Effect of Diffuse Glioma with Precentral Gyrus Invasion on Interhemispheric Brain Activation： A Task-based FMRI Study / 中山大学学报(医学科学版)

ObjectivesTo explore the effect of diffuse glioma with precentral-gyrus invasion on fMRI activation maps by grasping T-fMRI. MethodsA total of 56 diffuse glioma patients were divided into precentral-gyrus invasion （PGI： n=21） and precentral-gyrus non-invasion （PGNI： n=35） groups. Three statistical thresholds （P value： 10-4， P1； 10-6， P2； 10-8， P3） were set to obtain the activation maps accordingly （V1， V2 and V3）. The interhemispheric and bilateral precentral gyrus activation volumes ratios （IAVR and PAVR） were calculated， respectively. The activation volumes ［△V1=V1-V2； △V2=V2-V3； △Vn （ipsilateral）/△Vn’ （contralateral）， n=1， 2］ within two statistical thresholds and the corresponding interhemispheric ratio was further compared. In addition， the associations of tumor characteristics with IAVR and PAVR were analyzed. ResultsCompared with PGNI， PGI showed significantly decreased IAVR at p1， and the same trends of PAVR in PGI at P1 and P2 （P＜0.05）. However， neither IAVR nor PAVR showed significant differences at P3. PGI showed significantly lower ratios of △V1/△V1’ than PGNI （P=0.02）， except for △V2/△V2’. Additionally， within PGI， PAVR was negatively correlated with tumor volume （P=0.043）， and the distance from the tumor to the hand-knob was positively correlated with the IAVR and PAVR （P＜0.05）. ConclusionDiffuse glioma invading eloquent areas tended to affect interhemispheric asymmetry of activation at relatively lower statistical thresholds than diffuse glioma without invasion， rather than stricter statistical thresholds. Multiple ranges of statistical thresholds were recommended to analyze T-fMRI.

Advances in molecular classification of diffuse WHO grade II/III glioma in adults / 肿瘤

Objective: Glioma is the most common malignant primary central nervous system tumor. The traditional histologic classification has been applied for predicting biological behavior of glioma and deciding the treatment strategy. The scope of survival in WHO grade II/III is very broad, some progress to glioblastoma in a few months, and some in stable for many years; some is sensitive to radiation and chemotherapy, but some are not sensitive. In recent years, the studies have found that the molecular classification is more accurate in judging prognosis than traditional histologic classification. Almost all grade II/III glioma can be separated into two subtypes according to mutation status of isocitrate dehydrogenase 1/2 (IDH 1/2), and further classification is based on 1 p19q, ATRX (alpha thalassemia/mental retardation syndrome X-linked) and TP 53 (tumor protein p53) status. IDH mutation combined with 1p19q co-deletion most harbored in oligodendroglioma, often accompanies with mutation in CIC, far upstream element binding protein 1 (FUBP 1), Notch1 and telomerase reverse transcriptase (TERT) promoter. The IDH wild type can be further divided into three subtypes with different prognosis based on DNA-methylation platform.