Genetic Profile of Primary Brain Tumours and the Degree of Their Resection Versus Survival of Patients Undergoing Surgery and Complementary Oncological Treatment

L. Grzelak, S. Grzyb, Wiktoria Fiał
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Abstract

Introduction. Recently, the incidence of brain glial tumours has increased significantly worldwide. Gliomas are among the most malignant types of tumours of the central nervous system. Patients diagnosed with glial tumours have a very unfavourable prognosis leading to death, and the course of the disease itself has a negative impact on their physical, mental and social condition. Aim. The aim of this study was to determine the effect of the results of histological and genetic tests as well as the degree of resection of primary CNS tumours on the survival of patients undergoing neurosurgery and complementary oncological treatment — pharmacology and radiotherapy. Material and Methods. The research was carried out on the basis of an analysis of medical records (2019–2021) of 63 adult patients from the Department of Neurosurgery of the Specialist Municipal Hospital of Nicolaus Copernicus in Toruń. The study group included patients who had been diagnosed with a primary brain tumour and had undergone neurosurgery and complementary oncological treatment. The analysis of medical documentation consisted in comparing the results of histopathological tests with the results of specialized molecular tests and correlating them with the survival time of patients. The statistical analysis was carried out using the Pearson correlation, statistical inference was made at the significance level of p=0.05. Results. Based on the obtained results, it was found that the presence of MGMT gene promoter methylation (r=0.30, p=0.018) and IDH mutation (r=0.38, p=0.002) correlated positively with survival. The extent of resection also had a significant impact on patient survival (r=0.55, p<0.001). Patients who underwent complete tumour resection survived an average of 19.34 months, while those who underwent biopsy survived for 7.94 months. Conclusions. The data collected during the conducted analyses may be important for the prognosis perspective and the selection of the optimal treatment strategy for both current and future patients. (JNNN 2022;11(4):162–166)
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原发性脑肿瘤的遗传特征及其切除程度与接受手术和肿瘤补充治疗的患者的生存
介绍。近年来,脑神经胶质肿瘤的发病率在世界范围内显著增加。神经胶质瘤是中枢神经系统最恶性的肿瘤之一。被诊断为神经胶质肿瘤的患者预后非常不利,可能导致死亡,而且疾病本身的病程对患者的身体、精神和社会状况都有负面影响。本研究的目的是确定组织学和基因检测结果以及原发性中枢神经系统肿瘤的切除程度对接受神经外科手术和补充肿瘤治疗(药理学和放疗)的患者生存的影响。材料和方法。该研究是在对托卢奇尼古拉斯·哥白尼专科市立医院神经外科63名成年患者的医疗记录(2019-2021年)进行分析的基础上进行的。研究组包括被诊断患有原发性脑肿瘤并接受神经外科手术和辅助肿瘤治疗的患者。对医学文献的分析包括将组织病理学检查结果与专门的分子检查结果进行比较,并将其与患者的生存时间联系起来。采用Pearson相关进行统计学分析,在p=0.05的显著性水平上进行统计学推断。根据得到的结果,我们发现MGMT基因启动子甲基化(r=0.30, p=0.018)和IDH突变(r=0.38, p=0.002)的存在与生存率呈正相关。切除程度对患者生存也有显著影响(r=0.55, p<0.001)。接受肿瘤完全切除的患者平均存活19.34个月,而接受活检的患者平均存活7.94个月。在进行的分析中收集的数据可能对预后观点和当前和未来患者的最佳治疗策略的选择很重要。(JNNN 2022; 11 (4): 162 - 166)
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