A better surgical resectability of WHO grade II gliomas is independent of favorable molecular markers
A better surgical resectability of WHO grade II gliomas is independent of favorable molecular markers
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DOI：
10.1007/s11060-014-1623-y
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发表时间：
2015-01-01
影响因子：
3.9
通讯作者：
Duffau, Hugues
中科院分区：
文献类型：
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作者：
Cordier, Dominik;Goze, Catherine;Duffau, Hugues
WHO II级胶质瘤（GIIG）中较高的切除程度（EOR）与较长的生存期相关。然而，分子标志物也具有预后相关性。在这里，我们研究了最大EOR是否与遗传特征有关。我们回顾性研究了1 p19 q，IDH 1，53表达和Ki 67指数对200例连续GIIG（2007-2013）的EOR的预测价值。数据以线性模型建模。采用两种统计方法（arcsin-sqrt和Logit链接的Beta回归模型）进行分析。1 p19 q无缺失118例，1 p19 q共缺失57例，1 p单缺失4例，19 q单缺失16例。155例患者存在IDH 1突变。p53分级为4级（0：92例，1：52例，2：31例，3：8例）。平均Ki 67指数为5.2%（范围1- 20%）。平均术前肿瘤体积为60.8 cm（3）（范围3.3-250 cm（3）），平均EOR为0.917（范围0.574-1）。统计学分析显示，1 p19 q共缺失（OR 0.738，p = 0.0463）和19 q单缺失（OR 0.641，p = 0.0168）患者的EOR较低。IDH 1和p53与EOR无明显相关性。较高的Ki 67与较高的EOR略微相关（p = 0.0603）。该研究表明，在一个大型的GIIG队列中，较高的EOR并不归因于有利的遗传标记。这一原始结果支持最大限度的手术切除作为一个重要的治疗因素本身，以优化预后，独立的分子模式。
A higher extent of resection (EOR) in WHO grade II gliomas (GIIG) is correlated with longer survival. However, the molecular markers also feature prognostic relevance. Here, we examined whether maximal EOR was related to the genetic profile. We retrospectively investigated the predictive value of 1p19q, IDH1, 53 expression and Ki67 index for the EOR in 200 consecutive GIIGs (2007-2013). Data were modeled in a linear model. The analysis was performed with two statistical methods (arcsin-sqrt and Beta-regression model with logit link). There was no deletion 1p19q in 118 cases, codeletion 1p19q (57 cases), single deletion 1p (4 cases) or19q (16 cases). 155 patients had a mutation of IDH1. p53 was graded in 4 degrees (0: 92 cases, 1: 52 cases, 2: 31 cases, 3: 8 cases). Mean Ki67 index was 5.2 % (range 1-20 %). Mean preoperative tumor volume was 60.8 cm(3) (range 3.3-250 cm(3)) and mean EOR was 0.917 (range 0.574-1). The statistical analysis was significant for a lower EOR in patients with codeletion 1p19q (OR 0.738, p = 0.0463) and with a single deletion 19q (OR 0.641, p = 0.0168). There was no significant correlation between IDH1 or p53 and the EOR. Higher Ki67 was marginally associated with higher EOR (p = 0.0603). The study demonstrates in a large cohort of GIIG that a higher EOR is not attributable to favorable genetic markers. This original result supports maximal surgical resection as an important therapeutic factor per se to optimize prognosis, independently of the molecular pattern.