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吴小延, 王苏杰, 王芳, 杜紫明, 邓玲. IDH突变和1p/19q共缺失型少突胶质细胞瘤临床病理特征和预后分析[J]. 肿瘤防治研究, 2024, 51(3): 178-184. DOI: 10.3971/j.issn.1000-8578.2024.23.1036
引用本文: 吴小延, 王苏杰, 王芳, 杜紫明, 邓玲. IDH突变和1p/19q共缺失型少突胶质细胞瘤临床病理特征和预后分析[J]. 肿瘤防治研究, 2024, 51(3): 178-184. DOI: 10.3971/j.issn.1000-8578.2024.23.1036
WU Xiaoyan, WANG Sujie, WANG Fang, DU Ziming, DENG Ling. Clinicopathologic Characteristics and Prognosis of Oligodendroglioma with IDH Mutation and 1p/19q Codeletion[J]. Cancer Research on Prevention and Treatment, 2024, 51(3): 178-184. DOI: 10.3971/j.issn.1000-8578.2024.23.1036
Citation: WU Xiaoyan, WANG Sujie, WANG Fang, DU Ziming, DENG Ling. Clinicopathologic Characteristics and Prognosis of Oligodendroglioma with IDH Mutation and 1p/19q Codeletion[J]. Cancer Research on Prevention and Treatment, 2024, 51(3): 178-184. DOI: 10.3971/j.issn.1000-8578.2024.23.1036

IDH突变和1p/19q共缺失型少突胶质细胞瘤临床病理特征和预后分析

Clinicopathologic Characteristics and Prognosis of Oligodendroglioma with IDH Mutation and 1p/19q Codeletion

  • 摘要:
    目的 探讨IDH突变和1p/19q共缺失型少突胶质细胞瘤的临床病理特征及预后相关影响因素。
    方法 收集54例IDH突变和1p/19q共缺失型少突胶质细胞瘤病例, 分析其临床病理特点, 包括年龄、组织学分级和肿瘤部位等因素对无进展生存期和总生存期的影响。
    结果 54例患者中, 肿瘤发生于1个脑叶者46例, 发生于2个脑叶以上者8例。肿瘤组织学WHO分级2级12例, 3级42例。FISH检测显示54例均为1p/19q共缺失; 免疫组织化学检测显示Olig2均为弥漫强阳性; GFAP均为阳性; p53有6例强阳性; 48例患者ATRX未缺失; Ki-67增殖指数5%~60%。Sanger测序显示54例均发生IDH基因突变(40例为IDH1突变, 14例为IDH2突变), 33例发生TERT启动子突变。16例在治疗过程中发生复发及转移。单因素分析显示, 手术后复发转移间隔时间超过2年可以延长患者无进展生存和总生存期。54例患者平均无进展生存期33.5个月, 平均总生存期40.7个月。
    结论 IDH突变和1p/19q共缺失型少突胶质细胞瘤术后联合精准放化疗降低了进展风险, 手术后复发转移间隔时间与该型患者预后相关。

     

    Abstract:
    Objective To analyze the clinicopathological characteristics and prognosis of oligodendroglioma with IDH mutation and 1p/19q codeletion.
    Methods We collected the data of 54 oligodendroglioma patients with IDH mutation and 1p/19q codeletion.The patients'clinicopathological data, including age, histological grade, and tumor site, were analyzed for the effects on progression-free and overall survival.
    Results Among the 54 patients, 46 cases were with tumor sites in one lobe, and eight cases involved tumor sites in more than two lobes.A total of 12 and 42 cases had WHO grades 2 and 3 oligodendroglioma, respectively.Detection by fluorescence in situ hybridization showed 1p/19q co-deletion in all cases.Immunohistochemical tests revealed diffuse and strong positive results for Olig2.All glial fibrillary acidic proteins were positive.p53 was strongly positive in six cases.ATRX was expressed in all 48 cases.Ki-67 proliferation index ranged from 5% to 60%.Sanger sequencing showed that all 54 cases had IDH gene mutations (40 cases were IDH1 mutations, and 14 were IDH2 mutations), and 33 cases had telomerase reverse transcriptase promoter mutations.Relapse and metastasis occurred in 16 patients during treatment.Univariate analysis indicated that the postoperative recurrence and metastasis interval of more than two years can prolong the progression-free and overall survival of patients.All 54 patients had a mean progression-free survival of 33.5 months and the mean overall survival of 40.7 months.
    Conclusion For oligodendroglioma with IDH mutation and 1p/19q codeletion, precision chemoradiotherapy after surgery can reduce the risk of progression, and the postoperative recurrence and metastasis interval is associated with the prognosis.

     

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