Cetin Bulent, Gonul Ipek Isık, Gumusay Ozge, Bilgetekin Irem, Algin Efnan, Ozet Ahmet, Uner Aytug
Department of Internal Medicine, Division of Medical Oncology, Recep Tayyip Erdogan University Faculty of Medicine, Rize, Turkey.
Department of Pathology, Gazi University Faculty of Medicine, Ankara, Turkey.
Neuropathology. 2018 Oct;38(5):457-462. doi: 10.1111/neup.12485. Epub 2018 Jun 28.
The identification of prognostic factors in patients with glioblastoma multiforme (GBM) represents an area of increasing interest. Carbonic anhydrase IX (CA-IX), a hypoxia marker, correlates with tumor progression in a variety of human cancers. However, the role of CA-IX in GBM remains largely unknown. In the present study, we evaluated the prognostic role of CA-IX in GBM patients. In total, 66 consecutive patients with GBM who received concomitant chemoradiotherapy and adjuvant chemotherapy with temozolomide were retrospectively reviewed, and all patients received temozolomide chemotherapy for at least 3 months. Kaplan-Meier curves and log-rank tests were used for analysis of progression-free survival (PFS) and overall survival (OS), and a multivariate Cox proportional hazard model was employed to identify factors with an independent effect on survival. The median OS was longer in patients with low levels of CA-IX expression (18 months) compared to patients overexpressing CA-IX (9 months) (P = 0.004). There was not a statistically significant difference in median PFS (3.5 vs. 8 months, P = 0.054) between patients with high or low levels of CA-IX expression. In multivariate analysis, the variables that were identified as significant prognostic factors for OS were preoperative Karnofsky performance scale score (KPS) (hazard ratio (HR), 3.703; P = 0.001), CA-IX overexpression (HR, 1.967; P = 0.019), and incomplete adjuvant temozolomide treatment (HR, 2.241; P = 0.003) and gross-total resection (HR, 1.956; P = 0.034). Our findings indicated that CA-IX may be a potential prognostic biomarker in the treatment of GBM.
多形性胶质母细胞瘤（GBM）患者预后因素的识别是一个日益受到关注的领域。碳酸酐酶IX（CA-IX）作为一种缺氧标志物，与多种人类癌症的肿瘤进展相关。然而，CA-IX在GBM中的作用仍 largely未知。在本研究中，我们评估了CA-IX在GBM患者中的预后作用。总共回顾性分析了66例连续接受同步放化疗和替莫唑胺辅助化疗的GBM患者，所有患者均接受了至少3个月的替莫唑胺化疗。采用Kaplan-Meier曲线和对数秩检验分析无进展生存期（PFS）和总生存期（OS），并使用多变量Cox比例风险模型识别对生存有独立影响的因素。与CA-IX过表达的患者（9个月）相比，CA-IX表达水平低的患者中位OS更长（18个月）（P = 0.004）。CA-IX表达水平高或低的患者之间中位PFS无统计学显著差异（3.5个月对8个月，P = 0.054）。在多变量分析中，被确定为OS显著预后因素的变量包括术前卡诺夫斯基功能状态评分（KPS）（风险比（HR），3.703；P = 0.001）、CA-IX过表达（HR，1.967；P = 0.019）、辅助替莫唑胺治疗不完全（HR，2.241；P = 0.003）和全切除（HR，1.956；P = 0.034）。我们的研究结果表明，CA-IX可能是GBM治疗中的一种潜在预后生物标志物。
