title: Evaluation of human glioma using in-vivo proton magnetic resonance spectroscopy combined with expression of cyclooxygenase-2: a preliminary clinical trial.
abstract: We sought to investigate the correlation between in-vivo proton magnetic resonance spectroscopy (H-MRS) and cyclooxygenase-2 (COX-2) expression in human glioma, and to advance their roles in diagnostic mapping and monitoring of glioma biological behavior. Thirty-nine patients with different grades of glioma (WHO classification I-IV) included in this study were scanned at 3.0 T MR before operation or biopsy puncture. Tumor morphology and H-MRS metabolites ratio [choline (Cho)/creatine (Cr)] were evaluated independently by two experienced radiologists. Paraffin-embedded glioma specimens were detected for the COX-2 expression using immunohistochemistry. Parametric and nonparametric tests including correlation, logistic regression and receiver operating characteristic analysis were applied to assess the predicative roles and relation diagram of H-MRS and COX-2. The COX-2 expression showed a significant difference between low and high grade gliomas (P<0.01). Varying degrees of COX-2 expression have positive correlation with the Cho/Cr values in tumor zone (r=0.49, P=0.013), and showed not significant correlation with sex, age, and tumor location. For patients with high grade gliomas after surgery and radiation, COX-2 was associated with shortened survival in univariate analysis (P=0.025). The COX-2, Cho/Cr value and age were the significant prognostic indicators shown in multivariate survival analysis. The COX-2 and Cho/Cr value of H-MRS have correlation, and are both positive indicators for overall survival of human high grade glioma, and could be combined as a joint role to provide more evidences to assess the biological behavior.
authors.affiliation: Department of Radiology, Qilu Hospital of Shandong University, Jinan, Shandong Province, China.
authors.forename: Wenqi
authors.initials: W
authors.lastname: Shi
authors.forename: Fuyan
authors.initials: F
authors.lastname: Li
authors.forename: Hongxia
authors.initials: H
authors.lastname: Li
authors.forename: Yanjie
authors.initials: Y
authors.lastname: Xu
authors.forename: Qingshi
authors.initials: Q
authors.lastname: Zeng
mesh_terms: D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000378:metabolism; D001921:Brain / Q000000981:diagnostic imaging / Q000378:metabolism / Q000601:surgery; D001932:Brain Neoplasms / Q000000981:diagnostic imaging* / Q000378:metabolism* / Q000473:pathology / Q000601:surgery; D002794:Choline / Q000378:metabolism; D003401:Creatine / Q000378:metabolism; D051546:Cyclooxygenase 2 / Q000378:metabolism*; D005260:Female; D005500:Follow-Up Studies; D005910:Glioma / Q000000981:diagnostic imaging* / Q000378:metabolism* / Q000473:pathology / Q000601:surgery; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D066244:Proton Magnetic Resonance Spectroscopy; D016019:Survival Analysis; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor; D051546:Cyclooxygenase 2; C496540:PTGS2 protein, human; D003401:Creatine; D002794:Choline