基于IDH1/2和p53突变的初诊恶性脑胶质瘤预后分型

Prognosis classification of newly diagnosed malignant gliomas based on IDH1/2 and p53 mutation

目的基于分子病理标志物IDH1/2和p53突变状态对初诊恶性脑胶质瘤（WHOⅡ~Ⅳ级）进行分型。方法选择541例初诊胶质瘤样本,通过焦磷酸测序检测IDH1/2突变状态,免疫组化检测突变型P53蛋白表达水平来获得p53突变状态,进一步联合分析IDH1/2突变和p53突变在初诊脑胶质瘤分型中的临床价值。结果联合IDH1/2和p53突变状态可以将脑胶质瘤分成4种分子亚型。其中IDH1/2突变型/p53野生型（Group1）预后最好,IDH1/2突变型/p53突变型（Group2）预后次之,IDH1/2野生型/p53野生型（Group3）再次之,IDH1/2野生型/p53突变型（Group4）预后最差。结论基于IDH1/2和p53突变状态提出初诊脑胶质瘤的预后分型,其具有更加简便的临床应用性和潜在的治疗指导价值。

Objective To classify subtypes of the newly diagnosed gliomas （WHO grade Ⅱ to Ⅳ） based on IDH1/2 and p53 mutation status. Methods A total of 541 newly diagnosed glioma samples were selected. IDH1/2 mutation status was assessed by pyrosequencing and p53 mutation status was obtained via immunohistochemical staining examination of mutant P53 protein. The clinical value of IDH1/2 and p53 mutation status in the subtype of gliomas was analyzed conjointly. Results Conjoint analysis of IDH1/2 andp53 mutation status defined 4 subtypes of gliomas. IDH1/2 mutation/p53 wild-type （Groupl） had the best prognosis, 1DH1/2 mutation/p53 mutation （Group2） took second place, IDH1/2 wild-type/p53 wild-type （Group3） was the third, and IDH1/2 wild-type/p53 mutation （Group4） showed the worst prognosis. Conclusion Based on IDH1/2 and p53 mutation status in newly diagnosed glioma, the novel subtype has more convenient clinical application and potential guidance value for treatment.