IDH野生型胶质母细胞瘤患者预后影响因素分析

【摘要】目的探讨WHO Ⅳ级IDH野生型胶质母细胞瘤患者预后影响因素。方法回顾性分析97例WHO Ⅳ级IDH野生型胶质母细胞瘤患者的临床资料，分析临床因素及分子标志物对患者预后的影响。 结果单因素及多因素分析显示，在IDH野生型胶质母细胞瘤中，年龄、KPS（Karnofsky功能状态评分标准）评分、肿瘤是否全切、术后是否接受同步的放化疗为独立影响因素（P<0.05），分子标志物中，O6-甲基鸟嘌呤-DNA甲基转移酶（MGMT）蛋白表达为独立的预后影响因素（P<0.05），ATRX、 P53、Ki-67的蛋白表达以及1p/19q杂合性缺失与预后不相关（P>0.05），并且非参数分析显示IDH突变型的WHO Ⅳ级成人弥漫性胶质瘤预后好于IDH野生型的WHO Ⅳ级成人弥漫性胶质瘤。结论在WHO Ⅳ级IDH野生型胶质母细胞瘤中，年龄，KPS评分，肿瘤是否全切，术后是否接受同步放化疗以及MGMT蛋白表达为有价值的参考指标，并且WHO Ⅳ级的IDH野生型成人弥漫性胶质瘤的预后比IDH突变型差。

Abstract: ObjectiveTo analyze the prognostic factors of IDH wild-type glioblastoma patients. MethodsThe clinical data of 97 patients with WHO grade Ⅳ IDH wild-type glioblastoma were analyzed retrospectively, and the effects of clinical factors and molecular markers on the prognosis were analyzed. ResultsUnivariate and multivariate analysis showed that in IDH wild-type glioblastoma, age, KPS score, extent of surgical resection, and concurrent chemo-radiotherapy were independently correlated with OS(P<0.05). The expression of MGMT were independently correlated with OS(P<0.05) and ATRX, P53, Ki-67 protein expression and 1p/19q co-deletion were not related to OS(P>0.05). And nonparametric analysis showed that the prognosis of IDH wild-type WHO Ⅳ adult-diffuse-glioma was worse than the IDH-mutant WHO Ⅳ adult-diffuse-glioma. ConclusionsIn IDH wild-type glioblastoma, age, KPS score, extent of surgical resection, concurrent chemo-radiotherapy, and MGMT expression are valuable reference indicator in IDH wild-type glioblastoma. In WHO Ⅳ adult-diffuse-glioma, the prognosis of IDH wild type is worse than IDH mutant type.