Absaliamova O V, Korshunov A G, Loshakov V A, Kobiakov G L, Golanov A V, Urakov S V, Amanov R D, Lichinitser M R
Zh Vopr Neirokhir Im N N Burdenko. 2009 Jan-Mar(1):17-23; discussion 23-4.
Previous studies demonstrated that patients with oligodendroglial tumors (OT) have longer overall and recurrence free survival than patients with other glial tumors of the same grade. Recent investigations showed high influence of genetic alterations on patients' outcome: overall and recurrence free survival increased in the case of presence 1p19q deletion and decreased in the presence of 9p or 10q deletion and/or EGFR amplification. In the series of 241 cases (107 male, 134 female patients, median age -- 38 years, (16-73)) we analyzed the impact of histology, tumor grade and genetic alterations on time to tumor progression (TTP). All patients underwent surgical resection of tumor or biopsy from 2000 to 2005. 70 patterns (oligodendroglioma (O) -- 13 cases, oligoastrocytoma (OA) -- 13, anaplastic oligodendroglioma (AO) -- 30, anaplastic oligoastrocytoma (AOA) -- 14) were assessed by fluorescent in situ hybridization. Median follow up was 24 months. The type of tumor (pure or mixed) didn't influence survival. TTP of patients with grade II and grade III tumors was 37.7 and 48.2 months, respectively (p = 0.035). Deletion 1p19q was noted in 34 (49%) cases. In pure O codeletion 1p19q was detected more frequently (in O -- 75%, in AO -- 56%) than in mixed tumors (in OA -- 31%, in AOA -- 35%). Deletions 9p, 10q and EGFR amplification were noted in 5, 6 and 4 cases, respectively. None of the tumors with 1pl9q deletion had other genetic alterations. Thus, we generated three prognostic groups: A -- deletion 1p19q; B -- balanced chromosomal profile; C -- deletion 9p. Median TTP in groups A, B and C was 46.6, 25.3 and 6.4 months, respectively (p < 0.001). The percentage of OT with 1p19q codeletion was lower than in previous studies. Pure O more frequently had 1p19q deletion than mixed tumors. Genetic alterations predict outcome stronger than histological criteria.
以往研究表明,与相同级别的其他胶质肿瘤患者相比,少突胶质细胞瘤(OT)患者的总生存期和无复发生存期更长。近期研究显示,基因改变对患者预后有很大影响:存在1p19q缺失时,总生存期和无复发生存期延长;存在9p或10q缺失和/或表皮生长因子受体(EGFR)扩增时,则缩短。在这241例患者(107例男性,134例女性,中位年龄38岁(16 - 73岁))中,我们分析了组织学、肿瘤分级和基因改变对肿瘤进展时间(TTP)的影响。所有患者在2000年至2005年期间均接受了肿瘤手术切除或活检。通过荧光原位杂交评估了70例病例(少突胶质细胞瘤(O)13例、少突星形细胞瘤(OA)13例、间变性少突胶质细胞瘤(AO)30例、间变性少突星形细胞瘤(AOA)14例)。中位随访时间为24个月。肿瘤类型(纯合型或混合型)不影响生存率。II级和III级肿瘤患者的TTP分别为37.7个月和48.2个月(p = 0.035)。34例(49%)病例检测到1p19q缺失。在纯合型O中,1p19q共缺失的检出率(O中为75%,AO中为56%)高于混合型肿瘤(OA中为31%,AOA中为35%)。分别有5例、6例和4例检测到9p、10q缺失和EGFR扩增。所有存在1p19q缺失的肿瘤均无其他基因改变。因此,我们划分出三个预后组:A组——1p19q缺失;B组——染色体核型平衡;C组——9p缺失。A、B、C三组的中位TTP分别为46.6个月、25.3个月和6.4个月(p < 0.001)。1p19q共缺失的OT比例低于以往研究。纯合型O比混合型肿瘤更易出现1p19q缺失。基因改变比组织学标准更能预测预后。