■分子亚群影响髓母细胞瘤的血管结构,特别是无翼(WNT)子组,这有助于其原发性肿瘤出血的倾向。这种机制是否影响术中失血尚不清楚。本研究旨在评估WNT髓母细胞瘤与失血倾向之间的关系。
■这是一项回顾性观察性研究,使用神经肿瘤中心的数据,包括2014年12月31日至2023年4月30日期间接受治疗的患者的分子数据。使用多变量调整线性回归评估WNT和其他亚组在主要结局-术中失血风险方面的差异。
■在分析的148名患者中,18例患者(12.2%)有WNT,42(28.4%)患有声波刺猬(SHH)TP53野生型,7(4.7%)具有SHHTP53突变体,81例(54.7%)为非WNT/非SHH。WNT亚组更频繁地发生原发性肿瘤内出血(22%vs.3.8%;p=0.011)。WNT的术中出血量中位数为400.00(四分位距[IQR]250,500)mL,其他亚组为300.00[200,400]mL(p=0.136),调整后的β为135.264(95%置信区间[CI],11.701-258.827;p=0.032)。在中线和非浸润性边缘髓母细胞瘤中观察到类似的结果。
WNT髓母细胞瘤通常与原发性瘤内出血和术中失血有关。根据影像学数据预测的分子亚型确定手术方法的有效性值得怀疑。然而,尝试以分子特异性方式与患者进行风险沟通是值得验证的.
UNASSIGNED: Molecular subgroups influence the vascular architecture within medulloblastomas, particularly the wingless (WNT) subgroup, which contributes to its propensity for primary tumor hemorrhage. Whether this mechanism affects intraoperative blood loss remains unknown. This
study aimed to assess the association between WNT
medulloblastoma and the predisposition for blood loss.
UNASSIGNED: This was a retrospective observational
study using data from a neuro-oncology center comprising molecular data on patients treated between December 31, 2014, and April 30, 2023. Differences between WNT and other subgroups in the risk of primary outcome-intraoperative blood loss were assessed using multivariable-adjusted linear regression.
UNASSIGNED: Of the 148 patients included in the analysis, 18 patients (12.2%) had WNT, 42 (28.4%) had sonic hedgehog (SHH) TP53-wildtype, 7 (4.7%) had SHH TP53-mutant, and 81 (54.7%) were non-WNT/ non-SHH. The WNT subgroup more frequently underwent primary intratumoral hemorrhage (22% vs. 3.8%; p = 0.011). The median intraoperative blood loss was 400.00 (interquartile range [IQR] 250, 500) mL for WNT and 300.00 [200, 400] mL for the other subgroups (p = 0.136), with an adjusted β of 135.264 (95% confidence intervals [CI], 11.701-258.827; p = 0.032). Similar results were observed in both midline and noninfiltrative margin
medulloblastoma.
UNASSIGNED: WNT
medulloblastoma is typically associated with primary intratumoral hemorrhage and intraoperative blood loss. The validity of determining the surgical approach based on predicted molecular subtypes from imaging data is questionable. However, attempting to engage in risk communication with patients in a molecular-specific way is worthwhile to validate.