2016 年世界卫生组织弥漫性胶质瘤分类对法国 POLA 队列的预后影响。

Prognostic impact of the 2016 WHO classification of diffuse gliomas in the French POLA cohort.

机构信息

APHM, Hôpital de la Timone, Service de Neurooncologie, Marseille, France.

Aix-Marseille Université, Inserm, CRO2 UMR_S 911, Marseille, France.

出版信息

Acta Neuropathol. 2016 Oct;132(4):625-34. doi: 10.1007/s00401-016-1611-8. Epub 2016 Aug 29.

Abstract

The new WHO classification of diffuse gliomas has been refined and now includes the 1p/19q codeletion, IDH1/2 mutation, and histone H3-K27M mutation. Our objective was to assess the prognostic value of the updated 2016 WHO classification in the French POLA cohort. All cases of high-grade oligodendroglial tumors sent for central pathological review and included into the French nationwide POLA cohort were reclassified according to the updated 4th WHO classification. In total, 1041 patients were included, with a median age at diagnosis of 50.4 years (range 17.1-84.4). Based on the new histomolecular classification, diagnoses included anaplastic oligodendroglioma IDH mutant and 1p/19q-codeleted (32.5 %), anaplastic astrocytoma IDH mutant (IDH (mut)) (11.0 %), anaplastic astrocytoma IDH wild type (IDH (wt)) (5.3 %), glioblastoma IDH (mut) (17.1 %), and glioblastoma IDH (wt) (33.2 %). Ten patients presented with a diffuse midline tumor, H3 K27M mutant. The new WHO classification was prognostic for progression-free survival (PFS) and overall survival (OS) (p < 0.001). We did not find prognosis differences between grades III and IV for IDH (mut) 1p/19q intact and IDH (wt) gliomas in univariate and multivariate analyses. Among anaplastic astrocytoma IDH (wt), cases with chromosome arm 7p gain and 10q loss (55 %) had shorter PFS than the others (p = 0.027). In conclusion, the new WHO histomolecular classification of diffuse gliomas presented with high prognostic value. Grading was not discriminant between grade III and IV high-grade gliomas.

摘要

新的世界卫生组织(WHO)弥漫性神经胶质瘤分类已经得到了完善,现在包括 1p/19q 缺失、IDH1/2 突变和组蛋白 H3-K27M 突变。我们的目的是评估更新的 2016 年 WHO 分类在法国 POLA 队列中的预后价值。所有送交中央病理复查并纳入法国全国性 POLA 队列的高级别少突胶质细胞瘤病例均根据更新的第 4 版 WHO 分类重新分类。共纳入 1041 例患者,中位诊断年龄为 50.4 岁(范围为 17.1-84.4 岁)。根据新的组织分子分类,诊断包括间变性少突胶质细胞瘤 IDH 突变和 1p/19q 缺失(32.5%)、IDH 突变的间变性星形细胞瘤(IDH(mut))(11.0%)、IDH 野生型的间变性星形细胞瘤(IDH(wt))(5.3%)、IDH 突变的胶质母细胞瘤(17.1%)和 IDH 野生型的胶质母细胞瘤(33.2%)。10 例患者表现为弥漫性中线肿瘤,H3 K27M 突变。新的 WHO 分类对无进展生存期(PFS)和总生存期(OS)具有预后意义(p<0.001)。在单变量和多变量分析中,我们未发现 IDH(mut)1p/19q 完整和 IDH(wt)胶质瘤的 III 级和 IV 级之间存在预后差异。在 IDH(wt)间变性星形细胞瘤中,染色体臂 7p 获得和 10q 缺失的病例(55%)比其他病例的 PFS 更短(p=0.027)。总之,新的 WHO 弥漫性神经胶质瘤的组织分子分类具有较高的预后价值。分级在 III 级和 IV 级高级别胶质瘤之间没有区别。

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索