A molecularly integrated grade for meningioma.
A molecularly integrated grade for meningioma.
复制标题
脑膜瘤的分子整合分级。
DOI：
10.1093/neuonc/noab213
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发表时间：
2022-05-04
期刊：
影响因子：
15.9
通讯作者：
中科院分区：
文献类型：
--
作者：
脑膜瘤是成人最常见的原发性颅内肿瘤。临床护理目前由世界卫生组织（WHO）分配给脑膜瘤的等级指导，这是一个基于组织病理学特征以及手术切除程度的三级分级系统。然而，临床行为往往不符合WHO分级。需要额外的预后信息来优化患者管理。我们评估了染色体拷贝数数据是否改善了相对于WHO模式的脑膜瘤手术治疗患者的复发时间预测。在527例脑膜瘤患者的发现队列中使用考克斯比例风险、随机生存森林和梯度增强开发模型，并在172例脑膜瘤患者的2个独立队列中验证，这些患者通过正交基因组平台表征。我们开发了一个3层分级方案（综合等级1-3），其中包括有丝分裂计数和染色体1 p、3 p、4、6、10、14 q、18、19或CDKN 2A的丢失。与WHO分级相比，32%的脑膜瘤被重新分类为低风险或高风险综合分级。相对于WHO分级，综合分级更准确地识别脑膜瘤患者的复发风险，如通过时间依赖性曲线下面积，平均精度和Brier评分确定的。我们提出了一个脑膜瘤的分子整合分级方案，该方案在预测无进展生存期方面显著改善了当前WHO分级系统。这个框架可以被临床医生广泛采用，使用广泛可用的基因组技术相对容易，并在脑膜瘤患者的护理方面取得了进展。
Meningiomas are the most common primary intracranial tumor in adults. Clinical care is currently guided by the World Health Organization (WHO) grade assigned to meningiomas, a 3-tiered grading system based on histopathology features, as well as extent of surgical resection. Clinical behavior, however, often fails to conform to the WHO grade. Additional prognostic information is needed to optimize patient management. We evaluated whether chromosomal copy-number data improved prediction of time-to-recurrence for patients with meningioma who were treated with surgery, relative to the WHO schema. The models were developed using Cox proportional hazards, random survival forest, and gradient boosting in a discovery cohort of 527 meningioma patients and validated in 2 independent cohorts of 172 meningioma patients characterized by orthogonal genomic platforms. We developed a 3-tiered grading scheme (Integrated Grades 1-3), which incorporated mitotic count and loss of chromosome 1p, 3p, 4, 6, 10, 14q, 18, 19, or CDKN2A. 32% of meningiomas reclassified to either a lower-risk or higher-risk Integrated Grade compared to their assigned WHO grade. The Integrated Grade more accurately identified meningioma patients at risk for recurrence, relative to the WHO grade, as determined by time-dependent area under the curve, average precision, and the Brier score. We propose a molecularly integrated grading scheme for meningiomas that significantly improves upon the current WHO grading system in prediction of progression-free survival. This framework can be broadly adopted by clinicians with relative ease using widely available genomic technologies and presents an advance in the care of meningioma patients.
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DOI：
10.1056/nejmoa1407279
发表时间：
2015-06-25
期刊：
The New England journal of medicine
影响因子：
--
作者：
Eckel-Passow JE;Lachance DH;Molinaro AM;Walsh KM;Decker PA;Sicotte H;Pekmezci M;Rice T;Kosel ML;Smirnov IV;Sarkar G;Caron AA;Kollmeyer TM;Praska CE;Chada AR;Halder C;Hansen HM;McCoy LS;Bracci PM;Marshall R;Zheng S;Reis GF;Pico AR;O'Neill BP;Buckner JC;Giannini C;Huse JT;Perry A;Tihan T;Berger MS;Chang SM;Prados MD;Wiemels J;Wiencke JK;Wrensch MR;Jenkins RB
通讯作者：
Jenkins RB
影响因子：
3.2
作者：
Gauchotte, Guillaume;Peyre, Matthieu;Bielle, Franck
通讯作者：
Bielle, Franck
影响因子：
15.9
作者：
Nassiri, Farshad;Mamatjan, Yasin;Zadeh, Gelareh
通讯作者：
Zadeh, Gelareh
影响因子：
1.9
作者：
Abedalthagafi, Malak S.;Bi, Wenya Linda;Santagata, Sandro
通讯作者：
Santagata, Sandro
影响因子：
4.6
作者：
Collord G;Tarpey P;Kurbatova N;Martincorena I;Moran S;Castro M;Nagy T;Bignell G;Maura F;Young MD;Berna J;Tubio JMC;McMurran CE;Young AMH;Sanders M;Noorani I;Price SJ;Watts C;Leipnitz E;Kirsch M;Schackert G;Pearson D;Devadass A;Ram Z;Collins VP;Allinson K;Jenkinson MD;Zakaria R;Syed K;Hanemann CO;Dunn J;McDermott MW;Kirollos RW;Vassiliou GS;Esteller M;Behjati S;Brazma A;Santarius T;McDermott U
通讯作者：
McDermott U