IDH、TERT及1p/19q对间变性少突胶质瘤患者预后的影响

IDH、TERT and 1p/19q predicting clinical outcomes in patients with anaplastic oligodendroglioma

目的研究异柠檬酸脱氢酶(IDH)、端粒酶逆转录酶基因启动子(TERT)及1p/19q的突变情况对间变性少突胶质瘤患者临床预后的影响。方法研究样本入组选取了2011至2016年在郑州大学第一附属医院确诊的间变性少突胶质瘤患者,收集临床资料,随访得到生存资料,共计纳入66例。χ2检验用来分析IDH、TERT及1p/19q和各个临床因素之间的关系,采用Kaplan-Meier法进行生存分析,不同组间生存率差异的比较采用Log rank检验。Cox比例风险模型进行独立预后影响因素的多因素分析。结果IDH-wt和IDH-mt两组患者的中位生存期分别为16.10及42.00个月,差异有统计学意义(P=0.001);1p/19q非联合缺失和1p/19q联合缺失两组的中位生存期分别为22.40及42.00个月,差异有统计学意义(P=0.012);而TERT-wt和TERT-mt两组的中位生存期分别为20.00及36.00个月,差异无统计学意义(P=0.176)。不同分子病理学分型分组显示,IDH-mt和1p/19q联合缺失组比IDH-wt和1p/19q非联合缺失组(P=0.001)(中位生存期42.00个月比16.05个月)(P=0.001)、IDH-mt和1p/19q非联合缺失组比IDH-wt和1p/19q非联合缺失组(P=0.041)(中位生存期36.50个月比16.05个月)(P=0.041)组间差异有统计学意义。多因素分析显示,分子病理学分型是影响间变性少突胶质瘤患者预后的独立影响因素(P=0.008)。结论具有IDH和(或)1p/19q联合缺失的间变性少突胶质瘤患者有着较好的临床预后,IDH和1p/19q突变情况可作为潜在的预测间变性少突胶质瘤患者预后的标志物。

Objective To investigate the prognostic values of IDH, TERT and 1p/19q in patients with anaplastic oligodendroglioma. Methods In the study, 66 patients with pathological diagnosis of anaplastic oligodendroglioma were enrolled (The First Affiliated Hospital of Zhengzhou University 2011 to 2016 years). Kaplan-Meier method was used to calculate the survival rates. Log-rank was used to calculate the differences in group. Chi-square testwas used tocalculate the differences in common factor group. Cox regression model was used to conduct multivariate analysis. Results The median survival time of IDH-wt and IDH-mt subgroups were 16.10 and 42.00 months with statistical significance (P=0.001). The median survival time of 1p/19q codeleted and 1p/19q noncodeleted subgroups were 42.00 and 22.40 months with statistical significance (P=0.012). IDH-mt and 1p/19q codeleted predicted better survivals compared with IDH-wt and 1p/19q noncodeleted (P=0.001). And IDH-mt and 1p/19q noncodeleted predicted better survivals compared with IDH-wt and 1p/19q noncodeleted (P=0.041), too. Multivariate survival analysis demonstrated that Molecular groups was an independent factor to evaluate the prognosis of anaplastic oligodendroglioma (P=0.008). Conclusion IDH-mtand (or) 1p/19q codeletedpredicted better survivals in patients with anaplastic oligodendroglioma. IDH and 1p/19q deleted might be a biomarker for predicting prognosis of patients with anaplastic oligodendroglioma.