Makino Ryutaro, Bajagain Madan, Higa Nayuta, Akahane Toshiaki, Yonezawa Hajime, Uchida Hiroyuki, Takajo Tomoko, Kirishima Mari, Yokoyama Seiya, Otsuji Ryosuke, Fujioka Yutaka, Kuga Daisuke, Yamahata Hitoshi, Kurosaki Masamichi, Yamamoto Junkoh, Yoshimoto Koji, Tanimoto Akihide, Hanaya Ryosuke
Department of Neurosurgery, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima-City, Kagoshima, 890-8520, Japan.
Center for Human Genome and Gene Analysis, Kagoshima University Hospital, 8-35-1 Sakuragaoka, Kagoshima-City, Kagoshima, 890-8544, Japan.
Brain Tumor Pathol. 2025 Apr 6. doi: 10.1007/s10014-025-00500-8.
In the 2021 WHO Central Nervous System tumor classification, the "Glioblastoma, IDH-wildtype" diagnosis changed markedly. In a Japanese cohort, we compared the clinical backgrounds and prognoses of molecular glioblastoma (mGBM) and conventional glioblastoma (histological glioblastoma, hGBM). We included 270 patients with glioblastoma treated at five institutions during 2011-2023. Driver gene analysis was performed using a brain tumor-specific custom gene panel to verify the association between molecular and clinical information. Patients with mGBM had better preoperative KPS, lower Ki-67, and lower removal rates than did those with hGBM. Overall survival was longer in patients with mGBM than in those with hGBM (1207 vs 599 days, p = 0.037). TP53 mutation (hazard ratio: 5.33, 95% confidence interval: 0.26-108.7, p = 0.012) and histological grade 3 (p = 0.051) were poor prognostic factors for mGBM. Patients with mGBM had better preoperative KPS, worse removal rates, lower Ki-67 labeling index, and better overall survival than did those with hGBM. In addition, the histological grade of mGBM is potentially useful for estimating prognosis. In the WHO CNS5 2021, glioblastoma patients remain a heterogeneous population, and prognostic stratification based on the patient's clinical background and molecular information is desirable.
在2021年世界卫生组织中枢神经系统肿瘤分类中，“异柠檬酸脱氢酶野生型胶质母细胞瘤”的诊断有了显著变化。在一个日本队列中，我们比较了分子型胶质母细胞瘤（mGBM）和传统型胶质母细胞瘤（组织学胶质母细胞瘤，hGBM）的临床背景和预后。我们纳入了2011年至2023年期间在五家机构接受治疗的270例胶质母细胞瘤患者。使用脑肿瘤特异性定制基因panel进行驱动基因分析，以验证分子信息与临床信息之间的关联。mGBM患者术前KPS更好、Ki-67更低，切除率低于hGBM患者。mGBM患者的总生存期长于hGBM患者（1207天对599天，p = 0.037）。TP53突变（风险比：5.33，95%置信区间：0.26 - 108.7，p = 0.012）和组织学3级（p = 0.051）是mGBM的不良预后因素。mGBM患者术前KPS更好、切除率更差、Ki-67标记指数更低，总生存期优于hGBM患者。此外，mGBM的组织学分级可能有助于估计预后。在2021年世界卫生组织中枢神经系统肿瘤分类第5版中，胶质母细胞瘤患者仍然是一个异质性群体，基于患者临床背景和分子信息的预后分层是可取的。
Acta Neuropathol Commun. 2024-10-29
Cochrane Database Syst Rev. 2018-2-6
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