Cho/Cr ratio at MR spectroscopy as a biomarker for cellular proliferation activity and prognosis in glioma: correlation with the expression of minichromosome maintenance protein 2. (January 2019)

• Record Type: Journal Article
• Authors: Gao, Wenjing; Wang, Xiao; Li, Fuyan; Shi, Wenqi; Li, Hongxia; Zeng, Qingshi
• Is Part Of: Acta radiologica. Volume 60:Number 1(2019)
• Page Start: 106
• Page End: 112
• Publication Date: 2019-01
• Subjects: Glioma -- 1H-MRS -- MCM2 -- cellular proliferation -- prognosis; Radiology, Medical -- Periodicals; Radiography, Medical -- Periodicals; Radiotherapy -- Periodicals; 616.0757
• DOI: 10.1177/0284185118770899
• Languages: English
• ISSNs: 0284-1851

Abstract

Background: Magnetic resonance (MR) spectroscopy ( 1 H-MRS) has been demonstrated to be useful in grading glioma, but the utility in assessing cellular proliferation activity and prognosis correlated with the expression of minichromosome maintenance protein 2 (MCM2) has not been reported. Purpose: To explore the correlation between proton MR spectroscopy parameters (including choline [Cho]/creatine [Cr], N -acetyl aspartate [NAA]/Cr, and Cho/NAA ratios) and the expression of MCM2 and to further evaluate whether 1 H-MRS can predict cell proliferative activity and provide prognostic information in high-grade gliomas (HGGs). Material and Methods: Forty-three patients with histopathologically confirmed gliomas were involved in this study. All patients underwent 1 H-MRS examination before surgery. Proliferative activity of gliomas was evaluated by MCM2 labeling index (LI). Pearson correlation analysis and empiric receiver operating characteristic (ROC) curves were performed. The Kaplan–Meier method and Cox regression were used for survival analysis. Results: Significant correlation was observed between the Cho/Cr ratio and MCM2 LI ( r = 0.522, P < 0.01); however, there was no correlation between MCM2 LI and the Cho/NAA or NAA/Cr ratios ( r = 0.295, P = 0.55 and r = −0.042, P = 0.788, respectively). According to ROC analysis, MCM2 LI of 50% and Cho/Cr ratio of 2.68 represented the optimized cut-off values, respectively, to distinguish longer or shorter survival than 15 months in HGGs patients. Multivariate analysis revealed that both the Cho/Cr ratio and MCM2 expression were independent prognostic markers. Conclusion: Cho/Cr ratio has a potential in predicting the expression of MCM2 and can evaluate cell proliferative activity noninvasively. Both the Cho/Cr ratio and MCM2 expression are independent prognostic markers in patients with HGGs.