Gliom nồng độ thấp kiểu hoang dã IDH với các đặc điểm phân tử của glioblastoma: một tổng quan hệ thống và phân tích tổng hợp

Brain Tumor Pathology - Tập 40 - Trang 143-157 - 2023
Satoshi Nakasu1,2, Shoichi Deguchi3, Yoko Nakasu2,3
1Division of Neurosurgery, Omi Medical Center, Kusatsu, Japan
2Department of Neurosurgery, Shiga University of Medical Science, Ohtsu, Japan
3Division of Neurosurgery, Shizuoka Cancer Center, Nagaizumi, Japan

Tóm tắt

Phân loại của WHO năm 2021 xác định glioma mức độ thấp kiểu hoang dã IDH (IDHw) là glioblastoma phân tử (mGBM) nếu có sự hiện diện của đột biến trình điều khiển TERT (pTERTm), sự khuếch đại EGFR hoặc các bất thường liên quan đến tăng nhiễm sắc thể 7 và mất nhiễm sắc thể 10. Chúng tôi đã đánh giá hệ thống các bài báo nghiên cứu về IDHw hLGG (49 nghiên cứu, N=3748) và phân tích tổng hợp tỷ lệ mGBM và thời gian sống sót tổng thể (OS) theo tuyên bố PRISMA. Tỷ lệ mGBM ở IDHw hLGG thấp đáng kể ở khu vực châu Á (43.7%, khoảng tin cậy 95% [CI: 35.8–52.0]) so với các khu vực không thuộc châu Á (65.0%, [CI: 52.9–75.4]) (P=0.005) và cũng thấp đáng kể trong mẫu đông lạnh tươi so với mẫu được chôn trong formalin (P=0.015). Các IDHw hLGG không có pTERTm hiếm khi thể hiện các dấu hiệu phân tử khác trong các nghiên cứu ở châu Á so với các nghiên cứu không thuộc châu Á. Bệnh nhân mGBM có thời gian sống sót tổng thể dài hơn đáng kể khi so với GBM mô học (hGBM) (tỷ lệ nguy cơ tổng hợp (pHR) 0.824, [CI: 0.694–0.98], P=0.03)). Trong số bệnh nhân có mGBM, cấp độ mô học là một yếu tố dự đoán quan trọng (pHR 1.633, [CI: 1.09–2.447], P=0.018), cũng như tuổi tác (P=0.001) và mức độ phẫu thuật (P=0.018). Mặc dù nguy cơ thiên lệch trong các nghiên cứu là trung bình, mGBM với cấp độ mô học II cho thấy tỷ lệ sống sót tổng thể tốt hơn khi so với hGBM.

Từ khóa

#glioma #IDH #glioblastoma #phân tích tổng hợp #sống sót tổng thể

Tài liệu tham khảo

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