Kanner Andrew A, Staugaitis Susan M, Castilla Elias A, Chernova Olga, Prayson Richard A, Vogelbaum Michael A, Stevens Glen, Peereboom David, Suh John, Lee Shih-Yuan, Tubbs Raymond R, Barnett Gene H
The Brain Tumor Institute, The Cleveland Clinic Taussig Cancer Center, The Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
J Neurosurg. 2006 Apr;104(4):542-50. doi: 10.3171/jns.2006.104.4.542.
Oligodendrogliomas are rare primary brain tumors. They comprise approximately 5 to 33% of all glial tumors but differ from astrocytomas by being associated with a more favorable prognosis, making their correct identification important. Allelic loss of chromosome arms 1p and 19q is found in a substantial subpopulation of tumors with an oligodendroglioma phenotype. Anaplastic oligodendrogliomas with allelic loss of 1p have been associated with chemosensitivity and a longer patient survival period.
Oligodendroglial neoplasms were studied using fluorescence in situ hybridization of formalin-fixed, paraffin-embedded tissue specimens; reference and target probe sets were used to map the telomeric regions of 1p and 19q. The results were correlated with the clinical characteristics of patients treated at our institution between 1993 and 2003. Data obtained in 96 patients were analyzed. This included 63 patients (65.6%) with World Health Organization (WHO) Grade II oligodendroglioma, 22 (23%) with Grade III oligodendroglioma, and 11 (11.4%) with mixed oligoastrocytoma. Analysis of 1p in patients with pure oligodendroglioma revealed a loss of 1p in 42 patients (49.4%). In 46 of these patients 19q was lost and in 70 (82.3%) there was concordance for combined loss or retention of both 1p and 19q (p < 0.0001). Patients with oligodendroglioma in whom a loss of 1p was present fared significantly better, and this outcome was unrelated to the treatment modality or WHO grade, compared with patients in whom 1p was intact (p < 0.05).
To the authors' knowledge, this study includes the largest published series of WHO Grade II oligodendroglioma and 1p analysis. The results suggest that the association between long-term survival and 1p loss in oligodendroglioma is unrelated to treatment. The authors of further prospective studies may better determine the true value of the allelic loss of 1p and its implication for clinical decision making.
少突胶质细胞瘤是罕见的原发性脑肿瘤。它们约占所有胶质细胞瘤的5%至33%，但与星形细胞瘤不同，其预后较好，因此正确识别很重要。在具有少突胶质细胞瘤表型的肿瘤亚群中发现了染色体臂1p和19q的等位基因缺失。伴有1p等位基因缺失的间变性少突胶质细胞瘤与化疗敏感性及患者较长生存期相关。
使用福尔马林固定、石蜡包埋组织标本的荧光原位杂交技术研究少突胶质细胞瘤；参考探针组和靶探针组用于定位1p和19q的端粒区域。结果与1993年至2003年在我们机构接受治疗的患者的临床特征相关。分析了96例患者的数据。其中包括63例（65.6%）世界卫生组织（WHO）二级少突胶质细胞瘤患者、22例（23%）三级少突胶质细胞瘤患者和11例（11.4%）混合性少突星形细胞瘤患者。对纯少突胶质细胞瘤患者的1p分析显示，42例（49.4%）患者存在1p缺失。其中46例患者19q缺失，70例（82.3%）患者1p和19q联合缺失或保留情况一致（p<0.0001）。与1p完整的患者相比，存在1p缺失的少突胶质细胞瘤患者预后明显更好，且这一结果与治疗方式或WHO分级无关（p<0.05）。
据作者所知，本研究纳入了已发表的最大系列的WHO二级少突胶质细胞瘤及1p分析。结果表明，少突胶质细胞瘤长期生存与1p缺失之间的关联与治疗无关。进一步前瞻性研究的作者可能会更好地确定1p等位基因缺失的真正价值及其对临床决策的影响。
