文章：

肿瘤与神经源性区域接触的定量评估及其对生存率的影响：超越传统预测因素的见解

Quantitative Assessment of Tumor Contact with Neurogenic Zones and Its Effects on Survival: Insights beyond Traditional Predictors

原文发布日期：29 April 2024

DOI: 10.3390/cancers16091743

类型: Article

开放获取: 是

英文摘要：

So far, the cellular origin of glioblastoma (GBM) needs to be determined, with prevalent theories suggesting emergence from transformed endogenous stem cells. Adult neurogenesis primarily occurs in two brain regions: the subventricular zone (SVZ) and the subgranular zone (SGZ) of the hippocampal dentate gyrus. Whether the proximity of GBM to these neurogenic niches affects patient outcome remains uncertain. Previous studies often rely on subjective assessments, limiting the reliability of those results. In this study, we assessed the impact of GBM’s relationship with the cortex, SVZ and SGZ on clinical variables using fully automated segmentation methods. In 177 glioblastoma patients, we calculated optimal cutpoints of minimal distances to the SVZ and SGZ to distinguish poor from favorable survival. The impact of tumor contact with neurogenic zones on clinical parameters, such as overall survival, multifocality, MGMT promotor methylation, Ki-67 and KPS score was also examined by multivariable regression analysis, chi-square test and Mann–Whitney-U. The analysis confirmed shorter survival in tumors contacting the SVZ with an optimal cutpoint of 14 mm distance to the SVZ, separating poor from more favorable survival. In contrast, tumor contact with the SGZ did not negatively affect survival. We did not find significant correlations with multifocality or MGMT promotor methylation in tumors contacting the SVZ, as previous studies discussed. These findings suggest that the spatial relationship between GBM and neurogenic niches needs to be assessed differently. Objective measurements disprove prior assumptions, warranting further research on this topic.

摘要翻译： 

迄今为止，胶质母细胞瘤（GBM）的细胞起源尚未明确，主流理论认为其源于转化内源性干细胞。成年神经发生主要发生在两个脑区：脑室下区（SVZ）和海马齿状回的颗粒下区（SGZ）。GBM与这些神经源性微环境的邻近性是否影响患者预后仍不确定。既往研究多依赖主观评估，限制了结果的可靠性。本研究采用全自动分割方法，系统评估了GBM与皮层、SVZ及SGZ的空间关系对临床变量的影响。通过对177例胶质母细胞瘤患者进行分析，我们计算了肿瘤至SVZ和SGZ最小距离的最佳截断值，以区分不良与良好生存期。同时采用多变量回归分析、卡方检验和曼-惠特尼U检验，评估了肿瘤与神经源性区域接触对总生存期、多灶性、MGMT启动子甲基化、Ki-67及KPS评分等临床参数的影响。分析证实，与SVZ接触的肿瘤生存期更短，其至SVZ距离的最佳截断值为14毫米，可有效区分不良与良好生存期。相反，肿瘤与SGZ接触未对生存期产生负面影响。与既往研究结论不同，我们未发现与SVZ接触的肿瘤在多灶性或MGMT启动子甲基化方面存在显著相关性。这些发现表明，需要采用差异化方法评估GBM与神经源性微环境的空间关系。客观测量结果否定了先前的假设，该领域值得进一步深入研究。

原文链接：

Quantitative Assessment of Tumor Contact with Neurogenic Zones and Its Effects on Survival: Insights beyond Traditional Predictors