Mu Luyan, Xu Wanzhen, Li Qingla, Ge Haitao, Bao Hongbo, Xia Songsong, Ji Jingjing, Jiang Jie, Song Yuwen, Gao Qiang
Department of Neurosurgery, the Fourth Affiliated Hospital, Harbin Medical University, Harbin, China.
Department of Neurosurgery, the First Affiliated Hospital, Harbin Medical University, Harbin, China.
J Cancer. 2017 Aug 22;8(14):2704-2712. doi: 10.7150/jca.20665. eCollection 2017.
IDH1 R132H mutation is an important marker of survival in patients with gliomas. Although there are many changes of genes in tumour malignant progression, IDH1 R132H mutation status in glioma progression remained unclear. Here, an in-depth characterization of IDH1 R132H mutations were assessed by immunohistochemistry in 55 paired primary-recurrent astrocytomas tissues, including 5 paired primary pilocytic astrocytoma (pPA, WHO grade I), 35 paired primary low grade astrocytoma (pLGA, WHO grade II and III) and 15 paired primary high grade astrocytoma (pHGA/ Glioblastoma, WHO grade IV). Meanwhile, the DNA was isolated from paired samples, and PCR amplification was used for IDH1 exon4 sequencing. Nonparametric test, KM and Cox models were used to examine the statistical difference and survival function. We found that the percent of IDH1 R132H mutation was 68.6% (24/35) in pLGA group, but no IDH1 mutation was found in pPA and pHGA groups. Meanwhile, the results from immunohistochemistry and DNA sequencing showed that, compared with primary astrocytoma, there was no change of IDH1 status in recurrent astrocytoma whatever tumour pathological grade raise or indolent. The pPA group has the longest recurrence-free period (RFP) and overall survival (OS) in three groups (), while the pHGA group has the shortest ones (). In pLGA group, the IDH1 R132H mutation subgroup has longer RFP than IDH1 wild type subgroup (), but the OS has no statistical difference between two subgroups (). Additionally, IDH1 R132H mutation independently predicted a long RFP in patients with pLGA (HR 1.073, 95% CI 0.151-0.775, ).
异柠檬酸脱氢酶1(IDH1)R132H突变是胶质瘤患者生存的重要标志物。尽管肿瘤恶性进展过程中有许多基因变化,但IDH1 R132H突变状态在胶质瘤进展中的情况仍不清楚。在此,通过免疫组织化学对55对原发性-复发性星形细胞瘤组织中的IDH1 R132H突变进行了深入表征,包括5对原发性毛细胞型星形细胞瘤(pPA,世界卫生组织一级)、35对原发性低级别星形细胞瘤(pLGA,世界卫生组织二级和三级)和15对原发性高级别星形细胞瘤(pHGA/胶质母细胞瘤,世界卫生组织四级)。同时,从配对样本中提取DNA,并使用聚合酶链反应(PCR)扩增进行IDH1第4外显子测序。采用非参数检验、卡普兰-迈耶(KM)法和考克斯(Cox)模型来检验统计学差异和生存函数。我们发现,pLGA组中IDH1 R132H突变率为68.6%(24/35),但pPA组和pHGA组未发现IDH1突变。同时,免疫组织化学和DNA测序结果显示,与原发性星形细胞瘤相比,复发性星形细胞瘤无论肿瘤病理分级升高还是进展缓慢,IDH1状态均无变化。pPA组在三组中无进展生存期(RFP)和总生存期(OS)最长(),而pHGA组最短()。在pLGA组中,IDH1 R132H突变亚组的RFP长于IDH1野生型亚组(),但两个亚组的OS无统计学差异()。此外,IDH1 R132H突变独立预测pLGA患者有较长的RFP(风险比1.073,95%置信区间0.151 - 0.775,)。