Carbohydrate Metabolism Parameters of Adult Glial Neoplasms According to Immunohistochemical Profile. Biomedicines 2022; 10:biomedicines10051007. [PMID: 35625744 PMCID: PMC9138280 DOI: 10.3390/biomedicines10051007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 04/22/2022] [Accepted: 04/25/2022] [Indexed: 11/16/2022] Open
Abstract
This research aimed to investigate the interrelationship of carbohydrate metabolism parameters and immunohistochemical characteristics of glial tumors. Tumor tissue, peritumoral area, and adjacent noncancerous tissue fragments of 20 patients with gliomas of varying degrees of anaplasia were analyzed. The greatest differences in the carbohydrate metabolism compared to adjacent noncancerous tissues were identified in the tumor tissue: reduction in the levels of lactate and glycogen synthase kinase-3β. Significant differences with adjacent noncancerous tissues for the peritumoral zone were not found. The activity of the carbohydrate metabolism enzymes was different depending on the immunohistochemical glioma profile, especially from Ki 67 level. Bioinformatic analysis of the interactions of immunohistochemical markers of gliomas and carbohydrate metabolism enzymes using the databases of STRING, BioGrid, and Signor revealed the presence of biologically significant interactions with glycogen synthase kinase 3β, hexokinase, glucose-6-phosphate dehydrogenase, and transketolase. The established interconnection of glycolysis with methylation of the promoter of O-6-methylguanine-DNA-methyltransferase (MGMT) of gliomas can be used to increase chemotherapy efficiency.
Collapse
|
12
|
Ak M, Toll SA, Hein KZ, Colen RR, Khatua S. Evolving Role and Translation of Radiomics and Radiogenomics in Adult and Pediatric Neuro-Oncology. AJNR Am J Neuroradiol 2021; 43:792-801. [PMID: 34649914 DOI: 10.3174/ajnr.a7297] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 07/19/2021] [Indexed: 12/24/2022]
Abstract
Exponential technologic advancements in imaging, high-performance computing, and artificial intelligence, in addition to increasing access to vast amounts of diverse data, have revolutionized the role of imaging in medicine. Radiomics is defined as a high-throughput feature-extraction method that unlocks microscale quantitative data hidden within standard-of-care medical imaging. Radiogenomics is defined as the linkage between imaging and genomics information. Multiple radiomics and radiogenomics studies performed on conventional and advanced neuro-oncology image modalities show that they have the potential to differentiate pseudoprogression from true progression, classify tumor subgroups, and predict recurrence, survival, and mutation status with high accuracy. In this article, we outline the technical steps involved in radiomics and radiogenomics analyses with the use of artificial intelligence methods and review current applications in adult and pediatric neuro-oncology.
Collapse
Affiliation(s)
- M Ak
- From the Department of Radiology (M.A., R.R.C.), University of Pittsburgh, Pittsburgh, Pennsylvania.,Hillman Cancer Center (M.A., R.R.C.), University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - S A Toll
- Department of Hematology-Oncology (S.A.T.), Children's Hospital of Michigan, Detroit, Michigan
| | - K Z Hein
- Department of Leukemia (K.Z.H.), The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - R R Colen
- From the Department of Radiology (M.A., R.R.C.), University of Pittsburgh, Pittsburgh, Pennsylvania.,Hillman Cancer Center (M.A., R.R.C.), University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - S Khatua
- Department of Pediatric Hematology-Oncology (S.K.), Mayo Clinic, Rochester, Minnesota.
| |
Collapse
|
13
|
Su C, Xu S, Lin D, He H, Chen Z, Damen FC, Ke C, Lv X, Cai K. Multi-parametric Z-spectral MRI may have a good performance for glioma stratification in clinical patients. Eur Radiol 2021; 32:101-111. [PMID: 34272981 DOI: 10.1007/s00330-021-08175-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 06/13/2021] [Accepted: 06/28/2021] [Indexed: 12/30/2022]
Abstract
OBJECTIVES To comprehensively and noninvasively risk-stratify glioma grade, isocitrate dehydrogenase (IDH) genotype, and 1p/19q codeletion status using multi-contrast Z-spectral magnetic resonance imaging (MRI). METHODS One hundred and thirteen patients with glioma were retrospectively included. Multiple contrasts contributing to Z-spectra, including direct saturation of water (DSW), semi-solid magnetization transfer contrast (MTC), amide proton transfer (APT) effect, aliphatic nuclear Overhauser effect, and the 2-ppm chemical exchange saturation transfer peak (CEST@2ppm), were fitted with five individual Lorentzian functions. Z-spectral contrasts were compared according to the three most important risk stratifications: tumor grade, IDH genotype, and 1p/19q codeletion status. We further investigated the differentiation of 1p/19q codeletion status within IDH mutant gliomas. The stratification performance of individual Z-spectral contrasts and their combination was quantified using receiver operating characteristic (ROC) analyses. RESULTS DSW was significantly different within grade, IDH genotypes, and 1p/19q codeletion status. APT was significantly different with grade and IDH mutation, but not with 1p/19q subtypes. CEST@2ppm was only significantly different with 1p/19q codeletion subtypes. DSW and CEST@2ppm were the two Z-spectral contrasts able to differentiate 1p/19q codeletion subtypes within IDH mutant gliomas. For differentiating glioma grades using ROC analyses, DSW achieved the largest AUC. For differentiating IDH genotypes, DSW and APT achieved comparable AUCs. DSW was the best metric for differentiating 1p/19q codeletion status within all patients and within the IDH mutant patients. Combining all Z-spectral contrasts improved sensitivity and specificity for all risk stratifications. CONCLUSIONS Multi-parametric Z-spectral MRI serves as a useful, comprehensive, and noninvasive imaging technique for glioma stratification in clinical patients. KEY POINTS • Multiple contrasts contributing to Z-spectra were separately fitted with Lorentzian functions. • Z-spectral contrasts were compared within the three most important and common tumor risk stratifications for gliomas: tumor grade, IDH genotype, and 1p/19q codeletion status. • The stratification performance of individual Z-spectral contrasts and their combination was quantified using receiver operating characteristic analyses, which found Z-spectral MRI to be a useful and comprehensive imaging biomarker for glioma stratification.
Collapse
Affiliation(s)
- Changliang Su
- Department of Medical Imaging, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, 510060, Guangzhou, China
| | - Shijie Xu
- Department of Neurosurgery, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, 510060, Guangzhou, China
| | - Danlin Lin
- Department of Medical Imaging, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, 510060, Guangzhou, China
| | - Haoqiang He
- Department of Medical Imaging, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, 510060, Guangzhou, China
| | - Zhenghe Chen
- Department of Neurosurgery, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, 510060, Guangzhou, China
| | - Frederick C Damen
- Department of Radiology College of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - Chao Ke
- Department of Neurosurgery, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, 510060, Guangzhou, China.
| | - Xiaofei Lv
- Department of Medical Imaging, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, 510060, Guangzhou, China.
| | - Kejia Cai
- Department of Radiology College of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| |
Collapse
|