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从创伤到肿瘤:探索创伤性脑损伤胶质母细胞瘤患者特征。

From Trauma to Tumor: Exploring Post-Traumatic Brain Injury Glioblastoma Patient Characteristics.

机构信息

Faculty of Medicine and Surgery, University of Malta, Imsida, Malta.

Faculty of Medicine and Surgery, University of Malta, Imsida, Malta.

出版信息

World Neurosurg. 2024 Apr;184:175-181. doi: 10.1016/j.wneu.2024.01.122. Epub 2024 Feb 1.


DOI:10.1016/j.wneu.2024.01.122
PMID:38307194
Abstract

OBJECTIVE: Glioblastoma multiforme (GBM) following traumatic brain injury (TBI) is very rare and has not been comprehensively characterized by current literature. This systematic review aimed to characterize demographics of patients with post-TBI GBM. METHODS: A systematic review of case studies and case series was conducted for reports published up to April 2023. All case reports that satisfied the criteria for diagnosing post-TBI GBM were included. The JBI case report appraisal was used to assess the quality of reporting of included articles. RESULTS: Our review comprised 13 studies including 16 patients, most of whom were male (81%). Contusive TBI was the most frequent initial insult observed, with most patients requiring surgical intervention to manage TBI. The median latency between TBI and GBM diagnosis was 9.5 years with a negative correlation observed against patient age at TBI occurrence, but a positive correlation was noted for patients with IDH-wildtype GBM. Median age at GBM diagnosis was 56 years. CONCLUSIONS: This systematic review highlights a possible link to GBM development at the previous TBI site. Updated criteria for identifying post-TBI brain tumors are proposed to keep abreast with the latest advances in classifying central nervous system tumors. To establish a definitive link, a large-scale international multicenter study investigating the occurrence of World Health Organization grade IV IDH-wildtype de novo GBM after TBI is crucial. Regular monitoring, especially in middle-aged and older patients with TBI, is advisable.

摘要

目的:创伤性脑损伤(TBI)后发生的多形性胶质母细胞瘤(GBM)非常罕见,目前的文献尚未对其进行全面描述。本系统评价旨在描述 TBI 后发生 GBM 的患者的人口统计学特征。

方法:对截至 2023 年 4 月发表的病例研究和病例系列进行了系统评价。所有符合诊断 TBI 后 GBM 标准的病例报告均被纳入。使用 JBI 病例报告评估工具评估纳入文章的报告质量。

结果:我们的综述包括 13 项研究,共纳入 16 名患者,其中大多数为男性(81%)。挫伤性 TBI 是最常见的初始损伤,大多数患者需要手术干预来治疗 TBI。TBI 与 GBM 诊断之间的中位潜伏期为 9.5 年,与 TBI 发生时患者年龄呈负相关,但 IDH 野生型 GBM 患者呈正相关。GBM 诊断时的中位年龄为 56 岁。

结论:本系统评价强调了 TBI 部位可能与 GBM 发展有关。为了与中枢神经系统肿瘤分类的最新进展保持一致,提出了用于识别 TBI 后脑肿瘤的更新标准。为了建立明确的联系,需要进行一项大规模的国际多中心研究,调查 TBI 后发生的世界卫生组织 IV 级 IDH 野生型新发 GBM 的发生率。建议对 TBI 患者,特别是中年和老年患者进行定期监测。

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