Predictors and mechanisms of epilepsy occurrence in cerebral gliomas: What to look for in clinicopathology
Predictors and mechanisms of epilepsy occurrence in cerebral gliomas: What to look for in clinicopathology
复制标题
脑胶质瘤癫痫发生的预测因素和机制：临床病理学的寻找
DOI：
10.1016/j.yexmp.2017.01.005
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发表时间：
2017-02-01
影响因子：
3.6
通讯作者：
Li, Jin-mei
中科院分区：
文献类型：
--
作者：
Huang, Cheng;Chi, Xiao-sa;Li, Jin-mei
胶质瘤，尤其是低级别胶质瘤，是高度致癫痫性脑肿瘤。组织学信息在评估各种胶质瘤的诊断和/或生物学行为方面具有重要价值。在这里，我们探讨了神经胶质瘤患者癫痫发生的临床数据和组织病理学预测因素。一项回顾性研究检查了2013年1月至2015年1月在我们机构接受神经胶质瘤手术治疗的310例连续患者。分析临床资料和病理检查结果。还回顾了1995-2015年期间关于胶质瘤相关癫痫发作的预测因素和病因的文献。共纳入234例（75.5%）星形细胞肿瘤和76例（24.5%）寡树突肿瘤。诊断时，33.6%的患者有癫痫发作。多变量分析显示皮质受累（OR = 7.991，95%CI = 1.599-39.926）、低世卫组织分级（OR = 3.584，95%CI =1.032-12.346）和拓扑异构酶II（TopoII）阳性（OR = 0.943，95%CI = 0.903-0.982）是术前癫痫发作的强预测因子。性别、病程、肿瘤类型、部位或体积对癫痫发作的发生无显著影响。在PubMed在线数据库中发现了43篇涉及胶质瘤相关癫痫的出版物，并提取和总结了关键数据。目前关于胶质瘤相关癫痫的研究相对有限且不一致。低级别胶质瘤、皮质受累和Topoll阳性是诊断时癫痫发作史的独立预测因素。对拓扑异构酶II及其他分子在脑胶质瘤癫痫发生中的作用机制尚需进一步研究。(C)2017由Elsevier Inc.出版
Gliomas, especially low-grade gliomas, are highly epileptogenic brain tumors. Histopathological information is valuable in evaluating the diagnosis and/or biologic behavior of various gliomas. Here we explored the clinical data and histopathological predictors of the occurrence of epilepsy in patients with gliomas. A retrospective study examined 310 consecutive patients who had undergone surgical treatment for gliomas in our institution from January 2013 to January 2015. Clinical data and pathological examination results were analyzed. Literatures regarding the predictors and etiology of glioma associated epileptic seizures in the period of 1995-2015 were also reviewed. A total of 234 (75.5%) astrocytic tumors and 76 (24.5%) oligodendrial tumors were included. At diagnosis, 33.6% of patients had epileptic seizures. Multivariate analysis revealed cortex involvement (OR = 7.991, 95%CI = 1.599-39.926), lower World Health Organization grade (OR = 3.584, 95%CI =1.032-12.346) and topoisomerase II (TopoII) positivity (OR = 0.943, 95%CI = 0.903-0.982) were strong predictors for preoperative epileptic seizures. Gender, disease course, tumor classification, location or volume did not significantly affect epileptic seizure occurrence. Forty-three publications involved glioma-associated epilepsy were found in PubMed online database and key data were extracted and summarized. The present studies on glioma-related epilepsy are relatively limited and inconsistent. Low-grade gliomas, cortex involvement and Topoll positivity were independent predictors of a history of epileptic seizures at diagnosis. Further studies to examine the underlying mechanism of topoisomerase II as well as other molecules in epilepsy occurrence in brain gliomas are needed in the future. (C) 2017 Published by Elsevier Inc.