IDH野生型胶质母细胞瘤患者预后影响因素分析

Prognostic factors of IDH wild-type glioblastoma patients

目的探讨WHOⅣ级IDH野生型胶质母细胞瘤患者预后影响因素。方法回顾性分析97例WHOⅣ级IDH野生型胶质母细胞瘤患者的临床资料,分析临床因素及分子标志物对患者预后的影响。结果单因素及多因素分析显示,在IDH野生型胶质母细胞瘤中,年龄、KPS(Karnofsky功能状态评分标准)评分、肿瘤是否全切、术后是否接受同步的放化疗为独立影响因素(P<0.05),分子标志物中,O6-甲基鸟嘌呤-DNA甲基转移酶(MGMT)蛋白表达为独立的预后影响因素(P<0.05),ATRX、P53、Ki-67的蛋白表达以及1p/19q杂合性缺失与预后不相关(P>0.05),并且非参数分析显示IDH突变型的WHOⅣ级成人弥漫性胶质瘤预后好于IDH野生型的WHOⅣ级成人弥漫性胶质瘤。结论在WHOⅣ级IDH野生型胶质母细胞瘤中,年龄,KPS评分,肿瘤是否全切,术后是否接受同步放化疗以及MGMT蛋白表达为有价值的参考指标,并且WHOⅣ级的IDH野生型成人弥漫性胶质瘤的预后比IDH突变型差。

Objective To analyze the prognostic factors of IDH wild-type glioblastoma patients.Methods The clinical data of 97 patients with WHO gradeⅣIDH wild-type glioblastoma were analyzed retrospectively,and the effects of clinical factors and molecular markers on the prognosis were analyzed.Results Univariate and multivariate analysis showed that in IDH wildtype glioblastoma,age,KPS score,extent of surgical resection,and concurrent chemo-radiotherapy were independently correlated with OS(P<0.05).The expression of MGMT were independently correlated with OS(P<0.05)and ATRX,P53,Ki-67 protein expression and 1 p/19 q co-deletion were not related to OS(P>0.05).And nonparametric analysis showed that the prognosis of IDH wild-type WHOⅣadult-diffuse-glioma was worse than the IDH-mutant WHOⅣadult-diffuseglioma.Conclusions In IDH wild-type glioblastoma,age,KPS score,extent of surgical resection,concurrent chemo-radiotherapy,and MGMT expression are valuable reference indicator in IDH wildtype glioblastoma.In WHOⅣadult-diffuse-glioma,the prognosis of IDH wild type is worse than IDH mutant type.