Wang Jing, Zhao Yi-ying, Li Jian-feng, Guo Cheng-cheng, Chen Fu-rong, Su Hong-kai, Zhao Hua-fu, Long Ya-kang, Shao Jian-yong, To Shing shun Tony, Chen Zhong-ping
Department of Neurosurgery/Neuro-oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.
Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, China.
Oncotarget. 2015 Nov 24;6(37):39651-60. doi: 10.18632/oncotarget.5630.
Glioma is the most frequent central nervous system tumor in adults. The overall survival of glioma patients is disappointing, mostly due to the poor prognosis of glioblastoma (Grade IV glioma). Isocitrate dehydrogenase (IDH) is a key factor in metabolism and catalyzes the oxidative decarboxylation of isocitrate. Mutations in IDH genes are observed in over 70% of low-grade gliomas and some cases of glioblastoma. As the most frequent mutation, IDH1(R132H) has been served as a predictive marker of glioma patients. The recently developed droplet digital PCR (ddPCR) technique generates a large amount of nanoliter-sized droplets, each of which carries out a PCR reaction on one template. Therefore, ddPCR provides high precision and absolute quantification of the nucleic acid target, with wide applications for both research and clinical diagnosis. In the current study, we collected 62 glioma tissue samples (Grade II to IV) and detected IDH1 mutations by Sanger direct sequencing, ddPCR, and quantitative real-time PCR (qRT-PCR). With the results from Sanger direct sequencing as the standard, the characteristics of ddPCR were compared with qRT-PCR. The data indicated that ddPCR was much more sensitive and much easier to interpret than qRT-PCR. Thus, we demonstrated that ddPCR is a reliable and sensitive method for screening the IDH mutation. Therefore, ddPCR is able to applied clinically in predicting patient prognosis and selecting effective therapeutic strategies. Our data also supported that the prognosis of Grade II and III glioma was better in patients with an IDH mutation than in those without mutation.
胶质瘤是成人中最常见的中枢神经系统肿瘤。胶质瘤患者的总体生存率令人失望,主要是由于胶质母细胞瘤(IV级胶质瘤)的预后较差。异柠檬酸脱氢酶(IDH)是代谢中的关键因素,催化异柠檬酸的氧化脱羧反应。在超过70%的低级别胶质瘤和一些胶质母细胞瘤病例中观察到IDH基因突变。作为最常见的突变,IDH1(R132H)已成为胶质瘤患者的预测标志物。最近开发的微滴数字PCR(ddPCR)技术产生大量纳升级别的微滴,每个微滴在一个模板上进行PCR反应。因此,ddPCR提供了核酸靶点的高精度和绝对定量,在研究和临床诊断中都有广泛应用。在本研究中,我们收集了62例胶质瘤组织样本(II至IV级),并通过桑格直接测序、ddPCR和定量实时PCR(qRT-PCR)检测IDH1突变。以桑格直接测序的结果为标准,将ddPCR的特点与qRT-PCR进行比较。数据表明,ddPCR比qRT-PCR更敏感且更易于解读。因此,我们证明ddPCR是一种可靠且敏感的筛选IDH突变的方法。因此,ddPCR能够在临床上用于预测患者预后和选择有效的治疗策略。我们的数据还支持,IDH突变的II级和III级胶质瘤患者的预后比未突变的患者更好。