Zreik Jad, Kerezoudis Panagiotis, Alvi Mohammed Ali, Yolcu Yagiz U, Kizilbash Sani H
College of Medicine, Central Michigan University, Mount Pleasant, MI, United States.
Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, United States.
Front Oncol. 2021 Nov 9;11:746844. doi: 10.3389/fonc.2021.746844. eCollection 2021.
A chromosomal 1p/19q codeletion was included as a required diagnostic component of oligodendrogliomas in the 2016 World Health Organization (WHO) classification of central nervous system tumors. We sought to evaluate disparities in reported testing for 1p/19q codeletion among oligodendroglioma and oligoastrocytoma patients before and after the guidelines.
The National Cancer Database (NCDB) was queried for patients with histologically-confirmed WHO grade II/III oligodendroglioma or oligoastrocytoma from 2011-2017. Adjusted odds of having a reported 1p/19q codeletion test for patient- and hospital-level factors were calculated before (2011-2015) and after (2017) the guidelines. The adjusted likelihood of receiving adjuvant treatment (chemotherapy and/or radiotherapy) based on reported testing was also evaluated.
Overall, 6,404 patients were identified. The reported 1p/19q codeletion testing rate increased from 45.8% in 2011 to 59.8% in 2017. From 2011-2015, lack of insurance (OR 0.77; 95% CI 0.62-0.97;p=0.025), lower zip code-level educational attainment (OR 0.62; 95% CI 0.49-0.78;p<0.001), and Northeast (OR 0.68; 95% CI 0.57-0.82;p<0.001) or Southern (OR 0.62; 95% CI 0.49-0.79;p<0.001) facility geographic region were negatively associated with reported testing. In 2017, Black race (OR 0.49; 95% CI 0.26-0.91;p=0.024) and Northeast (OR 0.50; 95% CI 0.30-0.84;p=0.009) or Southern (OR 0.42; 95% CI 0.22-0.78;p=0.007) region were negatively associated with reported testing. Patients with a reported test were more likely to receive adjuvant treatment (OR 1.73; 95% CI 1.46-2.04;p<0.001).
Despite the 2016 WHO guidelines, disparities in reported 1p/19q codeletion testing by geographic region persisted while new disparities in race/ethnicity were identified, which may influence oligodendroglioma and oligoastrocytoma patient management.
在2016年世界卫生组织（WHO）中枢神经系统肿瘤分类中，染色体1p/19q共缺失被列为少突胶质细胞瘤的一项必要诊断指标。我们旨在评估在该指南发布前后，少突胶质细胞瘤和少突星形细胞瘤患者中报告的1p/19q共缺失检测情况的差异。
查询国家癌症数据库（NCDB）中2011 - 2017年组织学确诊的WHO二级/三级少突胶质细胞瘤或少突星形细胞瘤患者。计算在指南发布前（2011 - 2015年）和发布后（2017年），针对患者和医院层面因素报告进行1p/19q共缺失检测的校正比值比。还评估了基于报告检测接受辅助治疗（化疗和/或放疗）的校正可能性。
总体而言，共识别出6404例患者。报告的1p/19q共缺失检测率从2011年的45.8%增至2017年的59.8%。在2011 - 2015年，未参保（比值比0.77；95%置信区间0.62 - 0.97；p = 0.025）、邮政编码区域教育程度较低（比值比0.62；95%置信区间0.49 - 0.78；p < 0.001）以及东北部（比值比0.68；95%置信区间0.57 - 0.82；p < 0.001）或南部（比值比0.62；95%置信区间0.49 - 0.79；p < 0.001）地区的医疗机构与报告检测呈负相关。在2017年，黑人种族（比值比0.49；95%置信区间0.26 - 0.91；p = 0.024）以及东北部（比值比0.50；95%置信区间0.30 - 0.84；p = 0.009）或南部（比值比0.42；95%置信区间0.22 - 0.78；p = 0.007）地区与报告检测呈负相关。报告进行检测的患者更有可能接受辅助治疗（比值比1.73；95%置信区间1.46 - 2.
