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[幕上高级别星形细胞瘤中异柠檬酸脱氢酶1(IDH1)突变与预后的相关性]

[Correlation between IDH1 mutation and prognosis in supratentorial high-grade astrocytomas].

作者信息

Xie Fei, Tang Jun-Jia, Wang Xiang, Liu Yan-Hui, Mao Qing

机构信息

Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu 610041, China.

出版信息

Sichuan Da Xue Xue Bao Yi Xue Ban. 2013 Mar;44(2):184-7, 192.

Abstract

OBJECTIVE

To study the correlation between isoeitratedehydrogenasel 1 (IDH1) mutation and prognosis in supratentorial high-grade astrocytomas.

METHODS

There were 217 samples of supratentorial high-grade astrocytomas specimens collected for DNA extraction, IDH1 mutation of each patient was determined by PCR and direct sequencing. The differences of clinical features were compared between mutant group and wild type group. The relationship between IDH1 mutation and overall survival of the patients was studied with Kaplan-Meier survival curve, while multiple factors analysis was carried out by COX regression model.

RESULTS

There were 43 (19.3%) IDH1 mutations in 217 specimens, of which 9 (24.3%) in WHO grade III, 34 (18.9%) in WHO grade IV. The mean age of primary glioblastoma multiforme (GBM) in mutant type group and wild type group were 39.17 and 47.66 years old respectively (P < 0.05). The median survival time was 64 weeks for the patients in IDH1 mutation group and 50 weeks for those in wild type group, and the difference was statistically significant (P < 0.001). The median survival time was 51 weeks for the wild type group of WHO grade III cases and 58 weeks for the mutant group of WHO grade IV cases (P < 0.001). COX multiple variable analysis showed that IDH1 mutation, surgical resection, preoperative Karnofsky performance, radiotherapy and chemotherapy were statistically significant in prognosis (P < 0.05).

CONCLUSION

IDH1 mutation can be found in supratentorial high-grade astrocytomas, the patients with IDH1 mutation may have a better prognosis.

摘要

目的

研究异柠檬酸脱氢酶1(IDH1)突变与幕上高级别星形细胞瘤预后的相关性。

方法

收集217例幕上高级别星形细胞瘤标本进行DNA提取,采用聚合酶链反应(PCR)和直接测序法检测每位患者的IDH1突变情况。比较突变组与野生型组的临床特征差异。采用Kaplan-Meier生存曲线研究IDH1突变与患者总生存的关系,同时通过COX回归模型进行多因素分析。

结果

217例标本中有43例(19.3%)存在IDH1突变,其中WHOⅢ级9例(24.3%),WHOⅣ级34例(18.9%)。突变型组和野生型组原发性多形性胶质母细胞瘤(GBM)的平均年龄分别为39.17岁和47.66岁(P<0.05)。IDH1突变组患者的中位生存时间为64周,野生型组为50周,差异有统计学意义(P<0.001)。WHOⅢ级病例野生型组的中位生存时间为51周,WHOⅣ级病例突变组为58周(P<0.001)。COX多变量分析显示,IDH1突变、手术切除、术前卡氏评分、放疗和化疗对预后有统计学意义(P<0.05)。

结论

幕上高级别星形细胞瘤中可发现IDH1突变,IDH1突变的患者可能预后较好。

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