Department of Molecular Pathology, Beijing Neurosurgical Institute, Capital Medical University, Beijing 100070, China.
Department of Neuropathology, Beijing Neurosurgical Institute, Capital Medical University, Beijing 100070, China.
Cancer Biol Med. 2022 Nov 1;19(10):1460-76. doi: 10.20892/j.issn.2095-3941.2022.0469.
We aimed to summarize the clinicopathological characteristics and prognostic features of various molecular subtypes of diffuse gliomas (DGs) in the Chinese population.
In total, 1,418 patients diagnosed with DG between 2011 and 2017 were classified into 5 molecular subtypes according to the 2016 WHO classification of central nervous system tumors. The IDH mutation status was determined by immunohistochemistry and/or DNA sequencing, and 1p/19q codeletion was detected with fluorescence in situ hybridization. The median clinical follow-up time was 1,076 days. T-tests and chi-square tests were used to compare clinicopathological characteristics. Kaplan-Meier and Cox regression methods were used to evaluate prognostic factors.
Our cohort included 15.5% lower-grade gliomas, IDH-mutant and 1p/19q-codeleted (LGG-IDHm-1p/19q); 18.1% lower-grade gliomas, IDH-mutant (LGG-IDHm); 13.1% lower-grade gliomas, IDH-wildtype (LGG-IDHwt); 36.1% glioblastoma, IDH-wildtype (GBM-IDHwt); and 17.2% glioblastoma, IDH-mutant (GBM-IDHm). Approximately 63.3% of the enrolled primary gliomas, and the median overall survival times for LGG-IDHm, LGG-IDHwt, GBM-IDHwt, and GBM-IDHm subtypes were 75.97, 34.47, 11.57, and 15.17 months, respectively. The 5-year survival rate of LGG-IDHm-1p/19q was 76.54%. We observed a significant association between high resection rate and favorable survival outcomes across all subtypes of primary tumors. We also observed a significant role of chemotherapy in prolonging overall survival for GBM-IDHwt and GBM-IDHm, and in prolonging post-relapse survival for the 2 recurrent GBM subtypes.
By controlling for molecular subtypes, we found that resection rate and chemotherapy were 2 prognostic factors associated with survival outcomes in a Chinese cohort with DG.
总结中国人群中各种弥漫性神经胶质瘤（DG）分子亚型的临床病理特征和预后特征。
共纳入 2011 年至 2017 年间诊断为 DG 的 1418 例患者，根据 2016 年中枢神经系统肿瘤世界卫生组织分类标准分为 5 个分子亚型。通过免疫组织化学和/或 DNA 测序确定 IDH 突变状态，荧光原位杂交检测 1p/19q 缺失。中位临床随访时间为 1076 天。采用 t 检验和卡方检验比较临床病理特征。采用 Kaplan-Meier 和 Cox 回归方法评估预后因素。
本队列包括 15.5%的低级别胶质瘤，IDH 突变型和 1p/19q 缺失型（LGG-IDHm-1p/19q）；18.1%的低级别胶质瘤，IDH 突变型（LGG-IDHm）；13.1%的低级别胶质瘤，IDH 野生型（LGG-IDHwt）；36.1%的胶质母细胞瘤，IDH 野生型（GBM-IDHwt）；17.2%的胶质母细胞瘤，IDH 突变型（GBM-IDHm）。入组的原发性胶质瘤中约有 63.3%为 LGG-IDHm、LGG-IDHwt、GBM-IDHwt 和 GBM-IDHm 亚型，中位总生存时间分别为 75.97、34.47、11.57 和 15.17 个月。LGG-IDHm-1p/19q 的 5 年生存率为 76.54%。我们观察到在所有原发性肿瘤亚型中，高切除率与良好的生存结局之间存在显著关联。我们还观察到化疗在延长 GBM-IDHwt 和 GBM-IDHm 总生存时间以及延长两种复发性 GBM 亚型的复发后生存时间方面具有显著作用。
通过控制分子亚型，我们发现切除率和化疗是与中国 DG 患者生存结局相关的 2 个预后因素。
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