Expression of p53 Combined with Ki-67 in IDH-wildtype Glioblastomas: Prediction by Apparent Diffusion Coefficient Values

Abstract The presence of p53 mutationscombined with high Ki-67 expression can predict poor prognosis and overall survival in IDH-wildtypeglioblastoma patients. This study aims to use magnetic resonance imaging (MRI) features and apparent diffusion coefficient(ADC) values to predict the expression of p53 and Ki-67 in IDH-wildtype glioblastomas to informclinical treatment. We retrospectively collected clinical and imaging data for 103 IDH-wildtype glioblastoma patients in our hospital between June 2021 and February 2023. The datasets were divided into four groups: p53(+)/Ki-67(+), p53(+)/Ki67(-), p53(-)/Ki67(+), and p53(-)/Ki67(-) according to mutant status of p53 and expression level of Ki-67. Six MRI morphological features and four ADC values for the tumor parenchyma were analyzed. In the 103 patients, 21 had p53(-)/Ki-67(-), 12 had p53(+)/Ki-67(-), 28 had p53(-)/Ki-67(+), and 42 had p53(+)/Ki-67(+). Tumor location showed statistically significant differences among the 4 groups (P < 0.05). ADC parameters were negatively correlated with p53 and Ki-67 expression status and could distinguish the co-expression of p53 and Ki-67 (P < 0.05). In distinguishing between the p53(+)/Ki-67(+) and p53(-)/Ki-67(-) groups, when ADCmin was 0.85×10-3 mm2/s, the sensitivity, specificity and accuracy reached their maximum values of 61.90%, 92.90% and 82.54%, respectively. In conclusion, the expression of p53 and Ki-67 in IDH-wildtypeglioblastoma can be evaluated by ADC values. ADC values can be used as a non-invasive quantitative parameter to assist in the clinical diagnosis of IDH-wildtype glioblastoma molecular states.