量化 "高级别 "特征的程度是否有助于解释无弹性星形细胞瘤的预后变异?

IF 1 4区 医学 Q4 CLINICAL NEUROLOGY British Journal of Neurosurgery Pub Date : 2024-04-01 Epub Date: 2020-12-30 DOI:10.1080/02688697.2020.1866163
Edward Goacher, Ryan Mathew, Oluwafikayo Fayaye, Aruna Chakrabarty, Richard Feltbower, Carmel Loughrey, Paul Roberts, Paul Chumas
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引用次数: 0

摘要

目的:表型和基因型的变异目前已成为胶质瘤分类的基础,从而有助于更准确地指导临床治疗。然而,WHO III级无弹性星形细胞瘤(AA)仍然是一种不可预测的异质性实体,其预后、临床过程和治疗反应各不相同。本研究旨在探讨其他肿瘤特征是否会影响AA的总生存率(OS)或3年生存率:收集2003年至2014年间所有新确诊AA病例的数据,并进行至少3年的随访。从病例记录中获取分子信息,如果缺失,则重新进行分析。对组织切片的Ki-67增殖指数、细胞度和有丝分裂数进行独立检查。采用 Kaplan-Meier 和 Cox 回归分析评估 OS:结果:共纳入50例病例,中位OS为14.5个月(范围:1-150个月)。累计 3 年生存率为 31.5%。中位年龄为 50 岁(范围:24 - 77)。年龄、IDH1突变状态、肺叶位置、肿瘤治疗和手术切除是影响OS的重要独立预后指标。在OS≥3年的病例中(n = 15),Ki-67指数、有丝分裂数目和 "高细胞度 "区域百分比显著降低,即更具有低级别/WHO II级胶质瘤的特征:结论:IDH1状态、年龄、治疗和位置仍是AA患者最重要的预后指标。然而,Ki-67指数、有丝分裂数和细胞度可能有助于鉴别存活期小于3年的AA病例(即更类似于胶质母细胞瘤的AA病例)和存活期大于3年的AA病例(即更类似于低级别胶质瘤的AA病例)。
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Can quantifying the extent of 'high grade' features help explain prognostic variability in anaplastic astrocytoma?

Purpose: Both phenotypic and genotypic variations now underpin glioma classification, thus helping to more accurately guide their clinical management. However, WHO Grade III anaplastic astrocytoma (AA) remains an unpredictable, heterogeneous entity; displaying a variable prognosis, clinical course and treatment response. This study aims to examine whether additional tumour characteristics influence either overall survival (OS) or 3-year survival in AA.

Materials and methods: Data were collected on all newly diagnosed cases of AA between 2003 and 2014, followed up for a minimum of 3 years. Molecular information was obtained from case records and if missing, was re-analysed. Histological slides were independently examined for Ki-67 proliferation index, cellularity and number of mitotic figures. Kaplan-Meier and Cox regression analyses were used to assess OS.

Results: In total, 50 cases were included with a median OS of 14.5 months (range: 1-150 months). Cumulative 3-year survival was 31.5%. Median age was 50 years (range: 24 - 77). Age, IDH1 mutation status, lobar location, oncological therapy and surgical resection were significant independent prognostic indicators for OS. In cases demonstrating an OS3 years (n=15), Ki-67 index, number of mitotic figures and percentage areas of 'high cellularity' were significantly reduced, i.e. more characteristic of lower-grade/WHO Grade II glioma.

Conclusions: IDH1 status, age, treatment and location remain the most significant prognostic indicators for patients with AA. However, Ki-67 index, mitotic figures and cellularity may help identify AA cases more likely to survive < 3 years, i.e. AA cases more similar to glioblastoma and those cases more likely to survive > 3 years, i.e. more similar to a low-grade glioma.

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来源期刊
British Journal of Neurosurgery
British Journal of Neurosurgery 医学-临床神经学
CiteScore
2.30
自引率
9.10%
发文量
139
审稿时长
3-8 weeks
期刊介绍: The British Journal of Neurosurgery is a leading international forum for debate in the field of neurosurgery, publishing original peer-reviewed articles of the highest quality, along with comment and correspondence on all topics of current interest to neurosurgeons worldwide. Coverage includes all aspects of case assessment and surgical practice, as well as wide-ranging research, with an emphasis on clinical rather than experimental material. Special emphasis is placed on postgraduate education with review articles on basic neurosciences and on the theory behind advances in techniques, investigation and clinical management. All papers are submitted to rigorous and independent peer-review, ensuring the journal’s wide citation and its appearance in the major abstracting and indexing services.
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