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Abstract：
BACKGROUND: Glioblastoma and astrocytoma, grade 4, are the most common and aggressive brain tumors. Several biomarkers, such as the isocitrate dehydrogenase mutation (IDH-1), alpha-thalassemia/mental retardation, and the X-linked mutation (ATRX), enable more accurate glioma classification and facilitate patient management. This study aimed to determine the prognostic value of clinical and molecular factors (IDH, TP53, and ATRX mutations). We also studied the relationship between these molecular markers and the overall survival (OS) of 126 patients with grade 4 glioblastoma/astrocytoma.
METHODS: The immunohistochemical study was conducted using antibodies namely, IDH1, R132H, p53, and ATRX. Statistical tests were used to investigate factors that might influence overall survival using IBM SPSS Statistics, version 25.0 (IBM Corp., Armonk, NY).
RESULTS: The median age at diagnosis was 51.5 years. Patients with a Karnofsky performance score (KPS) <70 presented less favorable survival outcomes compared to those with a KPS ≥70. The median OS for patients was found to be 11.17 months. Expression of IDH1 R132H was found in 13.5% of patients, p53 overexpression was identified in 55.6% of cases, and loss of ATRX expression was detected in 11.9%. The group of patients with IDH mutant/ATRX mutant/p53 wild-type had the best prognosis (OS = 27.393 months; p = 0.015). Our results were in line with previous studies.
CONCLUSIONS: The clinical value of IDH and ATRX mutations in prognostic assessment was confirmed (p ≤0.05). The overexpression of p53 had no significant impact on OS (p = 0.726). Therefore, p53 alone cannot predict survival in glioblastoma patients. Based on the results, these biomarkers may be a potential therapeutic target to prolong patient survival, hence the need for further investigations.
METHODS: The immunohistochemical study was conducted using antibodies namely, IDH1, R132H, p53, and ATRX. Statistical tests were used to investigate factors that might influence overall survival using IBM SPSS Statistics, version 25.0 (IBM Corp., Armonk, NY).
RESULTS: The median age at diagnosis was 51.5 years. Patients with a Karnofsky performance score (KPS) <70 presented less favorable survival outcomes compared to those with a KPS ≥70. The median OS for patients was found to be 11.17 months. Expression of IDH1 R132H was found in 13.5% of patients, p53 overexpression was identified in 55.6% of cases, and loss of ATRX expression was detected in 11.9%. The group of patients with IDH mutant/ATRX mutant/p53 wild-type had the best prognosis (OS = 27.393 months; p = 0.015). Our results were in line with previous studies.
CONCLUSIONS: The clinical value of IDH and ATRX mutations in prognostic assessment was confirmed (p ≤0.05). The overexpression of p53 had no significant impact on OS (p = 0.726). Therefore, p53 alone cannot predict survival in glioblastoma patients. Based on the results, these biomarkers may be a potential therapeutic target to prolong patient survival, hence the need for further investigations.
摘要：
背景：胶质母细胞瘤和星形细胞瘤，4级，是最常见和侵袭性脑肿瘤。几种生物标志物，如异柠檬酸脱氢酶突变（IDH-1），α-地中海贫血/智力低下，和X连锁突变（ATRX），使更准确的神经胶质瘤分类和促进患者管理。本研究旨在确定临床和分子因素(IDH，TP53和ATRX突变)。我们还研究了这些分子标志物与126例4级胶质母细胞瘤/星形细胞瘤患者的总生存期（OS）之间的关系。
方法：使用抗体进行免疫组织化学研究，IDH1,R132H,p53和ATRX。使用IBMSPSSStatistics，使用统计检验来调查可能影响总体生存率的因素。版本25.0(IBMCorp.,Armonk,NY).
结果：诊断时的中位年龄为51.5岁。与KPS≥70的患者相比，Karnofsky表现评分（KPS）<70的患者的生存结局较差。患者的中位OS为11.17个月。在13.5%的患者中发现IDH1R132H的表达,在55.6%的病例中发现p53过度表达,在11.9%中检测到ATRX表达缺失。IDH突变体/ATRX突变体/p53野生型患者组预后最好(OS=27.393个月;p=0.015)。我们的结果与以前的研究一致。
结论：IDH和ATRX突变在预后评估中的临床价值得到证实（p≤0.05）。p53的过表达对OS无显著影响(p=0.726)。因此,p53不能单独预测胶质母细胞瘤患者的生存。根据结果,这些生物标志物可能是延长患者生存期的潜在治疗靶点，因此需要进一步调查。
方法：使用抗体进行免疫组织化学研究，IDH1,R132H,p53和ATRX。使用IBMSPSSStatistics，使用统计检验来调查可能影响总体生存率的因素。版本25.0(IBMCorp.,Armonk,NY).
结果：诊断时的中位年龄为51.5岁。与KPS≥70的患者相比，Karnofsky表现评分（KPS）<70的患者的生存结局较差。患者的中位OS为11.17个月。在13.5%的患者中发现IDH1R132H的表达,在55.6%的病例中发现p53过度表达,在11.9%中检测到ATRX表达缺失。IDH突变体/ATRX突变体/p53野生型患者组预后最好(OS=27.393个月;p=0.015)。我们的结果与以前的研究一致。
结论：IDH和ATRX突变在预后评估中的临床价值得到证实（p≤0.05）。p53的过表达对OS无显著影响(p=0.726)。因此,p53不能单独预测胶质母细胞瘤患者的生存。根据结果,这些生物标志物可能是延长患者生存期的潜在治疗靶点，因此需要进一步调查。
