| Objective:To explore the correlation between proton MR spectroscopy(1H-MRS)parameters[including Choline(Cho)/creatine(Cr),N-acetyl aspartate(NAA)/Cr,and Cho/NAA ratios]and the expression of minichromosome maintenance protein 2(MCM2),and to further evaluate whether 1H-MRS can predict cell proliferative activity and provide prognostic information in high-grade gliomas(HGGs).Materials and Methods:Forty-three patients with histopathologically confirmed gliomas were involved in this study.All patients underwent 1H-MRS examination before surgery.Proliferative activity of glioma was evaluated by MCM2 labeling index(LI).Pearson correlation analysis and empiric receiver operating characteristic(ROC)curves were performed.Kaplan-Meier method and a Cox proportional hazards regression model were used for survival analysis.Results:Cho/Cr and Cho/NAA ratios were significantly different between low-grade gliomas(LGGs)and HGGs(P<0.01 and P=0.023,respectively),whereas NAA/Cr ratio did not show significant difference between these two groups(P=0.372).Significant correlation was observed between Cho/Cr ratio and MCM2 LI(r=0.522,P<0.01),however,MCM2 LI hadn't any correlation with Cho/NAA or NAA/Cr ratios(r=0.295,P=0.55 and r=-0.042,P=0.788,respectively).According to ROC analysis,the MCM2 LI of 50%and Cho/Cr ratio of 2.68 represented the optimized cutoff values respectively to distinguish survival longer or shorter than 15 months in HGGs patients.Multivariate analysis revealed that both 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 Cho/Cr ratio and MCM2 expression are independent prognostic markers in patients with HGGs. |
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