Hypoxia-regulated protein expression, patient characteristics, and preoperative imaging as predictors of survival in adults with glioblastoma multiforme
Hypoxia-regulated protein expression, patient characteristics, and preoperative imaging as predictors of survival in adults with glioblastoma multiforme
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DOI：
10.1002/cncr.23678
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发表时间：
2008-09-01
期刊：
影响因子：
6.2
通讯作者：
Jensen, Randy L.
中科院分区：
文献类型：
--
作者：
Flynn, Jeannette R.;Wang, Libo;Jensen, Randy L.
背景多形性胶质母细胞瘤（GBM）内的缺氧区域很常见，可能会影响肿瘤的侵袭性、对治疗的反应和患者的总体生存期。在这项研究中，作者研究了4个市场的缺氧（缺氧诱导因子I [HIF-1 α]、葡萄糖转运蛋白1 [GLUT-1]、血管内皮生长因子[VEGF]和碳酸酐酶9 [CA IX]）、细胞增殖和微血管密度（MVD）指数、手术切除程度，和术前影像学特征，并与成人GBM的总体生存率进行比较。在这项回顾性队列研究中，将患有较低级别星形细胞瘤的患者与患有GBM的患者进行比较，以验证所使用的方法可以确定肿瘤级别之间的差异。通过使用术前成像，确定坏死量与肿瘤总面积的关系。作者还比较了术前和术后图像，以确定切除的肿瘤量;他们比较了GBM患者的分子市场、增殖、MVD和成像研究与生存率。低氧调节分子（HRM）、MVD和细胞增殖指数与肿瘤分级显著相关。当>= 95%的肿瘤被切除时，生存率提高。虽然总肿瘤面积与总生存期相关，但当坏死量或肿瘤坏死指数（坏死面积/肿瘤面积）与生存期相比时，未观察到差异。结果表明，GLUT-1和VEGF与控制年龄后的生存相关。用HRM、MVD和增殖来区分肿瘤分级，但只有GLUT-1能预测这组GBM患者的生存率。结果提示GLUT-I可能是一个重要的独立预后指标。
BACKGROUND. Regions of hypoxia within glioblastoma multiforme (GBM) are common and may influence a tumor's aggressiveness, response to treatment, and the patient's overall survival. In this study, the authors examined 4 markets of hypoxia (hypoxia-inducible factor I [HIF-1 alpha], glucose transporter 1 [GLUT-1], vascular endothelial growth factor [VEGF], and carbonic anhydrase 9 [CA IX]), cellular proliferation and microvascular density (MVD) indices, extent of surgical resection, and preoperative imaging characteristics and compared them with the overall Survival rates of adults with GBM.METHODS. in this retrospective cohort study, patients who had lower grade astrocytomas were compared with patients who had GBM to verify that the methods used could establish differences between tumor grades. By using preoperative imaging, the amount of necrosis was established versus the overall tumor area. The authors also compared preoperative images with postoperative images to define the amount of tumor resected; and they compared molecular markets, proliferation, MVD, and imaging Studies with survival among patients who had GBM.RESULTS. The hypoxia-regulated molecules (HRMs) and indices for MVD and cellular Proliferation were associated significantly with tumor grade. Survival was improved when >= 95% of the tumor was resected. Although the total tumor area was associated with overall survival, no differences were observed when the amount of necrosis or a tumor necrosis index (area of necrosis/area of tumor) was compared with Survival. The findings indicated that GLUT-1 and VEGF were correlated with survival after controlling for age.CONCLUSIONS. Tumor grade was differentiated with HRMs, MVD, and proliferation, but only GLUT-1 predicted survival ill this group of patients with GBM. The results suggested that GLUT-I may be an important independent prognostic indicator.