Low levels of Human Cytomegalovirus Infection in Glioblastoma multiforme associates with patient survival; -a case-control study.
Low levels of Human Cytomegalovirus Infection in Glioblastoma multiforme associates with patient survival; -a case-control study.
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DOI：
10.1186/2042-4280-3-3
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发表时间：
2012-03-16
期刊：
影响因子：
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通讯作者：
Soderberg-Naucler, Cecilia
中科院分区：
文献类型：
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作者：
Rahbar, Afsar;Stragliotto, Giuseppe;Soderberg-Naucler, Cecilia
背景：多形性胶质母细胞瘤（GBM）是最具侵袭性的脑肿瘤，中位总生存期约为12-15个月。超过90%的GBM肿瘤最近被证明是感染了人巨细胞病毒（HCMV）。在这个病例对照研究中，我们评估了HCMV感染的分级和长期生存率之间是否存在关联（> 18个月）。材料和方法：来自存活超过18个月的连续GBM患者（n = 40）和相同数量的GBM患者的脑肿瘤组织切片，与诊断和手术日期相匹配，选择2000-2005年在卡罗林斯卡大学医院手术的患者。通过估计肿瘤组织标本中HCMV阳性细胞（评分为阴性或1-4级）的数量来确定HCMV感染等级。使用卡方检验和logistic回归分析，我们分析了是否有长期生存和HCMV低度感染或其他临床参数已知与GBM患者的长期生存相关的相关性;年龄在50岁以下，根治性手术或低递归分区分析（RPA）subclass.RESULTS：HCMV感染在80例患者中的79例（99%）的肿瘤样本中检测到。在存活> 18个月的患者中，GBM肿瘤中的HCMV感染1级是主要的。19例患者发现HCMV轻度感染，其中16例存活> 18个月。因此，40例生存期> 18个月的GBM患者中有16例（40%）发生了低度HCMV感染，而40例生存期< 18个月的GBM患者中只有3例（8%）发生了低度HCMV感染（p <0.0006，卡方检验）。多元逻辑回归分析得出的比值比估计值为6.604，95%的置信区间（1.36-32.1）（p 0.019）为低级别HCMV调整后的RPA III级和IV级，根治性手术，年龄和伽玛刀treatment.CONCLUSION：总之，我们发现，低级别HCMV感染与GBM患者的长期生存密切相关。
BACKGROUND: Glioblastoma multiforme (GBM) represent the most aggressive brain tumor with a median overall survival of about 12-15 months. Over 90% of GBM tumors have recently been shown to be infected with human cytomegalovirus (HCMV). In this case-control study, we evaluated whether there was an association between the grade of HCMV infection and long-term survival (> 18 months) in GBM patients.MATERIAL AND METHODS: Brain tumor tissue sections from consecutive GBMs patients who survived more than 18 months (n = 40), and an equal number of GBM patients, matched to date of diagnosis and surgery, operated at Karolinska University Hospital in 2000-2005 were selected. HCMV infection grade was determined by estimation of the number of HCMV positive cells (scored negative or grade 1-4) in tumor tissue specimens. Using Chi-Square test and logistic regression analysis, we analyzed whether there was an association between long-term survival and HCMV low-grade infection or other clinical parameters known to be associated with prolonged survival of GBM patients; age under 50 years, radical surgery or low recursive partition analysis (RPA) subclass.RESULTS: HCMV infection was detected in tumor samples from 79 of 80 patients (99%). Among patients surviving > 18 months, HCMV infection grade 1 in the GBM tumor was predominant. A low grade HCMV infection was found in 19 patients, of these 16 survived > 18 months. Thus, 16 of 40 (40%) GBM patients who lived > 18 months had low-grade HCMV infection while only 3 of 40 (8%) GBM patients who lived < 18 months did (p .0006, Chi-Square test). Multiple logistic regression analyses yielded an odds ratio estimate of 6.604 with 95% confidence interval (1.36-32.1) (p .019) for low grade HCMV after adjustment for RPA class III and IV, radical surgery, age and gamma knife treatment.CONCLUSION: In conclusion, we found that low-grade HCMV infection was strongly associated with long-term survival in GBM patients.