IDH1、p53和Ki-67免疫表达水平与高级别胶质瘤患者形态学、临床预后参数、术前/术后影像学表现和治疗反应的相关性

Murtaza Parvizi, Ulkun Unsal, Olcay Nalbant, Derya Demir, Murat Akyol, Aydin Isisag
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摘要

在这项研究中,我们旨在探讨影响成人高级别神经胶质肿瘤患者生存的预后因素。该回顾性研究纳入了2010年至2017年期间连续79例转介至我诊所进行辅助放疗/放化疗的患者。采用单因素和多因素分析评估预后因素对总生存期(OS)和无病生存期(DFS)的影响。中位年龄56.63岁(范围24-84岁),诊断时的中位Karnofsky Performance Status (KPS)为89%(范围50-100%)。大多数病例(n=69;87.1%)组织学诊断为世界卫生组织(WHO) IV级。中位随访12个月时,OS和DFS分别为12个月和8个月。单因素分析发现年龄、KPS、IDH1、p53、Ki-67状态在影响OS的预后因素中有统计学意义,多因素分析中只有KPS、p53、Ki-67有统计学意义。单因素分析发现年龄、KPS、IDH1和Ki-67是影响DFS的显著因素,多因素分析发现只有KPS和Ki-67是影响DFS的显著因素。KPS是OS和DFS最重要的预后因素。在评估术后组织病理学结果时,发现p53和Ki-67是OS的预后指标,而只有Ki-67是DFS的预后指标。然而,IDH1被认为是一个重要的预后因素,但没有显著的预后价值,这可能是由于我们研究的病例数量有限。
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Correlation of IDH1, p53 and Ki-67 immunoexpression levels with morphological, clinical prognostic parameters and preoperative/postoperative radiological findings and response to treatment in high-grade glial tumor case
In this study, we aimed to investigate the prognostic factors affecting survival in adult patients with high-grade glial tumors. The retrospective study included 79 consecutive patients who were referred to our clinic for adjuvant radiotherapy/radiochemotherapy between 2010 and 2017. The effect of proposed prognostic factors on overall survival (OS) and disease-free survival (DFS) was evaluated with univariate and multivariate analyses. Median age was 56.63 (range, 24-84) years and the median Karnofsky Performance Status (KPS) at diagnosis was 89% (range, 50-100%). Most the cases (n=69; 87.1%)were histologically diagnosed as World Health Organization (WHO) grade IV. At a median follow-up of 12 months, OS and DFS were 12 and 8 months, respectively. Although age, KPS, IDH1, p53 and Ki-67 status were found to be statistically significant among the prognostic factors affecting OS in univariate analyses, only KPS, p53 and Ki-67 were statistically significant in multivariate analysis.In contrast, age, KPS, IDH1, and Ki-67 were found to be significant factors for DFS in univariate analysis, while only KPS and Ki-67 were found to be significant factors for DFS in multivariate analysis. KPS was the most important prognostic factor for OS and DFS. In the evaluation of postoperative histopathological findings, p53 and Ki-67 were found to be prognostic for OS while only Ki-67 was prognostic for DFS. However, IDH1, which is known as an important prognostic factor, did not have a significant prognostic value, which could be due to the limited number of cases in our study.
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