Corresponding Author: Ross Laxton, PhD, Department of Clinical Neuropathology, King's College Hospital, Denmark Hill, London SE5 9RS, UK.
Neuro Oncol. 2013 Dec;15(12):1635-43. doi: 10.1093/neuonc/not125. Epub 2013 Oct 24.
Glioblastoma multiforme with an oligodendroglial component (GBMO) has been recognized in the World Health Organization classification-however, the diagnostic criteria, molecular biology, and clinical outcome of primary GBMO remain unclear. Our aim was to investigate whether primary GBMO is a distinct clinicopathological subgroup of GBM and to determine the relative frequency of prognostic markers such as loss of heterozygosity (LOH) on 1p and/or 19q, O(6)-methylguanine-DNA methyltransferase (MGMT) promoter methylation, and isocitrate dehydrogenase 1 (IDH1) mutation.
We examined 288 cases of primary GBM and assessed the molecular markers in 57 GBMO and 50 cases of other primary GBM, correlating the data with clinical parameters and outcome.
GBMO comprised 21.5% of our GBM specimens and showed significantly longer survival compared with our other GBM (12 mo vs 5.8 mo, P = .006); there was also a strong correlation with younger age at diagnosis (56.4 y vs 60.6 y, P = .005). Singular LOH of 19q (P = .04) conferred a 1.9-fold increased hazard of shorter survival. There was no difference in the frequencies of 1p or 19q deletion, MGMT promoter methylation, or IDH1 mutation (P = .8, P = 1.0, P = 1.0, respectively).
Primary GBMO is a subgroup of GBM associated with longer survival and a younger age group but shows no difference in the frequency of LOH of 1p/19q, MGMT, and IDH1 mutation compared with other primary GBM.
少突胶质细胞成分的多形性胶质母细胞瘤(GBMO)已被纳入世界卫生组织的分类中-然而,原发性 GBMO 的诊断标准、分子生物学和临床结局仍不清楚。我们的目的是研究原发性 GBMO 是否是胶质母细胞瘤的一个独特的临床病理亚组,并确定预后标志物的相对频率,如 1p 和/或 19q 的杂合性丢失(LOH)、O(6)-甲基鸟嘌呤-DNA 甲基转移酶(MGMT)启动子甲基化和异柠檬酸脱氢酶 1(IDH1)突变。
我们检查了 288 例原发性胶质母细胞瘤,并在 57 例 GBMO 和 50 例其他原发性胶质母细胞瘤中评估了分子标志物,将数据与临床参数和结果相关联。
GBMO 占我们胶质母细胞瘤标本的 21.5%,与我们的其他胶质母细胞瘤相比,生存时间明显更长(12 个月 vs 5.8 个月,P =.006);与诊断时的年龄也有很强的相关性(56.4 岁 vs 60.6 岁,P =.005)。19q 的单 LOH(P =.04)导致生存时间缩短的风险增加 1.9 倍。1p 或 19q 缺失、MGMT 启动子甲基化或 IDH1 突变的频率无差异(P =.8、P = 1.0、P = 1.0)。
原发性 GBMO 是胶质母细胞瘤的一个亚组,与更长的生存时间和更年轻的年龄组相关,但与其他原发性胶质母细胞瘤相比,1p/19q、MGMT 和 IDH1 突变的 LOH 频率无差异。