Gliomas are primary brain lesions involving cerebral structures without well-defined boundaries and constitute the most prevalent central nervous system (CNS) neoplasms. Among gliomas, glioblastoma (GB) is a glioma of the highest grade and is associated with a grim prognosis. We examined how clinical variables and molecular profiles may have affected overall survival (OS) over the past ten years. A retrospective study was conducted at Sina Hospital in Tehran, Iran and examined patients with confirmed glioma diagnoses between 2012 and 2020. We evaluated the correlation between OS in GB patients and sociodemographic as well as clinical factors and molecular profiling based on IDH1, O-6-Methylguanine-DNA Methyltransferase (MGMT), TERTp, and epidermal growth factor receptor (EGFR) amplification (EGFR-amp) status. Kaplan–Meier and multivariate Cox regression models were used to assess patient survival. A total of 178 patients were enrolled in the study. The median OS was 20 months, with a 2-year survival rate of 61.0%. Among the 127 patients with available IDH measurements, 100 (78.7%) exhibited mutated IDH1 (IDH1-mut) tumors. Of the 127 patients with assessed MGMT promoter methylation (MGMTp-met), 89 (70.1%) had MGMT methylated tumors. Mutant TERTp (TERTp-mut) was detected in 20 out of 127 cases (15.7%), while wildtype TERTp (wildtype TERTp-wt) was observed in 107 cases (84.3%). Analyses using multivariable models revealed that age at histological grade (p< 0.0001), adjuvant radiotherapy (p< 0.018), IDH1 status (p< 0.043), and TERT-p status (p< 0.014) were independently associated with OS. Our study demonstrates that patients with higher tumor histological grades who had received adjuvant radiotherapy exhibited IDH1-mut or presented with TERTp-wt experienced improved OS. Besides, an interesting finding showed an association between methylation of MGMTp and TERTp status with tumor location.
胶质瘤是原发性脑部病变，累及脑组织且边界不清，是最常见的中枢神经系统肿瘤。其中，胶质母细胞瘤是恶性程度最高的胶质瘤亚型，预后极差。本研究旨在探讨过去十年间临床变量与分子特征对患者总生存期的影响。我们在伊朗德黑兰西纳医院开展了一项回顾性研究，纳入2012年至2020年间确诊的胶质瘤患者。通过分析IDH1、O6-甲基鸟嘌呤-DNA甲基转移酶启动子甲基化、端粒酶逆转录酶启动子及表皮生长因子受体扩增状态，评估胶质母细胞瘤患者总生存期与社会人口学特征、临床因素及分子谱的关联性。采用Kaplan-Meier法和多变量Cox回归模型评估患者生存状况。研究共纳入178例患者，中位总生存期为20个月，2年生存率为61.0%。在127例完成IDH检测的患者中，100例（78.7%）存在IDH1突变。127例完成MGMT启动子甲基化检测的患者中，89例（70.1%）呈现甲基化状态。127例患者中检测到20例（15.7%）存在TERT启动子突变，107例（84.3%）为TERT启动子野生型。多变量模型分析显示：组织学分级年龄（p<0.0001）、辅助放疗（p<0.018）、IDH1状态（p<0.043）和TERT启动子状态（p<0.014）与总生存期存在独立相关性。研究表明，接受辅助放疗、存在IDH1突变或TERT启动子野生型的高级别胶质瘤患者总生存期更优。此外，研究还发现MGMT启动子甲基化状态与TERT启动子状态之间存在与肿瘤定位相关的有趣关联。
Genetic Prognostic Factors in Adult Diffuse Gliomas: A 10-Year Experience at a Single Institution
肿瘤(癌症)患者之家