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Dynamic contrast-enhanced MRI predicts PTEN protein expression which can function as a prognostic measure of progression-free survival in NPC patients

  • Original Article – Clinical Oncology
  • Published:
Journal of Cancer Research and Clinical Oncology Aims and scope Submit manuscript

Abstract

Objectives

The objective of our study was to investigate whether a phosphatase and tensin homolog deleted on chromosome 10 (PTEN) expression was associated with dynamic contrast-enhanced MRI (DCE-MRI) parameters and prognosis in nasopharyngeal carcinoma (NPC).

Methods

Two-hundred-and-forty-five (245) patients with NPC who underwent pretreatment biopsy, expression of PTEN detected by immunohistochemistry of biopsy, and radical intensity-modulated radiation therapy (IMRT) with or without chemotherapy were included. Tumor segmentations were delineated on pretreatment MRI manually. The pharmacokinetic parameters (Ktrans, Kep, Ve, and Vp) derived from dynamic contrast-enhanced MRI (DCE-MRI) using the extended Toft’s model within the tumor segmentations were estimated. The following demographics and clinical features were assessed and correlated against each other: gender, age, TNM stage, clinical-stage, Epstein–Barr virus (EBV), pathological type, progression-free survival (PFS), and prognosis status. DCE parameter evaluation and clinical feature comparison between the PTEN positive and negative groups were performed and correlation between PTEN expression with the PFS and prognosis status using Cox regression for survival analysis were assessed.

Results

A significantly lower Ktrans and Kep were found in NPC tumors in PTEN negative patients than in PTEN positive patients. Ktrans performed better than Kep in detecting PTEN expression with the ROC AUC of 0.752. PTEN negative was associated with later TNM stage, later clinical-stage, shorter PFS, and worse prognosis. Moreover, N stage, pathological type, Kep, and prognostic status can be considered as independent variables in discrimination of PTEN negative expression in NPCs.

Conclusions

PTEN negative indicated a shorter PFS and worse prognosis than PTEN positive in NPC patients. Ktrans and Kep derived from DCE-MRI, which yielded reliable capability, may be considered as potential imaging markers that are correlated with PTEN expression and could be used to predict PTEN expression noninvasively. Combined radiological and clinical features can improve the performance of the classification of PTEN expression.

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Availability of data and material

All datasets generated or analyzed during this study are included in this published article and its supplementary information files.

Code availability

Not applicable.

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Acknowledgements

We would like to thank all the patients and the personnel involved in this study. We are also grateful to Ganmian Dai and Tiansheng Li at the Radiology Department, the Hainan General Hospital, for help with data collation.

Funding

This work was supported by the Key Research and Development Program of Hainan Province (ZDYF2019137) and the National Natural Science Foundation of China (Grant nos. 81660285, 81871346, 82060514 and 81960519).

Author information

Author notes

  1. Gang Wu, Weiyuan Huang and Junnv Xu contributed equally to this manuscript.

Authors and Affiliations

  1. Hainan Provincial Key Laboratory of Carcinogenesis and Intervention, Hainan Medical University, No. 3, Xueyuan Road, Longhua District, HaiKou, 571199, Hainan, People’s Republic of China

    Gang Wu, Junnv Xu, Kun Liu, Mingyue Zhu & Mengsen Li

  2. Department of Radiology, Affiliated Hainan Hospital of Hainan Medical University (Hainan General Hospital), HaiKou, People’s Republic of China

    Weiyuan Huang, Wenzhu Li & Qianyu Yang

  3. Department of Radiotherapy, Affiliated Hainan Hospital of Hainan Medical University (Hainan General Hospital), HaiKou, People’s Republic of China

    Gang Wu

  4. Department of Pathology, Affiliated Hainan Hospital of Hainan Medical University (Hainan General Hospital), HaiKou, People’s Republic of China

    Yu Wu

  5. Department of Electrical and Computer Engineering, Cornell University, Ithaca, USA

    Priya S. Balasubramanian

  6. Institution of Tumor, Hainan Medical University, No. 3, Xueyuan Road, Longhua District, HaiKou, 571199, Hainan, People’s Republic of China

    Mengsen Li

  7. Department of Medical Oncology, the Second Affiliated Hospital of Hainan Medical University, HaiKou, People’s Republic of China

    Junnv Xu

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  1. Gang Wu
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Contributions

Conceptualization was done by GW. Data curation was performed by GW, WH, JX, WL, and QY. Pathology analysis was conducted by YW. Formal analysis was conducted by WH. Investigation was performed by GW, WH, WL, QY, and KL. Methodology was contributed by GW, WH, JX, MZ, and ML. Project administration was done by all the authors. Visualization was performed by WH. Supervision was done by ML. Writing of the original draft was performed by GW. Writing in terms of review and editing were performed by ML, MZ, and WH.

Corresponding author

Correspondence to Mengsen Li.

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Conflict of interest

The authors declare that there are no conflicts of interest.

Ethical approval

This prospective study was approved by Hainan General Hospital (The Affiliated Hainan Hospital of Hainan Medical University) IRB (NO.2018025).

Consent to participate

All participating subjects were formally informed about the purpose of this study and a letter of consent was signed by every subject involved.

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Written informed consent was obtained from the patient for publication and any accompanying images.

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Wu, G., Huang, W., Xu, J. et al. Dynamic contrast-enhanced MRI predicts PTEN protein expression which can function as a prognostic measure of progression-free survival in NPC patients. J Cancer Res Clin Oncol 148, 1771–1780 (2022). https://doi.org/10.1007/s00432-021-03764-7

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  • DOI: https://doi.org/10.1007/s00432-021-03764-7

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