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Master's Dissertation
DOI
https://doi.org/10.11606/D.17.2020.tde-23082020-151747
Document
Author
Full name
Carlos Alberto Ferreira Coelho Neto
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
Ribeirão Preto, 2020
Supervisor
Committee
Simão, Gustavo Novelino (President)
Matias, Caio César Marconato Simões
Serafini, Luciano Neder
Title in Portuguese
Sinal Mismatch T2-FLAIR e sua relação com o prognóstico em gliomas difusos
Keywords in Portuguese
Codeleção 1p19q
Gliomas difusos
Mismatch T2-FLAIR
Mutação IDH
Ressonância magnética
Abstract in Portuguese
Introdução: Os gliomas difusos de baixo grau (Grau 2 OMS) são tumores originados de tecido glial do sistema nervoso central, de crescimento habitualmente lento, com potencial de progressão para anaplasia (grau 3 OMS). Estes dois grupos são caracterizados como gliomas de menor grau neste trabalho (1). Atualmente, em adição ao estudo histológico habitual, a análise molecular vem se consolidando como principal ferramenta diagnóstica nestes casos, visto que diferentes subtipos tumorais apresentam comportamentos biológicos diferentes, com impacto no tratamento e sobrevida dos pacientes. Há a recente descrição de um marcador de imagem em ressonância magnética, denominado Mismatch T2-FLAIR, que apresenta correlação com um subtipo molecular específico de glioma difuso. Objetivo: Identificar, entre os pacientes com gliomas difusos, a presença do sinal Mismatch T2-FLAIR no exame de ressonância magnética e se existe correlação com o prognóstico nestes casos. Método: foram incluídos e avaliados casos de gliomas difusos do sistema nervoso central (Grau II e III OMS) dos últimos 15 anos. O aspecto de imagem na ressonância magnética foi avaliado, em busca do sinal Mismatch T2-FLAIR. Posteriormente, foram obtidos dados prognósticos de todos os pacientes do estudo, no intuito de comparar a sobrevida global e a sobrevida em relação a progressão de doença dos pacientes portadores ou não do sinal em questão. A sobrevida também foi avaliada em relação a outras variáveis isoladas, com idade, sexo, tipo histológico e grau tumoral. Resultados: não houve diferença estatisticamente significatica na sobrevida, tanto em relação a óbito quanto a progressão de doença, entre os pacientes portadores ou não do sinal Mismatch T2-FLAIR. Na análise das outras variáveis isoladas, houve sobrevida significativamente inferior dos pacientes com tumores grau III em relação aos de grau II (OMS). Conclusão: Como fator isolado de prognóstico, nosso estudo não demonstrou relação do sinal Mismatch T2-FLAIR com o prognóstico nos pacientes portadores deste grupo de tumor.
Title in English
The prognostic value of T2-FLAIR Mismatch Sign in diffuse gliomas
Keywords in English
1p19q codeletion
Diffuse gliomas
IDH mutation
Magnetic resonance
Mismatch T2/FLAIR
Abstract in English
Introduction: Low grade gliomas (OMS grade II) are originated from glial tissue in central nervous system, habitually with slow growth and with possibility of progression to anaplasia (WHO grade III). These two groups are called lower grade gliomas in this study. Nowadays, in addition to habitual histologic analysis, the mollecular pattern is becoming the main diagnostic tool in these cases, as different tumor subtypes have different biological behaviours, with impact in therapy and survival rates. In this context, there has been recently described an image marker in magnetic resonance imaging, called Mismatch T2-FLAIR, which correlates to a specific molecular subtype of diffuse glioma. Objectives: Identify, among patients with diffuse gliomas, the presence of Mismatch T2-FLAIR sign in magnetic resonance imaging. Then, compare the survival rates between these patients and the ones without the image sign. Methods: we included and evaluated diffuse glioma cases (WHO grade II AND III) treated in the last 15 years in our institution. The MRI was evaluated searching for the Mismatch T2-FLAIR sign. Then, we searched for prognostic data of all patients, in order to compare global and disease progression survival rates between the patients with presence or absence of the image sign. The survival rates were also evaluated considering other variants, such as histologic type, sex, tumor grade and age. Results: there was no statistically significant difference in survival rates between patients with diffuse gliomas and presence or absence of the Mismatch T2- FLAIR sign, considering obit or even disease progression. The analysis of other variants showed significant lower survival rates in patients with WHO grade III tumors than in WHO II tumors. Conclusion: As an isolated prognostic marker, our study did not show relation between the image sign and prognostic rates in patients with diffuse gliomas.
 
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Publishing Date
2020-10-19
 
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