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少突胶质细胞瘤的预后变量:单机构 95 例研究。

Prognostic variables in oligodendroglial tumors: a single-institution study of 95 cases.

机构信息

Department of Pathology, Oslo University Hospital, Rikshospitalet, P.O. Box 4950 Nydalen, 0424 Oslo, Norway.

出版信息

Neuro Oncol. 2011 Nov;13(11):1225-33. doi: 10.1093/neuonc/nor114. Epub 2011 Aug 19.

Abstract

We analyzed the relationships among clinical variables, histology, 1p/19q status, and outcome in 95 patients with oligodendroglial tumors. The study enrolled adult patients who underwent first-time surgery for a supratentorial oligodendroglial tumor at Oslo University Hospital, Rikshospitalet. Tumors were: 27 oligodendrogliomas, WHO grade II; 32 oligoastrocytomas, WHO grade II; 16 anaplastic oligodendrogliomas, WHO grade III; 14 anaplastic oligoastrocytomas, WHO grade III; and 6 glioblastomas with a major oligodendroglial component, WHO grade IV. The clinical files were reviewed. Three neuropathologists evaluated the histological slides independently. Loss-of-heterozygosity analysis for 1p and 19q was performed by PCR. Favorable prognostic factors from univariate analyses included seizures as presenting symptom, female sex, location in the frontal lobe, low WHO grade, classic histology, absence of gemistocytic cells, and combined 1p/19q loss. Solitary 19q loss was a negative prognostic marker. 1p/19q status was of prognostic significance in both tumors with classic and nonclassic oligodendroglial histology. In the multivariate analysis, WHO grade II (P< .001), frontal tumor location (P= .002), and combined 1p/19q loss (P< .001) remained favorable prognostic variables. Our results suggest that tumor location, WHO grade, and 1p/19q status are important independent variables associated with survival in oligodendroglial tumors. The study suggests that solitary 19q loss is a negative prognostic variable and that 1p/19q loss is associated with prolonged survival also in oligodendroglial tumors without classic histology.

摘要

我们分析了 95 例少突胶质细胞瘤患者的临床变量、组织学、1p/19q 状态和预后之间的关系。该研究纳入了在奥斯陆大学医院 Rikshospitalet 首次接受幕上少突胶质细胞瘤手术的成年患者。肿瘤为:27 例少突胶质细胞瘤,WHO 分级 II 级;32 例少突星形细胞瘤,WHO 分级 II 级;16 例间变性少突胶质细胞瘤,WHO 分级 III 级;14 例间变性少突星形细胞瘤,WHO 分级 III 级;6 例伴主要少突胶质成分的胶质母细胞瘤,WHO 分级 IV 级。对临床档案进行了回顾。3 位神经病理学家独立评估了组织学切片。通过 PCR 进行 1p 和 19q 的杂合性丢失分析。单变量分析的有利预后因素包括以癫痫发作为首发症状、女性、额叶位置、低 WHO 分级、经典组织学、无巨细胞胶质细胞、1p/19q 联合缺失。孤立的 19q 缺失是一个负预后标志物。1p/19q 状态在经典和非经典少突胶质组织学肿瘤中均具有预后意义。在多变量分析中,WHO 分级 II(P<.001)、额叶肿瘤位置(P=.002)和 1p/19q 联合缺失(P<.001)仍然是有利的预后变量。我们的研究结果表明,肿瘤位置、WHO 分级和 1p/19q 状态是与少突胶质细胞瘤患者生存相关的重要独立变量。该研究表明,孤立的 19q 缺失是一个负预后变量,1p/19q 缺失与无经典组织学的少突胶质细胞瘤患者的生存延长有关。

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