Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China.
Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China.
World Neurosurg. 2021 Mar;147:42-46. doi: 10.1016/j.wneu.2020.12.029. Epub 2020 Dec 13.
Newly emerged molecular markers in gliomas provide prognostic values beyond the capabilities of histologic classification. BRAF mutation, especially BRAF V600E, is common in a subset of gliomas and may represent a potential prognostic marker. The aim of our study is to investigate the potential use of BRAF mutations on the prognosis of low-grade glioma patients.
Four electronic databases were searched for potential articles including PubMed, Web of Science, Embase, and Cochrane. Data of hazard ratio (HR) for overall survival and progression-free survival were directly obtained from original papers or indirectly estimated from the Kaplan-Meier curve. A random effect model weighted by inverse variance method was used to calculate the pooled HR. From 483 articles, we finally included 8 articles with 698 glioma patients for the final analysis. The overall estimates showed that BRAF V600E was associated with an improved overall survival in glioma patients (HR = 0.64; 95% confidence interval = 0.45-0.92).
Results for progression-free survival, however, were not statistically significant (HR = 0.97; 95% confidence interval = 0.7-1.36). In subgroup analyses, BRAF V600E showed its effect in improving survival in pediatric patients but did not have prognostic value in adult. Our meta-analysis provides evidence that BRAF mutation has a favorable prognostic impact in low-grade gliomas, and its prognostic value might be dependent on patient age.
This mutation can be used as a prognostic factor in low-grade glioma, but additional studies are required to clarify its prognostic value taking into account other confounding factors.
新出现的神经胶质瘤分子标志物在组织学分类能力之外提供了预后价值。BRAF 突变，特别是 BRAF V600E，在一部分神经胶质瘤中很常见，可能代表一种潜在的预后标志物。我们的研究旨在探讨 BRAF 突变对低级别神经胶质瘤患者预后的潜在应用。
通过 PubMed、Web of Science、Embase 和 Cochrane 四个电子数据库搜索可能的文章。直接从原始论文中获取总生存和无进展生存的风险比（HR）数据，或间接从 Kaplan-Meier 曲线中估计。采用逆方差法加权的随机效应模型计算汇总 HR。从 483 篇文章中，我们最终纳入了 8 篇文章，共 698 例神经胶质瘤患者进行最终分析。总体估计表明，BRAF V600E 与神经胶质瘤患者的总体生存改善相关（HR=0.64；95%置信区间=0.45-0.92）。
然而，无进展生存的结果没有统计学意义（HR=0.97；95%置信区间=0.7-1.36）。在亚组分析中，BRAF V600E 显示在改善儿科患者的生存方面有效果，但在成人中没有预后价值。我们的荟萃分析提供了证据表明，BRAF 突变对低级别神经胶质瘤有有利的预后影响，其预后价值可能取决于患者年龄。
该突变可作为低级别神经胶质瘤的预后因素，但需要进一步研究以阐明其预后价值，同时考虑其他混杂因素。
