术后同步放化疗原发性胶质母细胞瘤患者预后影响因素分析

Influencing factors of prognosis of primary glioblastoma patients undergoing postoperative concurrent ra-diochemotherapy

目的本研究拟通过回顾性研究探讨IDH1、MGMT、p53在术后同步放化疗原发性胶质母细胞瘤(primary glioblastoma,pGBM)中的表达并对其预后进行分析以期指导胶质母细胞瘤患者的个体化、精准化治疗。方法通过电子病历系统获取2014年1月至2018年6月我院及郑大一附院收治的107例术后同步放化疗pGBM患者的临床资料及IDH1基因、MGMT启动子甲基化、p53蛋白表达情况。使用SPSS 21.0统计学软件进行统计学分析。结果术后同步放化疗pGBM患者IDH1突变、mMGMT和p53蛋白阳性表达率分别为9.34%、31.78%、15.89%。年龄≤55岁、非功能区、IDH1突变的术后同步放化疗pGBM患者具有更长的无进展生存期(progression-free survival,PFS)和总生存期(overall survival,OS)(P<0.05)。结论IDH1、肿瘤部位、年龄为术后同步放化疗pGBM患者预后影响因素。IDH1突变预示术后同步放化疗pGBM患者具有更长的PFS和OS,是预测患者预后的重要分子标志物。

Objective To explore the expression of IDH1,MGMT,and p53 in primary glioblastoma(pGBM)after postoperative concurrent radiochemotherapy through a retrospective study and analyze its prognosis in order to provide the patients with individualized and precise treatment.Methods The clinical data,IDH1 gene,MGMT promoter methylation,and p53 protein expression of 107 pGBM patients admitted to our hospital and Zhengda First Affiliated Hospital for concurrent radiochemotherapy from January 2014 to June 2018 through the electronic medical record system.Statistical analysis was performed using SPSS 21.0.Results The positive expression rates of IDH1 mutation,mMGMT and p53 protein in the pGBM patients with concurrent radiochemotherapy were 9.34%,31.78%,and 15.89%,respectively.The pGBM patients with age≤55,non-functional area,IDH1 mutation and concurrent radiochemotherapy had longer progression-free survival(PFS)and overall survival(OS)(P<0.05).Conclusion IDH1,tumor location,and age are independent factors affecting the prognosis of pGBM patients with concurrent radiochemotherapy.IDH1 mutation indicates longer PFS and OS in the patients with concurrent radiochemotherapy,and therefore it is an important molecular marker for predicting the prognosis of patients.