A targeted gene expression biomarker predicts clinic low-risk meningioma recurrence.

IF 16.4 1区 医学 Q1 CLINICAL NEUROLOGY Neuro-oncology Pub Date : 2024-09-28 DOI:10.1093/neuonc/noae198
Minh P Nguyen, Ramin A Morshed, Mark W Youngblood, Haley K Perlow, Calixto-Hope G Lucas, Akash J Patel, Joshua D Palmer, Craig M Horbinski, Stephen T Magill, William C Chen, David R Raleigh
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Abstract

Background: Despite reassuring clinical and histological features, low grade meningiomas can recur after surgery. Targeted gene expression profiling improves risk stratification of meningiomas, but the utility of this approach for clinical low-risk meningiomas is incompletely understood.

Methods: This was a multicenter retrospective cohort study of meningiomas from patients who were treated at 4 institutions from 1992 to 2023. Adult patients with newly diagnosed or recurrent World Health Organization (WHO) grade 1 meningiomas that were treated with gross total resection (GTR) or subtotal resection (STR), or newly diagnosed WHO grade 2 meningiomas that were treated with GTR, were included. A 34-gene expression biomarker and gene expression risk score (continuous from 0 to 1) was evaluated in all samples.

Results: The study cohort was comprised of 723 patients, none of which were used for discovery or training of the gene expression biomarker and 265 of which were previously unreported. There were 626 WHO grade 1 meningiomas, 490 with GTR and 126 with STR, and 97 WHO grade 2 meningiomas with GTR. Targeted gene expression profiling classified 51.3% of clinical low-risk meningiomas as molecular intermediate-risk and 9.5% as molecular high-risk. Combining the gene expression biomarker with extent of resection revealed 19.8% of clinical low-risk meningiomas had unfavorable local freedom from recurrence (LFFR) and overall survival (OS), including 7.1% of newly diagnosed WHO grade 1 meningiomas with GTR. The risk score was prognostic for LFFR (HR per 0.1 increase in risk score 1.89, 95% CI 1.58-2.25) across all WHO grades, extents of resection, and newly diagnosed or recurrent presentations.

Conclusions: Targeted gene expression profiling can identify clinical low-risk meningiomas that are likely to recur after surgery.

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一种靶向基因表达生物标志物可预测临床低风险脑膜瘤复发。
背景:尽管临床和组织学特征令人欣慰,但低级别脑膜瘤术后仍可能复发。靶向基因表达谱分析可改善脑膜瘤的风险分层,但这种方法对临床低风险脑膜瘤的效用尚不完全清楚:这是一项多中心回顾性队列研究,研究对象是1992年至2023年期间在4家医疗机构接受治疗的脑膜瘤患者。研究纳入了新诊断或复发的世界卫生组织(WHO)1级脑膜瘤成人患者,这些患者接受了全切术(GTR)或次全切术(STR)治疗,或新诊断的WHO 2级脑膜瘤患者接受了全切术治疗。在所有样本中评估了34个基因表达生物标志物和基因表达风险评分(从0到1连续评分):研究队列由 723 例患者组成,其中没有一例用于发现或训练基因表达生物标志物,265 例之前未曾报道过。其中626例为WHO 1级脑膜瘤,490例伴有GTR,126例伴有STR;97例为WHO 2级脑膜瘤,伴有GTR。靶向基因表达谱分析将51.3%的临床低危脑膜瘤归类为分子中危,9.5%归类为分子高危。将基因表达生物标志物与切除范围相结合后发现,19.8%的临床低危脑膜瘤的局部无复发率(LFFR)和总生存率(OS)不理想,其中包括7.1%新诊断的WHO 1级脑膜瘤GTR。风险评分是LFFR的预后指标(风险评分每增加0.1,HR为1.89,95% CI为1.58-2.25),适用于所有WHO分级、切除范围、新诊断或复发表现:靶向基因表达谱分析可以识别术后可能复发的临床低风险脑膜瘤。
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来源期刊
Neuro-oncology
Neuro-oncology 医学-临床神经学
CiteScore
27.20
自引率
6.30%
发文量
1434
审稿时长
3-8 weeks
期刊介绍: Neuro-Oncology, the official journal of the Society for Neuro-Oncology, has been published monthly since January 2010. Affiliated with the Japan Society for Neuro-Oncology and the European Association of Neuro-Oncology, it is a global leader in the field. The journal is committed to swiftly disseminating high-quality information across all areas of neuro-oncology. It features peer-reviewed articles, reviews, symposia on various topics, abstracts from annual meetings, and updates from neuro-oncology societies worldwide.
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