胰岛素样生长因子结合蛋白2(IGFBP2)的表达可预测异柠檬酸脱氢酶(IDH)突变型胶质瘤患者的生存期。

IGFBP2 expression predicts IDH-mutant glioma patient survival.

作者信息

Huang Lin Eric, Cohen Adam L, Colman Howard, Jensen Randy L, Fults Daniel W, Couldwell William T

机构信息

Department of Neurosurgery, Clinical Neurosciences Center, Salt Lake City, Utah, USA.

Department of Oncological Sciences, Huntsman Cancer Institute, Salt Lake City, Utah, USA.

出版信息

Oncotarget. 2017 Jan 3;8(1):191-202. doi: 10.18632/oncotarget.13329.

Abstract

Mutations of the isocitrate dehydrogenase (IDH) 1 and 2 genes occur in ~80% of lower-grade (WHO grade II and grade III) gliomas. Mutant IDH produces (R)-2-hydroxyglutarate, which induces DNA hypermethylation and presumably drives tumorigenesis. Interestingly, IDH mutations are associated with improved survival in glioma patients, but the underlying mechanism for the difference in survival remains unclear. Through comparative analyses of 286 cases of IDH-wildtype and IDH-mutant lower-grade glioma from a TCGA data set, we report that IDH-mutant gliomas have increased expression of tumor-suppressor genes (NF1, PTEN, and PIK3R1) and decreased expression of oncogenes(AKT2, ARAF, ERBB2, FGFR3, and PDGFRB) and glioma progression genes (FOXM1, IGFBP2, and WWTR1) compared with IDH-wildtype gliomas. Furthermore, each of these genes is prognostic in overall gliomas; however, within the IDH-mutant group, none remains prognostic except IGFBP2 (encodinginsulin-like growth factor binding protein 2). Through validation in an independent cohort, we show that patients with low IGFBP2 expressiondisplay a clear advantage in overall and disease-free survival, whereas those with high IGFBP2 expressionhave worse median survival than IDH-wildtype patients. These observations hold true across different histological and molecular subtypes of lower-grade glioma. We propose therefore that an unexpected biological consequence of IDH mutations in glioma is to ameliorate patient survival by promoting tumor-suppressor signaling while inhibiting that of oncogenes, particularly IGFBP2.

摘要

异柠檬酸脱氢酶(IDH)1和2基因的突变发生在约80%的低级别(世界卫生组织II级和III级)胶质瘤中。突变型IDH产生(R)-2-羟基戊二酸,其诱导DNA高甲基化并可能驱动肿瘤发生。有趣的是,IDH突变与胶质瘤患者生存期的改善相关,但生存差异的潜在机制仍不清楚。通过对来自TCGA数据集的286例IDH野生型和IDH突变型低级别胶质瘤病例进行比较分析,我们报告与IDH野生型胶质瘤相比,IDH突变型胶质瘤中肿瘤抑制基因(NF1、PTEN和PIK3R1)的表达增加,癌基因(AKT2、ARAF、ERBB2、FGFR3和PDGFRB)以及胶质瘤进展基因(FOXM1、IGFBP2和WWTR1)的表达降低。此外,这些基因中的每一个在总体胶质瘤中都具有预后价值;然而,在IDH突变组中,除了IGFBP2(编码胰岛素样生长因子结合蛋白2)外,没有一个基因仍然具有预后价值。通过在一个独立队列中进行验证,我们发现IGFBP2表达低的患者在总生存期和无病生存期方面具有明显优势,而IGFBP2表达高的患者的中位生存期比IDH野生型患者更差。这些观察结果在低级别胶质瘤的不同组织学和分子亚型中均成立。因此,我们提出,胶质瘤中IDH突变的一个意外生物学后果是通过促进肿瘤抑制信号传导同时抑制癌基因信号传导,特别是IGFBP2信号传导,来改善患者生存。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a4f5/5352106/7d7702e0974b/oncotarget-08-191-g001.jpg

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