中华病理学杂志
中華病理學雜誌
중화병이학잡지
Chinese Journal of Pathology
2014年
10期
668-672
,共5页
蒋梦婉%董祥慧%李嘉瑶%李婧琦%戚基萍
蔣夢婉%董祥慧%李嘉瑤%李婧琦%慼基萍
장몽완%동상혜%리가요%리청기%척기평
星形细胞瘤%异柠檬酸脱氢酶%预后
星形細胞瘤%異檸檬痠脫氫酶%預後
성형세포류%이저몽산탈경매%예후
Astrocytoma%Isocitrate dehydrogenase%Prognosis
目的 探讨人脑星形细胞瘤中IDH1突变及MGMT蛋白的表达与临床病理特征之间的关系,以及不同表达类型在放疗条件下对预后的影响.方法 应用EnVision二步法进行免疫组织化学染色,观察48例星形细胞瘤(WHOⅡ～Ⅲ级)患者石蜡包埋组织中IDH1突变及MGMT蛋白表达情况,并对患者放化疗情况及生存时间进行随访.结果 星形细胞瘤中IDH1突变及MGMT蛋白表达率分别为62.7％ (30/48)和47.9％(23/48),IDH1突变与MGMT蛋白表达之间呈负相关(r=-0.641,P＜0.01).IDH1突变患者发病年龄较低,WHOⅡ级星形细胞瘤患者IDH1突变率高于WHOⅢ级患者(P＜0.05).发病年龄为IDH1突变表达的独立影响因素.放射治疗后IDH1突变+/MGMT-表达型患者总体生存时间长于IDH1突变-/MGMT+表达型患者,差异具有统计学意义(P＜0.05).结论 星形细胞瘤WHOⅡ～Ⅲ级中IDH1突变表达与MGMT蛋白表达存在相关性;发病年龄为IDH1突变表达的独立影响因素;放射治疗对IDH1突变+/MGMT-表达型患者治疗效果优于IDH1突变-/MGMT+型患者.临床上对IDH1突变及MGMT蛋白表达的检测可为星形细胞瘤患者术后治疗方式的选择提供一定的指导和帮助.
目的 探討人腦星形細胞瘤中IDH1突變及MGMT蛋白的錶達與臨床病理特徵之間的關繫,以及不同錶達類型在放療條件下對預後的影響.方法 應用EnVision二步法進行免疫組織化學染色,觀察48例星形細胞瘤(WHOⅡ～Ⅲ級)患者石蠟包埋組織中IDH1突變及MGMT蛋白錶達情況,併對患者放化療情況及生存時間進行隨訪.結果 星形細胞瘤中IDH1突變及MGMT蛋白錶達率分彆為62.7％ (30/48)和47.9％(23/48),IDH1突變與MGMT蛋白錶達之間呈負相關(r=-0.641,P＜0.01).IDH1突變患者髮病年齡較低,WHOⅡ級星形細胞瘤患者IDH1突變率高于WHOⅢ級患者(P＜0.05).髮病年齡為IDH1突變錶達的獨立影響因素.放射治療後IDH1突變+/MGMT-錶達型患者總體生存時間長于IDH1突變-/MGMT+錶達型患者,差異具有統計學意義(P＜0.05).結論 星形細胞瘤WHOⅡ～Ⅲ級中IDH1突變錶達與MGMT蛋白錶達存在相關性;髮病年齡為IDH1突變錶達的獨立影響因素;放射治療對IDH1突變+/MGMT-錶達型患者治療效果優于IDH1突變-/MGMT+型患者.臨床上對IDH1突變及MGMT蛋白錶達的檢測可為星形細胞瘤患者術後治療方式的選擇提供一定的指導和幫助.
목적 탐토인뇌성형세포류중IDH1돌변급MGMT단백적표체여림상병리특정지간적관계,이급불동표체류형재방료조건하대예후적영향.방법 응용EnVision이보법진행면역조직화학염색,관찰48례성형세포류(WHOⅡ～Ⅲ급)환자석사포매조직중IDH1돌변급MGMT단백표체정황,병대환자방화료정황급생존시간진행수방.결과 성형세포류중IDH1돌변급MGMT단백표체솔분별위62.7％ (30/48)화47.9％(23/48),IDH1돌변여MGMT단백표체지간정부상관(r=-0.641,P＜0.01).IDH1돌변환자발병년령교저,WHOⅡ급성형세포류환자IDH1돌변솔고우WHOⅢ급환자(P＜0.05).발병년령위IDH1돌변표체적독립영향인소.방사치료후IDH1돌변+/MGMT-표체형환자총체생존시간장우IDH1돌변-/MGMT+표체형환자,차이구유통계학의의(P＜0.05).결론 성형세포류WHOⅡ～Ⅲ급중IDH1돌변표체여MGMT단백표체존재상관성;발병년령위IDH1돌변표체적독립영향인소;방사치료대IDH1돌변+/MGMT-표체형환자치료효과우우IDH1돌변-/MGMT+형환자.림상상대IDH1돌변급MGMT단백표체적검측가위성형세포류환자술후치료방식적선택제공일정적지도화방조.
Objective To study the correlation between IDH1 mutation,MGMT expression,clinicopathologic features and post-radiotherapy prognosis in patients with astrocytoma.Methods Detection of IDH1 mutation and MGMT expression was carried out in 48 cases of astrocytoma (WHO grade Ⅱ to Ⅲ)by EnVision method with immunohistochemical staining.Follow-up data,including treatment response and overall survival time,were analyzed.Results The rates of IDH1 mutation and MGMT expression in astrocytomas were 62.7％ (30/48) and 47.9％ (23/48),respectively.There was a negative correlation between IDH1 mutation and MGMT expression (r =-0.641,P ＜ 0.01).The age of patients with IDH1 mutation was younger at disease onset.The IDH1 mutation rate in patients with WHO grade Ⅱ astrocytoma was higher than that in patients with WHO grade Ⅲ tumor (P ＜ 0.05).The age at onset was an independent factor affecting the expression of mutant IDH1.After radiotherapy,patients with IDH1 mutation +/MGMT-tumor carried a longer overall survival time than patients with IDH1 mutation-/MGMT + tumor (P ＜ 0.05).Conclusions There is a correlation between IDH1 mutation and MGMT expression in WHO grade Ⅱ to Ⅲ astrocytoma.Age at onset is an independent factor affecting the expression of mutant IDH1.Tumors with IDH1 +/MGMT-pattern show better response to radiotherapy than tumors with IDH1-/MGMT + pattern.Detection of IDH1 mutation and MGMT protein expression can provide some guidance in choice of treatment modalities in patients with astrocytoma.
