Clinical Service of Pathology, Departments of Pathology, Sfantul Apostol Andrei Emergency County Hospital, 900591 Constanta, Romania.
Faculty of Medicine, "Ovidius" University of Constanta, 900470 Constanta, Romania.
Curr Oncol. 2022 Sep 30;29(10):7327-7342. doi: 10.3390/curroncol29100576.
Adult low-grade gliomas are a rare and aggressive pathology of the central nervous system. Some of their characteristics contribute to the patient's life expectancy and to their management. This study aimed to characterize and identify the main prognostic factors of low-grade gliomas. The six-year retrospective study statistically analyzed the demographic, imaging, and morphogenetic characteristics of the patient group through appropriate parameters. Immunohistochemical tests were performed: IDH1, Ki-67, p53, and Nestin, as well as FISH tests on the CDKN2A gene and 1p/19q codeletion. The pathology was prevalent in females, with patients having an average age of 56.31 years. The average tumor volume was 41.61 cm, producing a midline shift with an average of 7.5 mm. Its displacement had a negative impact on survival. The presence of a residual tumor resulted in decreased survival and is an independent risk factor for mortality. Positivity for p53 identified a low survival rate. CDKN2A mutations were an independent risk factor for mortality. We identified that a negative prognosis is influenced by the association of epilepsy with headache, tumor volume, and immunoreactivity to IDH1 and p53. Independent factors associated with mortality were midline shift, presence of tumor residue, and CDKN2A gene deletions and amplifications.
成人低级别胶质瘤是一种罕见且侵袭性的中枢神经系统病理学。其某些特征会影响患者的预期寿命和治疗方式。本研究旨在对低级别胶质瘤的特征和主要预后因素进行分析。这项为期六年的回顾性研究通过适当的参数对患者群体的人口统计学、影像学和形态发生特征进行了统计分析。进行了免疫组织化学测试:IDH1、Ki-67、p53 和 Nestin,以及 CDKN2A 基因和 1p/19q 缺失的 FISH 测试。该病理学在女性中更为普遍,患者的平均年龄为 56.31 岁。平均肿瘤体积为 41.61cm,导致中线移位,平均为 7.5mm。其移位对生存有负面影响。肿瘤残留会降低生存率,是死亡的独立危险因素。p53 阳性表明生存率较低。CDKN2A 突变是死亡的独立危险因素。我们发现,预后不良与癫痫与头痛、肿瘤体积以及 IDH1 和 p53 的免疫反应性有关。与死亡率相关的独立因素包括中线移位、肿瘤残留以及 CDKN2A 基因缺失和扩增。