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具有少突胶质细胞瘤成分的胶质母细胞瘤短期生存者:来自单一机构的186例中国患者的临床研究

Short-term survivors in glioblastomas with oligodendroglioma component: a clinical study of 186 Chinese patients from a single institution.

作者信息

Jiang Haihui, Ren Xiaohui, Wang Junmei, Zhang Zhe, Jia Wenqing, Lin Song

机构信息

Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100050, China.

出版信息

J Neurooncol. 2014 Jan;116(2):395-404. doi: 10.1007/s11060-013-1311-3. Epub 2013 Nov 22.

Abstract

This study was designed to display the molecular genetic features of short-term survivors in glioblastomas with oligodendroglioma component (GBMO). A total of 186 patients with histological diagnosis of primary gliomas, including 11 GBMO-STS (short-term survivors, survival ≤12 months), 29 GBMO-LTS (relatively long-term survivors, survival >12 months), 36 anaplastic oligoastrocytoma (AOA) and 110 glioblastoma multiforme (GBM), enrolled in the study. An evaluation form was developed and used to document molecular pathological, clinical and treatment-associated parameters between subgroups. Kaplan-Meier plots for survival showed that the median progression-free survival (PFS) and overall survival (OS) of GBMO-STS were 5.0 and 10.0 months, respectively. Intergroup comparison revealed that the GBMO-STS harbored the most dismal prognosis than those with AOA, GBMO-LTS or GBM (P < 0.001 for PFS, P < 0.001 for OS, respectively). Cox regression analyses revealed that 1p/19q co-deletion and 19p polysomy were independent prognostic factors (P < 0.05). Pearson's Chi square test demonstrated GBMO-STS exhibited lower 1p/19q co-deletion, IDH1 mutation rates than AOA or GBMO-LTS (P = 0.032, P = 0.045 for 1p/19q co-deletion; P = 0.034, P = 0.005 for IDH1 mutation, respectively) but higher chromosome 1q, 19p polysomy rates compared with AOA or GBM (P = 0.037, P = 0.030 for 1q polysomy; P = 0.017, P = 0.011 for 19p polysomy, respectively). Patients with glioblastomas with oligodendroglioma component concurrent with polysomy for chromosomes 1 and 19 always confers an unfavorable prognosis which needs our extra attention in clinic.

摘要

本研究旨在展示具有少突胶质细胞瘤成分的胶质母细胞瘤(GBMO)短期生存者的分子遗传学特征。共有186例经组织学诊断为原发性胶质瘤的患者纳入本研究,其中包括11例GBMO短期生存者(STS,生存时间≤12个月)、29例GBMO长期生存者(LTS,生存时间>12个月)、36例间变性少突星形细胞瘤(AOA)和110例多形性胶质母细胞瘤(GBM)。制定了一份评估表,用于记录各亚组之间的分子病理学、临床和治疗相关参数。生存的Kaplan-Meier曲线显示,GBMO-STS的中位无进展生存期(PFS)和总生存期(OS)分别为5.0个月和10.0个月。组间比较显示,GBMO-STS的预后比AOA、GBMO-LTS或GBM患者更差(PFS的P<0.001,OS的P<0.001)。Cox回归分析显示,1p/19q共缺失和19p多体性是独立的预后因素(P<0.05)。Pearson卡方检验表明,GBMO-STS的1p/19q共缺失率和IDH1突变率低于AOA或GBMO-LTS(1p/19q共缺失的P=0.032,P=0.045;IDH1突变的P=0.034,P=0.005),但与AOA或GBM相比,其1号染色体和19号染色体多体性率更高(1号染色体多体性的P=0.037,P=0.030;19号染色体多体性的P=0.017,P=0.011)。具有少突胶质细胞瘤成分且1号和19号染色体多体性并存的胶质母细胞瘤患者预后总是较差,在临床上需要我们格外关注。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/48cc/3890040/a675d26a796f/11060_2013_1311_Fig1_HTML.jpg

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