Wang Yaning, Li Junlin, Cao Yaning, Chen Wenlin, Xing Hao, Guo Xiaopeng, Shi Yixin, Wang Yuekun, Liang Tingyu, Ye Liguo, Liu Delin, Yang Tianrui, Wang Yu, Ma Wenbin
Department of Neurosurgery, Center for Malignant Brain Tumors, National Glioma MDT Alliance, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Eight-Year Medical Doctor Program, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Front Neurosci. 2023 Jun 9;17:1165823. doi: 10.3389/fnins.2023.1165823. eCollection 2023.
Elderly glioblastoma (GBM) patients is characterized by high incidence and poor prognosis. Currently, however, there is still a lack of adequate molecular characterization of elderly GBM patients. The fifth edition of the WHO Classification of Central Nervous System Tumors (WHO5) gives a new classification approach for GBM, and the molecular characteristics of elderly GBM patients need to be investigated under this new framework.
The clinical and radiological features of patients with different classifications and different ages were compared. Potential prognostic molecular markers in elderly GBM patients under the WHO5 classification were found using Univariate Cox regression and Kaplan-Meier survival analysis.
A total of 226 patients were included in the study. The prognostic differences between younger and elderly GBM patients were more pronounced under the WHO5 classification. Neurological impairment was more common in elderly patients ( = 0.001), while intracranial hypertension ( = 0.034) and epilepsy ( = 0.038) were more common in younger patients. Elderly patients were more likely to have higher Ki-67( = 0.013), and in elderly WHO5 GBM patients, ( = 0.082), ( = 0.1) and ( = 0.055) were each associated with overall survival (OS). Among them, and were found to be prognostic features unique to WHO5 elderly GBM patients.
Our study demonstrates that WHO5 classification can better distinguish the prognosis of elderly and younger GBM. Furthermore, and may be potential prognostic predictors in WHO5 elderly GBM patients. The specific mechanism of these two genes in elderly GBM remains to be further studied.
老年胶质母细胞瘤（GBM）患者具有发病率高和预后差的特点。然而，目前老年GBM患者仍缺乏充分的分子特征描述。世界卫生组织中枢神经系统肿瘤分类第五版（WHO5）给出了一种新的GBM分类方法，需要在这个新框架下研究老年GBM患者的分子特征。
比较不同分类和不同年龄患者的临床和放射学特征。使用单因素Cox回归和Kaplan-Meier生存分析，在WHO5分类下寻找老年GBM患者潜在的预后分子标志物。
本研究共纳入226例患者。在WHO5分类下，年轻和老年GBM患者的预后差异更为明显。神经功能损害在老年患者中更为常见（P = 0.001），而颅内高压（P = 0.034）和癫痫（P = 0.038）在年轻患者中更为常见。老年患者更有可能具有较高的Ki-67（P = 0.013），并且在老年WHO5 GBM患者中，IDH（P = 0.082）、ATRX（P = 0.1）和MGMT（P = 0.055）均与总生存期（OS）相关。其中，IDH和ATRX被发现是WHO5老年GBM患者独有的预后特征。
我们的研究表明，WHO5分类能够更好地区分老年和年轻GBM患者的预后。此外，IDH和ATRX可能是WHO5老年GBM患者潜在的预后预测指标。这两个基因在老年GBM中的具体机制仍有待进一步研究。
