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胶质母细胞瘤的分子谱与 MRI 特征和手术切除的预后预测:范围综述。

Molecular Profile as an Outcome Predictor in Glioblastoma along with MRI Features and Surgical Resection: A Scoping Review.

机构信息

Neurosurgery Department, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania.

ENT Department, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania.

出版信息

Int J Mol Sci. 2024 Sep 8;25(17):9714. doi: 10.3390/ijms25179714.

Abstract

Glioblastoma (GBM) is one of the most aggressive malignant tumors of the brain. We queried PubMed for articles about molecular predictor markers in GBM. This scoping review aims to analyze the most important outcome predictors in patients with GBM and to compare these factors in terms of absolute months of survival benefit and percentages. Performing a gross total resection for patients with GBM undergoing optimal chemo- and radiotherapy provides a significant benefit in overall survival compared to those patients who received a subtotal or partial resection. However, compared to GBMs, patients with GBMs have an increased survival. MGMT promoter methylation status is another strong outcome predictor for patients with GBM. In the reviewed literature, patients with methylated MGMT promoter lived approximately 50% to 90% longer than those with an unmethylated MGMT gene promoter. Moreover, KPS is an important predictor of survival and quality of life, demonstrating that we should refrain from aggressive surgery in important brain areas. As new therapies (such as TTFs) emerge, we are optimistic that the overall median survival will increase, even for GBMs. In conclusion, molecular profiles are stronger outcome predictors than the extent of neurosurgical resection for GBM.

摘要

胶质母细胞瘤(GBM)是最具侵袭性的脑恶性肿瘤之一。我们在 PubMed 上查询了关于 GBM 分子预测标志物的文章。本范围综述旨在分析 GBM 患者最重要的预后预测因素,并比较这些因素在绝对生存获益月数和百分比方面的差异。与接受部分或大部分切除的患者相比,接受最大限度肿瘤切除术的 GBM 患者在总生存期方面具有显著获益。然而,与 GBM 相比,GBM 患者的生存率有所提高。MGMT 启动子甲基化状态是 GBM 患者的另一个重要预后预测因素。在回顾的文献中,MGMT 启动子甲基化的患者比未甲基化的患者存活时间长约 50%至 90%。此外,KPS 是生存和生活质量的重要预测因素,表明我们应该避免在重要的脑区进行激进的手术。随着新疗法(如 TTFs)的出现,我们乐观地认为,即使是 GBM 患者的总体中位生存期也会延长。总之,分子谱比 GBM 的神经外科切除范围更能预测预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c733/11395592/23976dfce194/ijms-25-09714-g001.jpg

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