Prediction of VEGF inhibitor effect for malignant brain tumor

2018 Fiscal Year Final Research Report

• Project/Area Number: 16K10757
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Neurosurgery
• Research Institution: Hiroshima University
• Principal Investigator: Yamasaki Fumiyuki 広島大学, 病院(医), 講師 (60444692)
• Co-Investigator(Kenkyū-buntansha): 杉山 一彦 広島大学, 病院(医), 教授 (30243554) ; 栗栖 薫 広島大学, 医歯薬保健学研究科(医), 教授 (70201473)
• Project Period (FY): 2016-04-01 – 2019-03-31
• Keywords: glioblastoma / brain metastasis / tumefactive lesion / brain abscess / histogram analysis / VEGF / radiomics / radiogenomics

Outline of Final Research Achievements

The presence of a nonenhancing peritumoral DWI high lesion (DNePDHL) was observed in 25% of glioblastoma patients, while it was conspicuously absent in patients with malignant lymphoma and metastatic brain tumors. Patients with DNePDHL had significantly early local (p=0.0467) and distant/dissemination recurrence (p<0.0001) and poor prognosis (p=0.0007). Histogram profile analysis also help for differential diagnosis of glioblastoma from other intracranial ring enhanced lesions. Evaluating ADC-MIN at b-4000 would be a useful tool for distinguishing posterior fossa tumors in both pediatric and adult patients. Lower ADC values and high lipid peaks detected on 1H-MRS are characteristics of germinomas.
The pathogenesis of multicentric gliomas is different from the mutant IDH1-R132H pathway. The expression of EZH2 is not associated with the PRC2 pathway and increases in patients with H3K27M-mutant diffuse midline glioma and a poor prognosis.

Free Research Field

脳神経外科

Academic Significance and Societal Importance of the Research Achievements

悪性脳腫瘍の術前診断は、手術において生検術を選択すべきか摘出術を選択すべきか、または手術ではなく放射線治療を選択すべきか、化学療法を選択すべきか、これらの意思決定に重要な役割を担っている。すなわち、悪性脳腫瘍の診断精度の向上は臨床上極めて意義が高く、学術的、社会的意義が大きいと言える。今回、膠芽腫の正確な診断法、予後推定法と、成人及び小児の後頭蓋窩腫瘍の鑑別診断法を確立したことと、germinomaの新規診断法を確立したことの医学的意義は極めて大きい。