Cordier Dominik, Gozé Catherine, Schädelin Sabine, Rigau Valérie, Mariani Luigi, Duffau Hugues
Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, 80 Av Augustin Fliche, 34295, Montpellier, France.
J Neurooncol. 2015 Jan;121(1):185-93. doi: 10.1007/s11060-014-1623-y. Epub 2014 Sep 28.
A higher extent of resection (EOR) in WHO grade II gliomas (GIIG) is correlated with longer survival. However, the molecular markers also feature prognostic relevance. Here, we examined whether maximal EOR was related to the genetic profile. We retrospectively investigated the predictive value of 1p19q, IDH1, 53 expression and Ki67 index for the EOR in 200 consecutive GIIGs (2007-2013). Data were modeled in a linear model. The analysis was performed with two statistical methods (arcsin-sqrt and Beta-regression model with logit link). There was no deletion 1p19q in 118 cases, codeletion 1p19q (57 cases), single deletion 1p (4 cases) or19q (16 cases). 155 patients had a mutation of IDH1. p53 was graded in 4 degrees (0:92 cases, 1:52 cases, 2:31 cases, 3:8 cases). Mean Ki67 index was 5.2 % (range 1-20 %). Mean preoperative tumor volume was 60.8 cm(3) (range 3.3-250 cm(3)) and mean EOR was 0.917 (range 0.574-1). The statistical analysis was significant for a lower EOR in patients with codeletion 1p19q (OR 0.738, p = 0.0463) and with a single deletion 19q (OR 0.641, p = 0.0168). There was no significant correlation between IDH1 or p53 and the EOR. Higher Ki67 was marginally associated with higher EOR (p = 0.0603). The study demonstrates in a large cohort of GIIG that a higher EOR is not attributable to favorable genetic markers. This original result supports maximal surgical resection as an important therapeutic factor per se to optimize prognosis, independently of the molecular pattern.
世界卫生组织II级胶质瘤（GIIG）中更高程度的切除范围（EOR）与更长的生存期相关。然而，分子标志物也具有预后相关性。在此，我们研究了最大EOR是否与基因图谱相关。我们回顾性调查了200例连续的GIIG（2007 - 2013年）中1p19q、异柠檬酸脱氢酶1（IDH1）、p53表达和Ki67指数对EOR的预测价值。数据采用线性模型进行建模。分析采用两种统计方法（反正弦平方根法和带对数链接的贝塔回归模型）。118例患者无1p19q缺失，57例患者1p19q共缺失，4例患者1p单缺失，16例患者19q单缺失。155例患者存在IDH1突变。p53分为4级（0级：92例，1级：52例，2级：31例，3级：8例）。平均Ki67指数为5.2%（范围1% - 20%）。术前平均肿瘤体积为60.8 cm³（范围3.3 - 250 cm³），平均EOR为0.917（范围0.574 - 1）。对于1p19q共缺失的患者（比值比0.738，p = 0.0463）和19q单缺失的患者（比值比0.641，p = 0.0168），统计分析显示EOR较低具有显著性。IDH1或p53与EOR之间无显著相关性。较高的Ki67与较高的EOR有微弱关联（p = 0.0603）。该研究在一大群GIIG中表明，较高的EOR并非归因于有利的基因标志物。这一原始结果支持最大程度的手术切除本身作为优化预后的重要治疗因素，独立于分子模式。
