Towards molecular classification and individualized treatment of glioma

我们通过比较基因组杂交分析了140例WHO II-III级胶质瘤，这些肿瘤根据遗传谱被划分为临床相关的亚组（7q增益vs 1p19q密码缺失vs 7增益/ 10q缺失）。颅底脊索瘤的分子遗传学分析显示，2p的增加、缺乏照射和brachyury（脊索发育的重要蛋白）的表达与这些肿瘤复发的风险呈负相关。我们已经表明，分子引导的前期化疗，即基于分子分析的化疗敏感性的胶质瘤的前期化疗，可以提供化疗后肿瘤体积减少的机会，根治性切除的机会，这在最初的很大一部分肿瘤中是不可能的。我们也证实了肿瘤钙化和肿瘤表面定位的结合预测了1p19q编码的存在，具有很高的阳性预测值。

We have analyzed 140 WHO grade II-III gliomas by comparative genomic hybridization, and those tumors have been shown to be classified into clinically relevant subgroups based on genetic profiles (gain on 7q vs 1p19q codeletion vs gain of 7/loss of 10q). Molecular genetic analyses of skull base chordomas have revealed that gain on 2p, lack of irradiation, and expression of brachyury (important protein on notochord development) were negatively associated with the risk of recurrence of those tumors.We have shown that molecular-guided upfront chemotherapy, i.e. upfront chemotherapy for gliomas suggested to be chemosensitive based on molecular analyses, could provide, following tumor volume decrease by chemotherapy, chance of radical resection that was not initially possible in significant portion of those tumors. We have also confirmed that combination of tumor calcification and surface tumor localization predicted presence of 1p19q codeletion with high positive predictive value.