性别和O6-甲基鸟嘌呤-DNA甲基转移酶甲基化状态在胶质母细胞瘤患者中的预后作用：女性力量
The Prognostic Roles of Gender and O6-Methylguanine-DNA Methyltransferase Methylation Status in Glioblastoma Patients: The Female Power.
作者信息
Franceschi Enrico, Tosoni Alicia, Minichillo Santino, Depenni Roberta, Paccapelo Alexandro, Bartolini Stefania, Michiara Maria, Pavesi Giacomo, Urbini Benedetta, Crisi Girolamo, Cavallo Michele A, Tosatto Luigino, Dazzi Claudio, Biasini Claudia, Pasini Giuseppe, Balestrini Damiano, Zanelli Francesca, Ramponi Vania, Fioravanti Antonio, Giombelli Ermanno, De Biase Dario, Baruzzi Agostino, Brandes Alba A
机构信息
Department of Medical Oncology, Bellaria Hospital, Azienda USL-IRCCS Institute of Neurological Sciences, Bologna, Italy.
Department of Oncology, Hematology, and Respiratory Diseases, University Hospital of Modena, Modena, Italy.
出版信息
World Neurosurg. 2018 Apr;112:e342-e347. doi: 10.1016/j.wneu.2018.01.045. Epub 2018 Jan 11.
BACKGROUND
Clinical and molecular factors are essential to define the prognosis in patients with glioblastoma (GBM). O6-methylguanine-DNA methyltransferase (MGMT) methylation status, age, Karnofsky Performance Status (KPS), and extent of surgical resection are the most relevant prognostic factors. Our investigation of the role of gender in predicting prognosis shows a slight survival advantage for female patients.
METHODS
We performed a prospective evaluation of the Project of Emilia Romagna on Neuro-Oncology (PERNO) registry to identify prognostic factors in patients with GBM who received standard treatment.
RESULTS
A total of 169 patients (99 males [58.6%] and 70 females [41.4%]) were evaluated prospectively. MGMT methylation was evaluable in 140 patients. Among the male patients, 36 were MGMT methylated (25.7%) and 47 were unmethylated (33.6%); among the female patients, 32 were methylated (22.9%) and 25 were unmethylated (17.9%). Survival was longer in the methylated females compared with the methylated males (P = 0.028) but was not significantly different between the unmethylated females and the unmethylated males (P = 0.395). In multivariate analysis, gender and MGMT methylation status considered together (methylated females vs. methylated males; hazard ratio [HR], 0.459; 95% confidence interval [CI], 0.242-0.827; P = 0.017), age (HR, 1.025; 95% CI, 1.002-1.049; P = 0.032), and KPS (HR, 0.965; 95% CI, 0.948-0.982; P < 0.001) were significantly correlated with survival.
CONCLUSIONS
Survival was consistently longer among MGMT methylated females compared with males. Gender can be considered as a further prognostic factor.
背景
临床和分子因素对于确定胶质母细胞瘤（GBM）患者的预后至关重要。O6-甲基鸟嘌呤-DNA甲基转移酶（MGMT）甲基化状态、年龄、卡诺夫斯基功能状态（KPS）以及手术切除范围是最相关的预后因素。我们对性别在预测预后中作用的调查显示女性患者有轻微的生存优势。
方法
我们对艾米利亚-罗马涅神经肿瘤项目（PERNO）登记处进行了前瞻性评估，以确定接受标准治疗的GBM患者的预后因素。
结果
总共对169例患者（99例男性[58.6%]和70例女性[41.4%]）进行了前瞻性评估。140例患者的MGMT甲基化情况可评估。在男性患者中，36例MGMT甲基化（25.7%），47例未甲基化（33.6%）；在女性患者中，32例甲基化（22.9%），25例未甲基化（17.9%）。甲基化的女性患者生存期比甲基化的男性患者长（P = 0.028），但未甲基化的女性患者和未甲基化的男性患者之间无显著差异（P = 0.395）。在多变量分析中，性别和MGMT甲基化状态综合考虑（甲基化女性与甲基化男性；风险比[HR]，0.459；95%置信区间[CI]，0.242 - 0.827；P = 0.017）、年龄（HR，1.025；95% CI，1.002 - 1.049；P = 0.032）和KPS（HR，0.965；95% CI，0.948 - 0.982；P < 0.001）与生存期显著相关。
结论
MGMT甲基化的女性患者生存期始终比男性患者长。性别可被视为一个进一步的预后因素。
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