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多变量回顾性分析高级别胶质瘤:生存和预后因素。

A multivariate retrospective analysis of high-grade gliomas: Survival and prognostic factors.

机构信息

Jilin Provincial Key Laboratory of Radiation Oncology & Therapy, The First Hospital of Jilin University, Changchun, China.

Department of Radiation Oncology, The First Hospital of Jilin University, Changchun, China.

出版信息

Cancer Med. 2024 Aug;13(15):e7456. doi: 10.1002/cam4.7456.

Abstract

OBJECTIVES

High-grade gliomas (HGGs) are highly malignant, aggressive, and have a high incidence and mortality rate. The aim of this study was to investigate survival outcomes and prognostic factors in patients with HGGs.

METHODS

In this retrospective study, a total of 159 patients with histologically confirmed HGGs were included. The recruitment period was from January 2011 to December 2019. We evaluated patient demographic data, tumor characteristics, treatment methods, immunocytochemistry results, overall survival (OS) time, and progression-free survival (PFS) time using Kaplan-<>Meier survival analysis with log-rank testing. Additionally, we employed Cox regression analysis to identify independent factors associated with survival outcomes.

RESULTS

Kaplan-Meier survival analysis revealed that the 1-, 2-, and 5-years OS rates were 81.8%, 50.3%, and 12.6%, respectively. Similarly, the 1-, 2-, and 5-years PFS rates were 50.9%, 22.4%, and 3.1%, respectively. The median OS duration was 35.0 months. The univariate analysis indicated that postoperative pathological classification, grade, and age were significantly associated with patient outcomes (p < 0.01). Among the patients, 147 received concurrent chemoradiotherapy, while 12 did not. The immunohistochemical markers of ki-67, MGMT, IDH1R132H, and p53 demonstrated statistically significant differences in their prognostic impact (p = 0.001, p = 0.020, p = 0.003, and p = 0.021, respectively). In conclusion, we found that grades, age, pathological classification, ki-67, MGMT, and IDH1R132H expression were statistically significantly associated with PFS (p < 0.01, p = 0.004, p = 0.003, p = 0.001, p = 0.036, and p = 0.028). Additionally, immunohistochemical expressions of TRIB3 and AURKA were significantly higher in patients with shorter survival (p = 0.015 and p = 0.023).

CONCLUSIONS

Tumor grade and the use of concurrent chemoradiotherapy after surgery were independent prognostic factors that significantly influenced patient survival. Additionally, tumor grade and MGMT expression were found to be independent factors affecting progression-free survival (PFS). Notably, the expression of TRIB3 and AURKA was higher in patients with poor survival outcomes.

摘要

目的

高级别胶质瘤(HGGs)恶性程度高、侵袭性强,发病率和死亡率均较高。本研究旨在探讨 HGG 患者的生存结局和预后因素。

方法

本回顾性研究共纳入 159 例经组织学证实的 HGG 患者。招募时间为 2011 年 1 月至 2019 年 12 月。我们使用 Kaplan-Meier 生存分析结合对数秩检验评估患者的人口统计学数据、肿瘤特征、治疗方法、免疫细胞化学结果、总生存(OS)时间和无进展生存(PFS)时间。此外,我们采用 Cox 回归分析识别与生存结局相关的独立因素。

结果

Kaplan-Meier 生存分析显示,1、2 和 5 年 OS 率分别为 81.8%、50.3%和 12.6%。同样,1、2 和 5 年 PFS 率分别为 50.9%、22.4%和 3.1%。中位 OS 时间为 35.0 个月。单因素分析表明,术后病理分级、肿瘤级别和年龄与患者结局显著相关(p<0.01)。在这些患者中,147 例接受了同期放化疗,而 12 例未接受。Ki-67、MGMT、IDH1R132H 和 p53 的免疫组化标志物在预后影响方面具有统计学显著差异(p=0.001、p=0.020、p=0.003 和 p=0.021)。总之,我们发现肿瘤级别、年龄、病理分级、Ki-67、MGMT 和 IDH1R132H 表达与 PFS 显著相关(p<0.01,p=0.004,p=0.003,p=0.001,p=0.036 和 p=0.028)。此外,TRIB3 和 AURKA 的免疫组化表达在生存期较短的患者中明显升高(p=0.015 和 p=0.023)。

结论

肿瘤分级和术后同期放化疗是独立的预后因素,显著影响患者的生存。此外,肿瘤分级和 MGMT 表达是影响无进展生存(PFS)的独立因素。值得注意的是,TRIB3 和 AURKA 的表达在生存结局较差的患者中较高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4140/11310549/bf3bdf7d3457/CAM4-13-e7456-g004.jpg

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