Tang Chao, Zhang Zhen-yu, Chen Ling-chao, Sun Zelin, Zhang Yi, Qin Zhiyong, Yao Yu, Zhou Liang-fu
Department of Neurosurgery, Huashan Hospital, Fudan University, No. 12 Wulumuqi Middle Road, Shanghai, 200040, China.
Neurosurgical Immunology Laboratory of Huashan Hospital, Fudan University, No. 12 Wulumuqi Middle Road, Shanghai, 200040, China.
J Neurooncol. 2016 Feb;126(3):499-507. doi: 10.1007/s11060-015-1989-5. Epub 2015 Nov 19.
Although the classification of insular glioma has been established based on the anatomical location in order to facilitate personalized surgical resection, the diagnosis based on anatomical and functional characteristics becomes more complex when insular tumors extend into either the frontobasal brain region and/or the temporal lobe, as part of the limbic system. Moreover, prognosis of insular tumor resection is still controversial. Further analysis of subgroup characteristics of insular grade II gliomas based on clinical and molecular analysis is required to reliably determine patients' survival rates. In this retrospective study 20 purely insular grade II gliomas patients and 22 paralimbic grade II gliomas that involved frontal and/or temporal lobes were compared with regard to epidemiological and clinical characteristics. The molecular profiles including Isocitrate dehydrogenase 1 (IDH1), telomerase reverse transcriptase (TERT) promoter, and P53 mutations, 1p19q co-deletion were analyzed, and microRNA profiles were assessed by microarray and bioinformatics analysis. Purely insular grade II gliomas displayed a high frequency of IDH1 mutations with favorable outcome. IDH1 mutated paralimbic glioma shared many parameters with the purely insular glioma in respect to growth patterns, survival, and microRNA profile, but differed significantly from the IDH1 wild type paralimbic gliomas. Our findings suggest that IDH1 mutations can define subpopulations of insular gliomas with distinct disease entities regardless of tumor extension patterns. These findings could be useful to develop a customized treatment strategy for insular glioma patients.
尽管岛叶胶质瘤的分类已基于解剖位置确立，以便于进行个性化手术切除，但当岛叶肿瘤延伸至额底脑区和/或作为边缘系统一部分的颞叶时，基于解剖和功能特征的诊断会变得更加复杂。此外，岛叶肿瘤切除的预后仍存在争议。需要基于临床和分子分析对岛叶二级胶质瘤的亚组特征进行进一步分析，以可靠地确定患者的生存率。在这项回顾性研究中，对20例纯岛叶二级胶质瘤患者和22例累及额叶和/或颞叶的边缘叶二级胶质瘤患者的流行病学和临床特征进行了比较。分析了包括异柠檬酸脱氢酶1（IDH1）、端粒酶逆转录酶（TERT）启动子和P53突变、1p19q共缺失在内的分子谱，并通过微阵列和生物信息学分析评估了微小RNA谱。纯岛叶二级胶质瘤显示出高频率的IDH1突变且预后良好。IDH1突变的边缘叶胶质瘤在生长模式、生存率和微小RNA谱方面与纯岛叶胶质瘤有许多共同参数，但与IDH1野生型边缘叶胶质瘤有显著差异。我们的研究结果表明，无论肿瘤的扩展模式如何，IDH1突变都可以定义具有不同疾病实体的岛叶胶质瘤亚群。这些发现可能有助于为岛叶胶质瘤患者制定定制的治疗策略。
