The Prognostic Roles of Gender and O6-Methylguanine-DNA Methyltransferase Methylation Status in Glioblastoma Patients: The Female Power
The Prognostic Roles of Gender and O6-Methylguanine-DNA Methyltransferase Methylation Status in Glioblastoma Patients: The Female Power
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DOI：
10.1016/j.wneu.2018.01.045
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发表时间：
2018-04-01
影响因子：
2
通讯作者：
Brandes, Alba A.
中科院分区：
文献类型：
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作者：
Franceschi, Enrico;Tosoni, Alicia;Brandes, Alba A.
背景：临床和分子因素是决定胶质母细胞瘤(GBM)预后的重要因素。O6-甲基鸟嘌呤-DNA甲基转移酶(MGMT)甲基化状态、年龄、Karnofsky功能状态(KPS)和手术切除程度是最相关的预后因素。我们对性别在预测预后中的作用的调查显示，女性患者略有生存优势。方法：我们对接受标准治疗的GBM患者进行了前瞻性评估，以确定影响预后的因素。结果：共有169名患者进行前瞻性评估，其中男性99例(58.6%)，女性70例(41.4%)。在140名患者中，MGMT甲基化是可评估的。在男性患者中，MGMT甲基化36例(25.7%)，未甲基化47例(33.6%)，女性患者中32例甲基化(22.9%)，25例未甲基化(17.9%)。甲基化女性的生存时间比甲基化男性长(P=0.028)，但非甲基化女性与非甲基化男性之间的生存期差异无统计学意义(P=0.395)。在多因素分析中，性别和MGMT甲基化状态(甲基化女性与甲基化男性；风险比[HR]，0.459；95%可信区间[CI]，0.242~0.827；P=0.017)、年龄(HR，1.025；95%CI，1.002~1.049；P=0.032)和KPS(HR，0.965；95%CI，0.948~0.982；P<；0001)与生存显著相关。性别可以被认为是进一步的预后因素。
BACKGROUND: Clinical and molecular factors are essential to define the prognosis in patients with glioblastoma (GBM). O6-methylguanine-DNA methyltransferase (MGMT) methylation status, age, Karnofsky Performance Status (KPS), and extent of surgical resection are the most relevant prognostic factors. Our investigation of the role of gender in predicting prognosis shows a slight survival advantage for female patients.METHODS: We performed a prospective evaluation of the Project of Emilia Romagna on Neuro-Oncology (PERNO) registry to identify prognostic factors in patients with GBM who received standard treatment.RESULTS: A total of 169 patients (99 males [58.6%] an d 70 females [41.4%]) were evaluated prospectively. MGMT methylation was evaluable in 140 patients. Among the male patients, 36 were MGMT methylated (25.7%) and 47 were unmethylated (33.6%); among the female patients, 32 were methylated (22.9%) and 25 were unmethylated (17.9%). Survival was longer in the methylated females compared with the methylated males (P = 0.028) but was not significantly different between the unmethylated females and the unmethylated males (P = 0.395). In multivariate analysis, gender and MGMT methylation status considered together (methylated females vs. methylated males; hazard ratio [HR], 0.459; 95% confidence interval [CI], 0.242-0.827; P = 0.017), age (HR, 1.025; 95% CI, 1.002-1.049; P = 0.032), and KPS (HR, 0.965; 95% CI, 0.948-0.982; P < 0.001) were significantly correlated with survival.CONCLUSIONS: Survival was consistently longer among MGMT methylated females compared with males. Gender can be considered as a further prognostic factor.