Adana City Education and Research Hospital, Department of Neurosurgery, Adana, Turkey.
Turk Neurosurg. 2021;31(4):641-653. doi: 10.5137/1019-5149.JTN.33332-20.3.
An increasing number of biomarkers of primary glioblastoma (GBM) have recently been described. We aimed to investigate the biological and clinical factors that affect survival in Turkish patients with primary GBM.
The clinical and demographic data of all patients with primary GBM diagnosed between 2007 and 2016 were evaluated. In all the patients? pathological specimens, O6 methylguanine-DNA methyltransferase (MGMT) methylation and isocitrate dehydrogenase (IDH) 1 mutation were detected retrospectively by immunohistochemistry. Kaplan-Meier survival analysis, log-rank test, and multivariate analyses of the Cox hazard proportional model for all the variables were performed using the SPSS statistical package. The treatment details and other patient-related factors were identified, and their correlations were analyzed.
We enrolled 137 primary GBM patients to the study. Median progression free survival (PFS) was 8.57 months (95% CI:6.8-9.5) and median overall survival (OS) was 12 months (95% CI:10.8-13.3). IDH-1 mutations were detected in 21 primary GBMs (15.3%). PFS was 15.43 ± 1.95 months. Survival rates were higher, but no statistically significant difference (p=0.074). MGMT methylation was detected in 40 primary GBMs (29.2%). OS and PFS of MGMT (+) cases were higher than MGMT(-) cases (p=0.001; p=0.001 respectively). Ki67 (%) measurement (10%-90%) average is 32.64 ± 16.56. No statistically significant between higher and lower ki67 levels (p=0.510, p=0.505 respectively). KPS (%) more than 70 at the time of diagnosis statistically significant longer median OS and PFS (p=0.001). PFS and OS were higher in all treatment modalities.
The most important factors that affected survival were performance score, MGMT methylation status, systemic oncologic therapy, and IDH mutation in the Turkish population with primary GBM. We demonstrated that MGMT methylation and higher KPS levels were associated with significiantly longer OS and PFS.
最近描述了越来越多的原发性脑胶质瘤（GBM）的生物标志物。我们旨在研究影响土耳其原发性 GBM 患者生存的生物学和临床因素。
评估了 2007 年至 2016 年间诊断为原发性 GBM 的所有患者的临床和人口统计学数据。通过免疫组织化学法，回顾性检测所有患者病理标本中的 O6 甲基鸟嘌呤-DNA 甲基转移酶（MGMT）甲基化和异柠檬酸脱氢酶 1 突变。使用 SPSS 统计软件包对所有变量进行 Kaplan-Meier 生存分析、对数秩检验和 Cox 风险比例模型的多变量分析。确定了治疗细节和其他与患者相关的因素，并分析了它们之间的相关性。
我们共纳入了 137 名原发性 GBM 患者。中位无进展生存期（PFS）为 8.57 个月（95%CI：6.8-9.5），中位总生存期（OS）为 12 个月（95%CI：10.8-13.3）。在 21 例原发性 GBM 中检测到 IDH-1 突变（15.3%）。PFS 为 15.43 ± 1.95 个月。生存率更高，但无统计学差异（p=0.074）。在 40 例原发性 GBM 中检测到 MGMT 甲基化（29.2%）。MGMT（+）病例的 OS 和 PFS 均高于 MGMT（-）病例（p=0.001;p=0.001）。Ki67（%）测量值（10%-90%）平均值为 32.64 ± 16.56。Ki67 水平较高和较低之间无统计学差异（p=0.510;p=0.505）。诊断时 KPS（%）大于 70 与中位 OS 和 PFS 显著延长相关（p=0.001）。所有治疗方式的 PFS 和 OS 均较高。
在土耳其原发性 GBM 患者中，影响生存的最重要因素是表现评分、MGMT 甲基化状态、全身肿瘤治疗和 IDH 突变。我们证明 MGMT 甲基化和较高的 KPS 水平与 OS 和 PFS 显著延长相关。
