Molecular Aberrations Associated with Seizure Control in Diffuse Astrocytic and Oligodendroglial Tumors
Molecular Aberrations Associated with Seizure Control in Diffuse Astrocytic and Oligodendroglial Tumors
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DOI：
10.2176/nmc.oa.2019-0218
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发表时间：
2020-03-01
影响因子：
1.9
通讯作者：
Hasegawa, Tadashi
中科院分区：
文献类型：
--
作者：
Suzuki, Hime;Mikuni, Nobuhiro;Hasegawa, Tadashi
弥漫性星形细胞和少突胶质细胞肿瘤常与症状性癫痫相关，预测性癫痫发作控制对改善患者生活质量很重要。从病理学角度探讨脑肿瘤相关癫痫耐药的相关因素。从2012年1月至2017年10月，纳入了36例诊断为弥漫性星形细胞或少突胶质细胞肿瘤的患者。根据Engel癫痫发作分类进行癫痫发作控制评估。根据以下16个变量对患者的临床、影像学和病理学数据进行分层：年龄、性别、肿瘤位置、术前癫痫发作的存在、切除程度、替莫唑胺给药、放疗、复发、Karnofsky体能量表、异柠檬酸脱氢酶1、1 p/19 q共缺失、Olig 2、血小板衍生生长因子受体α、p53、ATRX和Ki 67。比较癫痫控制良好组与耐药组的上述因素。27例患者发生癫痫发作;其中14例控制良好，13例耐药。无论是临床还是放射学特征，这两组之间的显着差异，虽然p53免疫检测水平显着较高，和1 p/19 q共缺失的频率显着较低的耐药癫痫发作组比在良好的控制组。在多因素分析中，根据逐步方法仅选择一个项目，并且观察到p53的显著差异（OR，21.600; 95%CI，2.135-218.579; P = 0.009）。p53的上调可能是弥漫性星形细胞和少突胶质细胞肿瘤相关耐药癫痫的分子机制。
Diffuse astrocytic and oligodendroglial tumors are frequently associated with symptomatic epilepsy, and predictive seizure control is important for the improvement of patient quality of life. To elucidate the factors related to drug resistance of brain tumor-associated epilepsy from a pathological perspective. From January 2012 to October 2017, 36 patients diagnosed with diffuse astrocytic or oligodendroglial tumors were included. Assessment for seizure control was performed according to the Engel classification of seizures. Patient clinical, radiological, and pathological data were stratified based on the following 16 variables: age, sex, location of tumor, existence of the preoperative seizure, extent of resection, administration of temozolomide, radiation therapy, recurrence, Karnofsky performance scale, isocitrate dehydrogenase 1, 1p/19q co-deletion, Olig2, platelet-derived growth factor receptor alpha, p53, ATRX, and Ki67. These factors were compared between the well-controlled group and drug-resistant seizure group. Twenty-seven patients experienced seizures; of these, 14 cases were well-controlled, and 13 cases were drug-resistant. Neither clinical nor radiological characteristics were significantly different between these two groups, though p53 immunodetection levels were significantly higher, and the frequency of 1p/19q co-deletion was significantly lower in the group with drug-resistant seizures than in the well-controlled group. In the multivariate analysis, only one item was selected according to stepwise methods, and a significant difference was observed for p53 (OR, 21.600; 95% CI, 2.135-218.579; P = 0.009). Upregulation of p53 may be a molecular mechanism underlying drug resistant epilepsy associated with diffuse astrocytic and oligodendroglial tumors.