1p/19q 缺失在弥漫性低级别胶质瘤肿瘤预后中的作用。

Role of 1p/19q Codeletion in Diffuse Low-grade Glioma Tumour Prognosis.

机构信息

Department of Human Neurosciences, Division of Neurosurgery, Policlinico Umberto I University Hospital, Sapienza University of Rome, Rome, Italy.

Nuffield Department of Surgical Sciences, University of Oxford, Oxford, U.K.;

出版信息

Anticancer Res. 2023 Jun;43(6):2659-2670. doi: 10.21873/anticanres.16432.

DOI:10.21873/anticanres.16432

PMID:37247932

Abstract

BACKGROUND/AIM: In the latest 2021 WHO classification of central nervous system tumours (CNS), gliomas that present isocitrate dehydrogenase (IDH) mutations are defined as diffuse low-grade gliomas (DLGGs). IDH mutations are commonly observed in this tumour type. The Extent of Resection (EOR) positively influence survival; however, it is still debated whether the predictive value of EOR is independent of the 1p/19q co-deletion. We carried out a retrospective analysis on patients operated on for DLGG at the Sant'Andrea University Hospital Sapienza University of Rome, correlating the outcome with the presence of 1p/19q co-deletion and EOR.

PATIENTS AND METHODS

The study examined 66 patients with DLGG who had undergone surgery for tumour resection between 2008 and 2018. Patients with DLGG were divided into two groups; diffuse astrocytoma (DA) in which 1p/19q codeletion is absent and oligodendroglioma (OG) in which 1p/19q codeletion is present. According to EOR, both groups were divided into two subgroups: subtotal resection (STR) and gross total resection (GTR). Three end-point variables were considered: overall survival (OS), progression-free survival (PFS) and time to malignant transformation (TMT).

RESULTS

In the DA group, the GTR subgroup had an average OS of 81.6 months, an average PFS of 45.9 months and an average TMT of 63.6 months. After surgery, these patients had an average Karnofsky Performance Score (KPS) of 83.4. The STR subgroup had an average OS of 60.4 months, PFS was 38.7 months, and TMT was 46.4 months, post-operative KPS was 83.4. In contrast, in the OG group, the GTR averagely had 101.7 months of OS, 64.9 months of PFS, 80.3 months of TMT and an average post-operative KPS of 84.2, and the STR subgroup had an average of OS of 73.3 months, PFS of 48.2 months, TMT of 57.3 and an average postoperative KPS of 96.2.

CONCLUSION

In patients affected by DLGGs, 1p/19q codeletion is significantly associated with prolonged survival and longer time-to-malignant transformation (TMT) compared to the absence of 1p/19q codeletion. Also, the extent of surgical resection (EOR) in DLGG patients has been confirmed as one of the main prognostic factors. However, its predictive value is substantially influenced by the presence of the 1p/19q codeletion.

摘要

背景/目的：在最新的 2021 年世界卫生组织中枢神经系统肿瘤分类中（CNS），存在异柠檬酸脱氢酶（IDH）突变的神经胶质瘤被定义为弥漫性低级别神经胶质瘤（DLGGs）。这种肿瘤类型中通常存在 IDH 突变。切除范围（EOR）对生存有积极影响；然而，EOR 的预测价值是否独立于 1p/19q 共缺失仍存在争议。我们对在罗马圣安德烈亚大学医院接受 DLGG 手术的患者进行了回顾性分析，将结果与 1p/19q 共缺失和 EOR 的存在相关联。

患者和方法

该研究检查了 66 名在 2008 年至 2018 年间接受肿瘤切除术的 DLGG 患者。DLGG 患者分为两组；弥漫性星形细胞瘤（DA），其中不存在 1p/19q 共缺失，和少突胶质细胞瘤（OG），其中存在 1p/19q 共缺失。根据 EOR，两组又分为两组：次全切除（STR）和大体全切除（GTR）。考虑了三个终点变量：总生存（OS）、无进展生存（PFS）和恶性转化时间（TMT）。

结果

在 DA 组中，GTR 亚组的平均 OS 为 81.6 个月，平均 PFS 为 45.9 个月，平均 TMT 为 63.6 个月。手术后，这些患者的平均卡诺夫斯基表现评分（KPS）为 83.4。STR 亚组的平均 OS 为 60.4 个月，PFS 为 38.7 个月，TMT 为 46.4 个月，术后 KPS 为 83.4。相比之下，在 OG 组中，GTR 组的平均 OS 为 101.7 个月，PFS 为 64.9 个月，TMT 为 80.3 个月，术后 KPS 平均为 84.2，STR 亚组的平均 OS 为 73.3 个月，PFS 为 48.2 个月，TMT 为 57.3 个月，术后 KPS 平均为 96.2。