Brat Daniel J, Seiferheld Wendy F, Perry Arie, Hammond Elizabeth H, Murray Kevin J, Schulsinger Alan R, Mehta Minesh P, Curran Walter J
Departments of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA 30322, USA.
Neuro Oncol. 2004 Apr;6(2):96-103. doi: 10.1215/s1152851703000231.
Survival periods vary considerably for patients with high-grade astrocytomas, and reliable prognostic markers are not currently available. We therefore investigated whether genetic losses from chromosomes 1p, 19q, 9p, or 10q were associated with survival in 89 high-grade astrocytomas using tissue microarrays (TMAs) derived from Radiation Therapy Oncology Group clinical trials. Cases included 15 anaplastic astrocytomas (AAs) and 74 glioblastomas (GBMs) selected on the basis of survival times significantly shorter or longer than the expected median. Genetic analysis was performed by TMA-fluorescence in situ hybridization (FISH) on array sections using 8 DNA probes, including those directed at 1p32, 19q13.4, 9p21 (p16/CDKN2A), and 10q (PTEN and DMBT1). Genetic status for each locus was correlated with patient survival group, and data were analyzed by using Fisher's exact test of association (adjusted P = 0.025). Losses of chromosome 1p, either alone or in combination with 19q, were encountered in only 2 cases, both AAs. This contrasts with oligodendrogliomas, in which combined 1p and 19q losses are frequent and predictive of prolonged survival. Solitary 19q loss was noted in 3/15 AAs and in 7/70 GBMs and was more frequent in the long-term survival group (P = 0.041, AA and GBM combined). Chromosome 9p loss was seen in 5/8 AAs and 39/57 GBMs, whereas chromosome 10q loss was detected in 4/15 AAs and 48/68 GBMs. The 9p and 10q deletions were slightly more frequent in short-term survivors, though none of the comparisons achieved statistical significance. Long-term and short-term survival groups of high-grade astrocytomas appear to have dissimilar frequencies of 19q, 9p, and 10q deletions. TMA-FISH is a rapid and efficient way of evaluating genetic alterations in such tumors.
高级别星形细胞瘤患者的生存期差异很大,目前尚无可靠的预后标志物。因此,我们利用放射治疗肿瘤学组临床试验中的组织微阵列(TMA),研究了89例高级别星形细胞瘤中1号染色体短臂(1p)、19号染色体长臂(19q)、9号染色体短臂(9p)或10号染色体长臂(10q)的基因缺失与生存期是否相关。病例包括15例间变性星形细胞瘤(AA)和74例胶质母细胞瘤(GBM),这些病例根据生存期显著短于或长于预期中位数进行选择。通过TMA荧光原位杂交(FISH)对阵列切片进行基因分析,使用8种DNA探针,包括针对1p32、19q13.4、9p21(p16/CDKN2A)和10q(PTEN和DMBT1)的探针。每个位点的基因状态与患者生存组相关,并使用Fisher精确检验进行数据分析(校正P = 0.025)。仅在2例病例(均为AA)中发现了1p染色体缺失,单独缺失或与19q联合缺失。这与少突胶质细胞瘤形成对比,在少突胶质细胞瘤中,1p和19q联合缺失很常见,且预示生存期延长。在15例AA中有3例、70例GBM中有7例发现孤立性19q缺失,在长期生存组中更常见(AA和GBM合并,P = 0.041)。在8例AA中有5例、57例GBM中有39例发现9p染色体缺失,而在15例AA中有4例、68例GBM中有48例发现10q染色体缺失。9p和10q缺失在短期幸存者中略为常见,尽管所有比较均未达到统计学显著性。高级别星形细胞瘤的长期和短期生存组在19q、9p和10q缺失频率上似乎存在差异。TMA-FISH是评估此类肿瘤基因改变的一种快速有效的方法。