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Radiology:软组织肉瘤MRI征象与组织学分级及患者预后的相关性

2019-09-04 shaosai MedSci原创

背景:软组织肉瘤(STS)的诊断治疗依赖于组织学分级,对于预后及活检常规评价非常有意义。然而,由于肿瘤异质性,组织学分级也会出现错误性低估。本研究旨在识别与高级别STS(3级)相关的MRI征象以及MRI征象与患者生存期的相关性。

背景:软组织肉瘤(STS)的诊断治疗依赖于组织学分级,对于预后及活检常规评价非常有意义。然而,由于肿瘤异质性,组织学分级也会出现错误性低估。本研究旨在识别与高级别STS(3级)相关的MRI征象以及MRI征象与患者生存期的相关性。

本研究共纳入了诊断为STS的患者,均进行了基线对比增强MRI检查且对手术标本进行了病理学分级、无新辅助化疗史。排除了脏器肉瘤、分化好的脂肪肉瘤和血管肉瘤。评价T2加权、T1加权平扫和强化图像中病变的大小、异质性、结构、边界和临近组织。利用卡方检验、Fisher检验和多元双边Logistic回归分析识别与病理学分级3级相关的MRI征象。利用Kaplan-Meier曲线和Cox模型分析 MRI征象与整体生存期、无转移生存期的相关性。

结果为,共有130例患者纳入研究,72/130例STS患者组织病理学分级为3级。多元分析中,3个MRI征象与3级STS具有相关性:瘤周强化(OR为3.4; P = .003)、坏死区域百分比(OR, 2.4; P = .03)和T2加权图像中不均质信号比例超过50%(OR, 2.3; P = .04)。至少有其中2个MRI征象是预测无转移生存期(hazard ratio, 4.5; P = .01)和整体生存期l (hazard ratio, 4.2; P = .04)的独立指标。

本研究表明,MRI中软组织肉瘤出现坏死、异质性和瘤周强化征象与病理学分级3级、无转移生存期和整体生存期具有相关性。

原始出处:

Crombé A, Marcellin PJ, Buy X,et al.Soft-Tissue Sarcomas: Assessment of MRI Features Correlating with Histologic Grade and Patient Outcome.Radiology.DOI:10.1148/radiol.2019181659

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    2019-09-06 qilu_qi

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