• 医学文献
  • 知识库
  • 评价分析
  • 中外期刊
  • 学位
  • 会议
  • 专利
  • 成果
  • 标准
  • 法规
  • 临床诊疗知识库
  • 中医药知识库
  • 机构
  • 作者
论文 期刊
高级检索

检索历史 清除

长生存期胶质母细胞瘤患者的临床特点及分子表达分析

A clinical and molecular study of long-term survival glioblastomas

摘要:

目的 探讨长期生存胶质母细胞瘤患者的临床特点及肿瘤分子表达特征.方法 选取2007年6月至2009年4月进行手术治疗的术后至少存活3年的胶质母细胞瘤患者15例纳入本研究,将同期手术且生存期低于1年的胶质母细胞瘤患者作为对照组.对其年龄、肿瘤大小及部位、手术切除程度、术后辅助治疗等临床特点进行总结分析.通过免疫组化的方法对肿瘤标本中表皮生长因子受体(EGFR)、肿瘤抑制基因P53、人第10号染色体缺失的磷酸酶及张力因子(PTEN)、O6-甲基鸟嘌呤-DNA甲基转移酶(MGMT)、异柠檬酸盐脱氢酶1(IDH1)和神经纤维瘤蛋白(NF-1)的蛋白表达进行检测,通过DNA直接测序法对IDH1和P53的突变情况进行检测.对两组间有差异的因素进行Kaplan-Meier生存分析,发现与预后相关的因素.结果 15例长期生存胶质母细胞瘤患者总体生存时间为3~6年,中位生存期为3.5年.其胶质瘤确诊时的平均年龄为45.6岁,肿瘤均未累及脑深部结构,13例患者手术全切除,14例患者使用了替莫唑胺化疗.筛选分子阳性发生率依次为PTEN(13/15)、IDH1(13/15)、IDH1突变(12/15)、P53(8/15)、P53突变(7/15)、EGFR(6/15)、MGMT(4/15)和NF-1(3/15).与对照组患者比较,年龄≤50岁(OR=0.262,95% CI:0.102 ~0.672)、手术全切除(OR=0.372,95% CI:0.149~ 0.931)、术后替莫唑胺化疗(OR=0.131,95% CI:0.044~0.390)、肿瘤表达PTEN(OR=0.201,95% CI:0.074~0.549)与IDH1(OR=0.151,95% CI:0.050~0.454)及IDH1突变(OR=0.276,95% CI:0.108 ~0.709)是有利于胶质母细胞瘤患者的预后因素.结论 长期生存胶质母细胞瘤患者具有相似的临床特点和分子表达特征,更多相关研究的开展,有助于我们更好地判断胶质瘤患者的预后.

更多
abstracts:

Objectives To analyze the long-term survivors of glioblastoma and to identify any prognostic factors that potentially contribute to survival.Methods Fifteen glioblastomas patients underwent surgery from June 2007 to April 2009 who survived longer than 3 years were enrolled in.Clinical characteristics such as age,location of tumor,extent of resection,and radiotherapy or chemotherapy were analyzed.The expressions of epidermal growth factor receptor(EGFR),tumor protein 53(P53),phosphatase and tensin homolog(PTEN),O6-methylguanine-DNA methyltransferase(MGMT),isocitrate dehydrogenase 1 gene(IDH1),and neurofibromatosis type 1(NF-1)in tumor samples were measured by immunohistochemical method,and the status of P53 and IDH1 were detected by direct DNA sequencing as well.And the patients who survived less than 1 year were set as control.Kaplan-Mcier analysis was used to evaluate the prognostic factors.Results The average age of patients at diagnosis was 45.6 years.And the overall survival time was 3-6 years(median survival time 3.5 years).Thirteen patients underwent a total resection,and 14 patients took orally temozolomide.The occurrence frequency of these molecular markers in long-term survivors was PTEN(13/15),IDH1(13/15),IDH1 mutation(12/15),P53(8/15),P53 mutation(7/15),EGFR(6/15),MGMT(4/15)and NF-1(3/15).There was a good correlation between IDH1 protein expression and IDHI mutation,and between P53 protein expression and P53 mutation.And the survival analysis showed that age above 50 years at diagnosis(OR =0.262,95% CI:0.102-0.672),total resection(OR =0.372,95% CI:0.149-0.931)and combined oral temozolomide(OR =0.131,95% CI:0.044-0.390)were favorable clinical prognostic factors.PTEN(OR =0.201,95% CI: 0.074-0.549)and IDH1(OR =0.151,95% CI:0.050-0.454)expression,IDH1 mutation(OR =0.276,95% CI:0.108-0.709)in tumor cells contributed to a favorable prognosis.Conclusions There is probably no single molecular marker that is responsible for long-term survival of patients with glioblastoma,may be a balance between all these molecular events result in a favorable outcome.

More
  • 浏览:446
  • 下载:49

加载中!

相似文献

  • 中文期刊
  • 外文期刊
  • 学位论文
  • 会议论文

加载中!

加载中!

加载中!

加载中!

扩展文献

特别提示:本网站仅提供医学学术资源服务,不销售任何药品和器械,有关药品和器械的销售信息,请查阅其他网站。

充值 订阅 收藏 移动端 使用
帮助