Department of Molecular Neuropathology, Beijing Neurosurgical Institute, Capital Medical University, Beijing, PR China.
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, PR China.
J Pathol. 2020 Jul;251(3):272-283. doi: 10.1002/path.5468. Epub 2020 Jun 15.
Isocitrate dehydrogenase (IDH) wild-type diffuse lower-grade glioma (LGG) is usually associated with poor outcome, but there have been disputes over its clinical outcome and classification. We present here a robust gene expression-based molecular classification of IDH wild-type diffuse LGG into two subtypes with distinct biological and clinical features. A discovery cohort of 49 IDH wild-type diffuse LGGs from the Chinese Glioma Genome Atlas (CGGA) was subjected to clustering and function analysis. Seventy-three tumors from The Cancer Genome Atlas (TCGA) were used to validate our findings. Consensus clustering of transcriptional data uncovered concordant classification of two robust and prognostically significant subtypes of IDH wild-type LGG. Subtype 1, associated with poorer outcomes, was characterized by significantly higher immune and cytolytic scores, M2 macrophages, and up-regulation of immune exhaustion markers, while Subtype 2, which had elevated lymphocytes and plasma cells, showed relatively favorable survival. Somatic alteration analysis revealed that Subtype 1 showed more frequently deleted regions, such as the locus of CDKN2A/CDKN2B, DMRTA1, C9orf53, and MTAP. Furthermore, we developed and validated a five-gene signature for better application of this acquired stratification. Our data demonstrate the biological and prognostic heterogeneity within IDH wild-type diffuse LGGs and deepen our molecular understandi-g of this tumor entity. © 2020 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.
异柠檬酸脱氢酶(IDH)野生型弥漫性低级别胶质瘤(LGG)通常与不良预后相关,但在其临床预后和分类方面存在争议。我们在此介绍了一种基于基因表达的 IDH 野生型弥漫性 LGG 的稳健分子分类方法,将其分为具有明显生物学和临床特征的两种亚型。中国胶质瘤基因组图谱(CGGA)的 49 例 IDH 野生型弥漫性 LGG 发现队列进行了聚类和功能分析。TCGA 的 73 例肿瘤用于验证我们的发现。转录数据的一致性聚类揭示了 IDH 野生型 LGG 两种稳健且具有预后意义的亚型的一致分类。与较差预后相关的 1 型特征是免疫和细胞毒性评分、M2 巨噬细胞显著升高,以及免疫耗竭标志物上调,而 2 型特征是淋巴细胞和浆细胞升高,生存相对较好。体细胞改变分析显示,1 型显示出更频繁的缺失区域,如 CDKN2A/CDKN2B、DMRTA1、C9orf53 和 MTAP 基因座。此外,我们开发并验证了一个五基因签名,以更好地应用这种获得的分层。我们的数据表明 IDH 野生型弥漫性 LGG 内存在生物学和预后异质性,并加深了我们对这种肿瘤实体的分子认识。©2020 英国和爱尔兰病理学学会。由 John Wiley & Sons, Ltd. 出版。
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