脑胶质瘤分子标志物IDH1R132突变、MGMT和Ki-67与病理分级及预后关系的研究

发布时间：2018-03-15 18:42

本文选题：胶质瘤　切入点：IDHR　出处：《安徽医科大学学报》2017年03期 　论文类型：期刊论文

【摘要】：目的联合检测脑胶质瘤中异柠檬酸脱氢酶1R132位点核苷酸突变(IDH1R132突变)、O~6-甲基鸟嘌呤-DNA-甲基转移酶(MGMT)和Ki-67蛋白的表达,探讨其表达与胶质瘤病理分级的相关性及对预后的影响。方法收集脑胶质瘤病理标本135例,采用免疫组织化学方法检测病理标本中IDH1R132突变、MGMT和Ki-67蛋白的表达情况,并对此部分患者进行长期随访,从而分析这3种分子标志物的表达与病理分级及预后的相关性。结果 135例脑胶质瘤标本中IDH1R132突变总阳性表达率为31.1%(42/135),Ⅱ级、Ⅲ级及Ⅳ级脑胶质瘤标本中IDH1R132突变阳性表达率分别为49.1%、22.2%、11.8%,三者间表达差异有统计学意义(P0.01);IDH1R132突变阳性表达者中位生存时间明显高于阴性表达者,分别为27个月和13个月(P0.01)。MGMT总体阳性表达率为42.2%,不同级别的胶质瘤之间MGMT阳性表达率差异无统计学意义;MGMT阳性表达者中位生存时间(12个月)低于阴性者(23个月)(P0.01)。所有患者Ki-67呈阳性表达,Ⅱ-Ⅳ级胶质瘤中Ki-67的表达率呈上升趋势,不同级别的胶质瘤之间Ki-67阳性表达程度差异有统计学意义(P0.001);Ki-67表达程度与患者中位生存时间无显著差异。结论 IDH1R132突变、Ki-67的表达水平与肿瘤的恶性程度密切相关,IDH1R132突变、MGMT在不同级别胶质瘤的预后评价中具有重要意义,可作为预后的独立预测指标。
[Abstract]:Objective to detect glioma isocitrate dehydrogenase 1R132 nucleotide mutation (IDH1R132 mutation), O~6- methylguanine -DNA- methyltransferase (MGMT) and Ki-67 protein expression, to investigate the correlation between the expression and pathological grades of glioma and its effect on prognosis. Methods: pathological specimens of 135 cases with glioma, detection the IDH1R132 mutation in pathological specimens by immunohistochemical method, the expression of MGMT and Ki-67 protein, and this part of patients were followed up, so as to analyze the correlation between expression and pathological grading and prognosis of the 3 molecular markers. Results in 135 cases of glioma IDH1R132 mutations in total positive rate was 31.1% (42/135), grade II, III and IV glioma specimens in IDH1R132 mutation positive expression rates were 49.1%, 22.2%, 11.8%, there is a significant difference between the three (P0.01); IDH1R132 mutation positive Expression of the median survival time was significantly higher than that of negative expression, respectively, 27 and 13 months (P0.01).MGMT positive expression rate was 42.2% overall, between different grades of glioma had no statistical significance between the positive expression rate of MGMT; the median survival time of MGMT positive expression in (12 months) than negative (23 months) (P0.01). All patients showed Ki-67 positive expression, the expression of Ki-67 II - IV in glioma rates rise, statistically significant differences between the degree of positive expression of Ki-67 in gliomas of different grades (P0.001); the degree of expression of Ki-67 and the median survival time was no significant difference. Conclusion IDH1R132 mutation is closely related to the malignant degree of Ki-67 expression and tumor IDH1R132 mutation has important significance in evaluation of prognosis of MGMT in different grades of glioma, can be used as an independent prognostic marker.

【作者单位】：河北医科大学第二医院放疗科;
【基金】：河北省医学科学研究重点课题计划(编号:20150255)
【分类号】：R739.41

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