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首页> 美国卫生研究院文献>Neuro-Oncology >PATH-09. MGMT PROMOTER METHYLATION IS A STRONG PROGNOSTIC FACTOR FOR SURVIVAL AFTER PROGRESSION IN HIGH GRADE GLIOMAS
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PATH-09. MGMT PROMOTER METHYLATION IS A STRONG PROGNOSTIC FACTOR FOR SURVIVAL AFTER PROGRESSION IN HIGH GRADE GLIOMAS

机译：路径09。 MgMT启动子甲基化是高级胶质瘤的进展后存活的强预后因素

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High grade gliomas (HGGs: anaplastic gliomas and GBM) are the most lethal type of primary brain tumor. Maximal resection and postoperative concurrent chemoradiotherapy, and followed with adjuvant chemotherapy is the standard treatment. But patients with HGGs have a relapse rapidly and short survival. Studies have identified many clinical characteristics and biomarkers were associated with progression free survival (PFS) and over survival (OS). However, there has not yet a comprehensive study on the effects of these factors to survival after the first progression (SAP). 319 patients with HGGs were conducted maximum resection followed by radiotherapy and/or temozolomide chemotherapy and have been confirmed the first progression. Clinical characteristics, biomarkers (IDH1/2 mutation, MGMT promoter methylation, LOH1p/19q, TP53 mutation, EGFR amplification, Ki-67 expression) and clinical interventions (extent of resection, chemoradiotherapy, operation after progression) were analyzed in accordance with SAP. The 1-year SAP was 14.2% (median SAP: 5.1 months). Significant prognostic factors of improved SAP were tumor grade, MGMT promoter methylation and Ki-67 expression in univariate analysis (p< 0.05). Further multivariate analysis showed that MGMT promoter methylation and Ki-67 expression were independently prognostic markers for SAP (p< 0.05). In our data, HGGs could be divided into low, intermediate and high risk groups for SAP by MGMT promoter methylation and Ki-67 expression. However, analysis of 308 patients with GBM from The Cancer Genome Atlas (TCGA) found that MGMT promoter methylation is the only prognostic marker for SAP in multivariate analysis (p< 0.05). Consequently, MGMT promoter methylation is independently prognostic marker for SAP in patients with HGGs. MGMT promoter methylation, combined with Ki-67 expression, might establish a risk model for SAP and this stratification may aid in treatment strategy selection and clinical prognosis evaluation in HGGs.
机译：高级别胶质瘤（HGGs：间变性神经胶质瘤和GBM）是最致命的类型的原发性脑肿瘤。最大切除和术后同时放化疗，并且随后与辅助化疗是标准的治疗方法。但患者HGGs迅速复发和生存期短。有研究发现了许多临床特征和生物标志物与无进展生存期（PFS）和总生存率（OS）相关。但是，对这些因素对生存的第一曲线（SAP）后的效果还没有进行全面的研究。 319例HGGs进行了最大切除后进行放射疗法和/或替莫唑胺化疗和已被确认的第一进程。临床特征，生物标记物（IDH1 / 2突变，MGMT启动子甲基化，LOH1p / 19Q，TP53突变，EGFR扩增，Ki-67的表达）和临床干预（切除术，化放疗，手术进展后的程度）按照与SAP进行分析。 1年SAP为14.2％（中位数SAP 5.1个月）。改进的SAP的显著预后因素是肿瘤等级，MGMT启动子甲基化和Ki-67的表达在单变量分析（P <0.05）。另外多变量分析表明，MGMT启动子甲基化和Ki-67的表达独立地分别为SAP预后标志物（P <0.05）。在我们的数据，HGGs可以通过MGMT启动子甲基化和Ki-67的表达被分为低，中，高风险群体用于SAP。然而，308名GBM患者从癌症基因组图谱（TCGA）分析发现，MGMT启动子甲基化是在多变量分析（P <0.05）SAP的唯一的预后标志物。因此，MGMT启动子甲基化是在患者HGGs用于SAP独立预后标志物。 MGMT启动子甲基化，与Ki-67的表达相结合，可以建立一个SAP风险模型，这种分层可以在治疗策略的选择和临床预后评价HGGs帮助。

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