central nervous system tumors

中枢神经系统肿瘤
  • 文章类型: Case Reports
    血管母细胞瘤很少见,良性,和中枢神经系统的高度血管性肿瘤,通常与冯·希佩尔-林道(VHL)综合征有关,一种以多种肿瘤为特征的常染色体显性疾病。我们介绍了一个32岁男性进行性头痛的病例,视觉障碍,和运动缺陷,通过MRI诊断为颈胸脊髓和双侧小脑多发性血管母细胞瘤。手术切除和组织病理学活检证实了诊断。该病例强调了MRI在诊断和治疗VHL相关血管母细胞瘤中的关键作用,并强调了定期成像对早期发现和干预新发或复发肿瘤的重要性。优化患者结果。
    Hemangioblastomas are rare, benign, and highly vascular tumors of the central nervous system, often associated with von Hippel-Lindau (VHL) syndrome, an autosomal dominant disorder characterized by multiple tumors. We present a case of a 32-year-old male with progressive headaches, visual disturbances, and motor deficits, who was diagnosed with multiple hemangioblastomas in the cervical-thoracic spinal cord and bilateral cerebellum through MRI. Surgical resection and histopathological biopsy confirmed the diagnosis. This case highlights the critical role of MRI in diagnosing and managing VHL-associated hemangioblastomas and underscores the importance of regular imaging for early detection and intervention of new or recurring tumors, optimizing patient outcomes.
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  • 文章类型: Journal Article
    法属圭亚那是法国在南美洲的领土。居住在那里的人与法国大陆的人有很大不同,人口的种族构成也有很大不同。贫困也很普遍,由于医疗专业密度低,难以获得护理。在这个奇异的背景下,我们的目的是测量儿童癌症的发病率,并将其与其他大洲进行比较。我们在2003年至2017年之间使用法属圭亚那认证的癌症登记处进行了研究。发病率使用三个阶层的世界人口进行标准化:0-4岁,5-9年,和10-14年。在15岁以下的儿童中诊断出164例实体瘤或血液系统恶性肿瘤(男孩92例,女孩72例)。在学习期间,15岁以下儿童的标准化发病率为每100,000人中14.1人.在研究期间没有显著的趋势。癌症的三个最常见的原因是白血病-主要是淋巴母细胞-中枢神经系统肿瘤,和肉瘤.法属圭亚那儿科癌症的标准化发病率与西欧和北美相似。正如其他人所发现的,我们发现男性更容易患癌症,尤其是白血病,中枢神经系统肿瘤,肉瘤,和视网膜母细胞瘤.和其他地方一样,主要的癌症类型随着年龄的增长而变化。我们最初的假设是,鉴于法属圭亚那的独特背景,儿科癌症发病率可能存在差异。在这里,我们展示了总的来说,与我们的假设和热带国家的趋势相反,儿科癌症的发病率在西欧和北美之间有一定的范围,在全球统计中观察到的主要癌症类型之间存在一些明显但不显著的差异.该热带地区的高质量癌症登记数据证实了这样一种怀疑,即热带低收入和中等收入国家的发病率较低可能是由于诊断和数据收集不完整所致。
    French Guiana is a French territory in South America. The exposome of persons living there is quite different from that in mainland France and the ethnic make-up of the population is also quite different. Poverty is also widespread with difficulties in accessing care magnified by the low medical-professional density. In this singular context, we aimed to measure the incidence of pediatric cancers and to compare it with other continents. We used French Guiana\'s certified cancer registry to study this between 2003 and 2017. Incidences were standardized using the world population with three strata: 0-4 years, 5-9 years, and 10-14 years. There were 164 solid tumors or hematologic malignancies diagnosed in children under the age of 15 (92 in boys and 72 in girls). Over the study period, the standardized incidence rate was 14.1 per 100,000 among children aged under 15 years. There was no significant trend during the study period. The three most common causes of cancer were leukemias-mostly lymphoblastic-CNS tumors, and sarcoma. The standardized incidence of pediatric cancers in French Guiana was similar to those in Western Europe and North America. As others have discovered, we found that males tended to be more likely to develop cancer, notably leukemia, CNS tumors, sarcoma, and retinoblastoma. As elsewhere, the predominant cancer types changed with age. Our initial assumption was that given the singular context of French Guiana, there may have been differences in pediatric cancer incidences. Here we showed that overall, contrary to our assumption and to trends in tropical countries, the incidence of pediatric cancers was in a range between Western Europe and North America with some apparent but non-significant differences in the main types of cancers observed in global statistics. Quality cancer registry data in this tropical region confirm the suspicion that lower incidences in tropical low- and middle-income countries are likely to result from incomplete diagnosis and data collection.
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  • 文章类型: Journal Article
    多药耐药(MDR)通常导致癌症治疗失败,因为癌细胞经常使用ATP结合盒(ABC)转运蛋白排出化疗药物。降低细胞内的药物水平。这项研究调查了ABCB1,ABCC1,ABCC2,ABCC4和ABCG2的临床特征和单核苷酸变异(SNV),以及它们与中枢神经系统肿瘤(CNST)儿科患者死亡率的关系。使用TaqMan探针,实时聚合酶链反应对111个样本中的15个SNP进行了基因分型。使用Cox比例风险模型对患者进行随访直至死亡或最后随访日。在隐性模型中发现rs1045642(ABCB1)之间存在关联(HR=2.433,95%CI1.098-5.392,p=0.029),和协同模型中的ICE方案(HR=9.810,95%CI2.74-35.06,p≤0.001),显性模型(HR=6.807,95%CI2.87-16.103,p≤0.001),和隐性模型(HR=6.903,95%CI2.915-16.544,p=0.038)显著增加了该队列患者的死亡率.在共显性模型(HR=5.35,95%CI1.83-15.39,p=0.002)和显性模型(HR=4.421,95%CI1.747-11.185,p=0.002)中也观察到变异rs3114020(ABCG2)与死亡率之间存在关联。在优势模型中,ICE治疗方案与死亡风险增加之间存在显着关联(HR=6.351,95%CI1.831-22.02,p=0.004,HR=9.571,95%CI2.856-32.07,p≤0.001),显性模型(HR=6.592,95%CI2.669-16.280,p≤0.001),和隐性模型(HR=5.798,95%CI2.411-13.940,p≤0.001)。ABCG2基因中的遗传变异rs3114020和ABCB1基因中的rs1045642以及ICE化疗方案与CNST儿科患者队列中死亡风险增加相关。
    Multidrug resistance (MDR) commonly leads to cancer treatment failure because cancer cells often expel chemotherapeutic drugs using ATP-binding cassette (ABC) transporters, which reduce drug levels within the cells. This study investigated the clinical characteristics and single nucleotide variant (SNV) in ABCB1, ABCC1, ABCC2, ABCC4, and ABCG2, and their association with mortality in pediatric patients with central nervous system tumors (CNST). Using TaqMan probes, a real-time polymerase chain reaction genotyped 15 SNPs in 111 samples. Patients were followed up until death or the last follow-up day using the Cox proportional hazards model. An association was found between the rs1045642 (ABCB1) in the recessive model (HR = 2.433, 95% CI 1.098-5.392, p = 0.029), and the ICE scheme in the codominant model (HR = 9.810, 95% CI 2.74-35.06, p ≤ 0.001), dominant model (HR = 6.807, 95% CI 2.87-16.103, p ≤ 0.001), and recessive model (HR = 6.903, 95% CI 2.915-16.544, p = 0.038) significantly increased mortality in this cohort of patients. An association was also observed between the variant rs3114020 (ABCG2) and mortality in the codominant model (HR = 5.35, 95% CI 1.83-15.39, p = 0.002) and the dominant model (HR = 4.421, 95% CI 1.747-11.185, p = 0.002). A significant association between the ICE treatment schedule and increased mortality risk in the codominant model (HR = 6.351, 95% CI 1.831-22.02, p = 0.004, HR = 9.571, 95% CI 2.856-32.07, p ≤ 0.001), dominant model (HR = 6.592, 95% CI 2.669-16.280, p ≤ 0.001), and recessive model (HR = 5.798, 95% CI 2.411-13.940, p ≤ 0.001). The genetic variants rs3114020 in the ABCG2 gene and rs1045642 in the ABCB1 gene and the ICE chemotherapy schedule were associated with an increased mortality risk in this cohort of pediatric patients with CNST.
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  • 文章类型: Case Reports
    一个13个月大的孩子,中性,男性,家养短跑猫有进行性轻瘫的病史,本体性共济失调,和腰椎疼痛。神经系统检查显示非卧床性轻瘫与L4-S1脊髓病一致。胸腰椎脊髓的磁共振确定了从L5到L6的背侧硬膜内髓外占位性病变。在T2加权成像中均匀地高强度,在T1加权成像中等强度,在T1加权后成像中表现出明显且均匀的对比增强。切除的组织由肿瘤细胞组成,排列成假分层或多层的小梁和管状结构,由内部和外部限制PAS阳性膜支持。肿瘤细胞对波形蛋白和NSE免疫反应,对GFAP阴性,Olig2,突触素,PCK,S-100,NeuN,还有Nestin.Ki-67核标记指数高达90%。肿瘤与髓上皮瘤的诊断一致,最常报道为眼内肿瘤。肿瘤的形态和免疫组织化学特征与大多数人髓上皮瘤均表现出明显的一致性。这是猫的第一个脊髓髓质上皮瘤报告,在临床上,神经放射学,组织学,和免疫组织化学结果正在描述中。
    A 13-month-old, neutered, male, domestic shorthair cat was referred with a history of progressive paraparesis, proprioceptive ataxia, and lumbar spinal pain. Neurological examination revealed non-ambulatory paraparesis consistent with L4-S1 myelopathy. Magnetic resonance of the thoracolumbar spinal cord identified a dorsal intradural extramedullary space-occupying lesion extending from L5 to L6. It was homogeneously hyperintense in T2-weighted imaging and isointense in T1-weighted imaging and exhibited marked and homogeneous contrast enhancement in the T1-weighted post-contrast imaging. The removed tissue was composed of neoplastic cells arranged as pseudostratified or multilayered trabecular and tubular structures, supported by internal and external limiting PAS-positive membranes. The neoplastic cells were immunoreactive for vimentin and NSE and negative for GFAP, Olig2, synaptophysin, PCK, S-100, NeuN, and nestin. The Ki-67 nuclear labeling index was up to 90%. The tumor was consistent with the diagnosis of medulloepithelioma, which is most frequently reported as an intraocular tumor. The morphological and immunohistochemical features of the tumor showed remarkable concordance with most human medulloepitheliomas. This is the first spinal cord medullopethelioma report in a cat, with the clinical, neuroradiological, histological, and immunohistochemical findings being described.
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  • 文章类型: Journal Article
    胶质瘤在中枢神经系统(CNS)内构成了多种复杂的肿瘤,其特点是广泛的预后结果和对治疗干预的反应。这篇文献综述试图对胶质瘤进行彻底的调查,特别强调胶质母细胞瘤(GBM),从它们的分类和流行病学特征开始,评估它们在中枢神经系统肿瘤谱中的相对重要性。我们检查了神经胶质瘤的免疫学背景,揭示了复杂的免疫环境及其对疾病进展和治疗策略的影响。此外,我们强调了理解肿瘤行为的关键进展,专注于治疗反应和细胞信号通路阐明方面的最新研究突破。分析最新颖的转录组学研究,我们研究了神经胶质瘤细胞中基因表达模式的变化,评估这些遗传改变的预后和治疗意义。此外,表观遗传修饰在胶质瘤发病机制中的作用得到了强调,这表明这种变化是肿瘤进化和可能的治疗进展的基础。最后,这种比较肿瘤学分析将GBM置于更广泛的肿瘤背景下,描绘与其他类型肿瘤的独特和共同特征。
    Gliomas constitute a diverse and complex array of tumors within the central nervous system (CNS), characterized by a wide range of prognostic outcomes and responses to therapeutic interventions. This literature review endeavors to conduct a thorough investigation of gliomas, with a particular emphasis on glioblastoma (GBM), beginning with their classification and epidemiological characteristics, evaluating their relative importance within the CNS tumor spectrum. We examine the immunological context of gliomas, unveiling the intricate immune environment and its ramifications for disease progression and therapeutic strategies. Moreover, we accentuate critical developments in understanding tumor behavior, focusing on recent research breakthroughs in treatment responses and the elucidation of cellular signaling pathways. Analyzing the most novel transcriptomic studies, we investigate the variations in gene expression patterns in glioma cells, assessing the prognostic and therapeutic implications of these genetic alterations. Furthermore, the role of epigenetic modifications in the pathogenesis of gliomas is underscored, suggesting that such changes are fundamental to tumor evolution and possible therapeutic advancements. In the end, this comparative oncological analysis situates GBM within the wider context of neoplasms, delineating both distinct and shared characteristics with other types of tumors.
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  • 文章类型: Journal Article
    脑膜瘤,一种常见的中枢神经系统肿瘤,是一种被广泛研究的脑膜肿瘤.根据世界卫生组织(WHO)2021年脑膜瘤分类,有15个亚型已分为1级,2级和3级。WHO1级脑膜瘤通常被归类为良性,而WHO2级和3级肿瘤被归类为恶性。孕激素受体和P63是常见的免疫组织化学标记,已被证明在诊断中有用,分级,和许多肿瘤如乳腺癌的预后,前列腺癌,和胃肠道肿瘤的组织病理学实践。已经报道了将这些免疫组织化学标记物应用于脑膜瘤的分级,并在非洲的报告中记录了它们的有用性,欧洲,北美,南美洲,和亚洲。这项研究,因此,试图确定这些发现是否适用于非洲人群中的脑膜瘤。
    对病态解剖学部门收到的脑膜瘤的结果和组织学诊断病例进行了10年审查,尼日利亚大学,埃努古.对孕激素受体(PgRs)和P63进行免疫染色,并将结果与组织学等级进行比较。
    在这项研究中评估了WHO三种级别的脑膜瘤。M:F比为1:1.4,峰值年龄为41-50岁(SD±16.54)。大多数病例为WHO1级(86.1%),而WHO2级和3级肿瘤分别为8%和5.9%,分别。纤维变体是最常见的亚型(27.1%)。孕激素受体和P63免疫阳性与脑膜瘤的WHO等级之间没有相关性(分别为P=0.112和P=0.138)。
    我们的研究表明,孕激素受体和P63免疫阳性与脑膜瘤的WHO等级无关。这可能是由于在本研究中看到的脑膜瘤的主要变异。这些发现表明,PgR拮抗剂可能不是无法手术的脑膜瘤患者的有效替代治疗方法。此外,P63免疫阳性可能不是管理我们人群脑膜瘤的足够分级工具。
    UNASSIGNED: Meningiomas, a common neoplasm of the central nervous system, is a widely studied meningeal tumor. According to the World Health Organization (WHO) 2021 classification of meningiomas, there are 15 subtypes that have been grouped into grades 1, 2, and 3. The WHO grade 1 meningiomas are generally grouped as benign while the WHO grades 2 and 3 tumors are grouped as malignant. Progesterone receptors and P63 are common immunohistochemical markers that have proven useful in the diagnosis, grading, and prognostication of many neoplasms such as breast carcinoma, prostate carcinoma, and gastrointestinal tumors in histopathology practice. The application of these immunohistochemical markers to the grading of meningiomas has been reported and their usefulness documented in reports from Africa, Europe, North America, South America, and Asia. This study, therefore, seeks to determine if these findings are applicable to the meningiomas seen in an African population.
    UNASSIGNED: A 10-year review of results and histologically diagnosed cases of meningiomas received in the Department of Morbid Anatomy, University of Nigeria, Enugu. Immunostaining for progesterone receptors (PgRs) and P63 were done and results compared with histologic grades.
    UNASSIGNED: The three WHO grades of meningioma were assessed in this study. M: F ratio was 1:1.4 and peak age was 41-50 years age range (SD ± 16.54). The majority of the cases were WHO grade 1 (86.1%) while the WHO grades 2 and 3 tumors were 8% and 5.9%, respectively. The fibrous variant was the most common subtype (27.1%). There was no correlation between progesterone receptor and P63 immunopositivity to the WHO grades of meningioma (P = 0.112 and P = 0.138, respectively).
    UNASSIGNED: Our study showed that progesterone receptors and P63 immunopositivity did not correlate with the WHO grades of meningiomas. This may be due to the predominant variant of meningioma seen in this study. These findings indicate that PgR antagonist may not be an effective alternative for treatment in patients with inoperable meningiomas. Furthermore, P63 immunopositivity may not be a sufficient grading tool for managing meningiomas in our population.
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  • 文章类型: Journal Article
    背景少突胶质细胞瘤,罕见的脑肿瘤在额叶的白质,由异柠檬酸脱氢酶突变和1p/19q共缺失等分子标记重塑,影响治疗结果。尽管最初的懒惰,这些肿瘤有很大的风险,中位生存期为10-12年。非侵入性替代方案,例如磁共振成像(MRI),用于评估T2-流体衰减反转恢复(FLAIR)失配和钙化,提供对分子亚型的见解并帮助预后。我们的研究探索了这些特征来预测少突胶质细胞瘤的状态并完善患者管理以改善预后。方法本回顾性研究,患者数据确定疑似中枢神经系统肿瘤患者接受MRI检查,揭示低度胶质瘤。手术活检和1p/19q荧光原位杂交证实了共缺失状态。MRI用于评估各种形态特征。统计分析包括x2检验,费希尔的精确检验,Kruskal-Wallis测试,和二元逻辑回归模型,显著性设置为p<0.05。结果73例患者(中位年龄,37年)根据1p/19q共缺失进行分层。大多数(61.6%)是18-40岁,大多数是男性(67.1%)。共同删除案例,主要是额叶病变(67.6%),是单方面的(88.2%),55.9%的非界限边缘和58.8%的轮廓不明确。在48.1%的1p/19q共缺失病例中观察到平滑的对比增强和无坏死。Logistic回归分析显示轮廓不清晰/不规则与1p/19q共缺失之间存在显着关联。Fisher的精确检验证实了这一点,但引起了人们对影响结论的小样本量的担忧。结论本研究建立了胶质瘤肿瘤轮廓特征之间的显著联系,特别是不规则和不明确的轮廓,以及1p/19q共缺失的可能性。我们的发现强调了在治疗决策和预后评估中使用肿瘤轮廓的临床相关性。
    Background Oligodendrogliomas, rare brain tumors in the frontal lobe\'s white matter, are reshaped by molecular markers like isocitrate dehydrogenase mutations and 1p/19q co-deletion, influencing treatment outcomes. Despite the initial indolence, these tumors pose a significant risk, with a median survival of 10-12 years. Non-invasive alternatives, such as magnetic resonance imaging (MRI) for assessing T2-fluid-attenuated inversion recovery (FLAIR) mismatch and calcifications, provide insights into molecular subtypes and aid prognosis. Our study explored these features to predict the oligodendroglioma status and refine patient management to improve outcomes. Methods In this retrospective study, patient data identified patients with suspected central nervous system tumors undergoing MRI, revealing low-grade gliomas. Surgical biopsy and 1p/19q fluorescence in situ hybridization confirmed the co-deletion status. MRI was used to assess various morphological features. Statistical analyses included x2 tests, Fisher\'s exact tests, Kruskal-Wallis tests, and binary logistic regression models, with significance set at p < 0.05. Results Seventy-three patients (median age, 37 years) were stratified according to 1p/19q co-deletion. Most (61.6%) were 18-40 years old and mostly male (67.1%). Co-deletion cases, primarily frontal lobe lesions (67.6%), were unilateral (88.2%), with 55.9% non-circumscribed margins and 58.8% ill-defined contours. Smooth contrast enhancement and no necrosis were observed in 48.1% of 1p/19q co-deletion cases. Logistic regression analysis showed a significant association between ill-defined/irregular contours and 1p/19q co-deletion. Fisher\'s exact test confirmed this but raised concerns about the small sample size influencing the conclusions. Conclusions This study established a significant link between glioma tumor contour characteristics, particularly irregular and ill-defined contours, and the likelihood of 1p/19q co-deletion. Our findings underscore the clinical relevance of using tumor contours in treatment decisions and prognosis assessments.
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  • 文章类型: Journal Article
    血脑屏障对于治疗中枢神经系统(CNS)的原发性和转移性癌症至关重要。患有原发性中枢神经系统肿瘤的患者的临床结果很差,并且在几十年内没有显着改善。随着颅外实体肿瘤患者治疗的改善,CNS转移的发生率呈上升趋势,原因是CNS暴露量不够理想.尽管有最先进的外科护理和越来越精确的放射治疗,临床进展受到向所有癌细胞递送有效剂量的治疗剂的能力的限制。鉴于中枢神经系统癌症的巨大异质性,跨越癌症亚型和单一肿瘤,以及正在调查的各种疗法,需要对CNS药物暴露进行细微差别检查.有一个共同的目标,常用词汇,和跨学科合作,该领域有望在中枢神经系统癌症的治疗方面取得新的进展。
    The blood-brain barrier is critically important for the treatment of both primary and metastatic cancers of the central nervous system (CNS). Clinical outcomes for patients with primary CNS tumors are poor and have not significantly improved in decades. As treatments for patients with extracranial solid tumors improve, the incidence of CNS metastases is on the rise due to suboptimal CNS exposure of otherwise systemically active agents. Despite state-of-the art surgical care and increasingly precise radiation therapy, clinical progress is limited by the ability to deliver an effective dose of a therapeutic agent to all cancerous cells. Given the tremendous heterogeneity of CNS cancers, both across cancer subtypes and within a single tumor, and the range of diverse therapies under investigation, a nuanced examination of CNS drug exposure is needed. With a shared goal, common vocabulary, and interdisciplinary collaboration, the field is poised for renewed progress in the treatment of CNS cancers.
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  • 文章类型: Journal Article
    在这里,我们介绍了一流的microRNA敏感的溶瘤寨卡病毒(ZIKV),用于针对中枢神经系统(CNS)肿瘤的病毒疗法应用。所描述的方法产生了两种在正常细胞中安全的合成修饰的ZIKV菌株,包括神经干细胞,同时保留肿瘤细胞的脑嗜性和溶瘤作用。对microRNA敏感的ZIKV在两个不同的病毒位点引入了遗传修饰:在已建立的3UTR区域中,其次,在ZIKV蛋白编码序列中,首次证明miRNA抑制系统可以在UTRRNA位点之外发挥功能。小鼠携带人类中枢神经系统肿瘤的总肿瘤缓解,包括转移性肿瘤生长,在心室内和全身改良ZIKV给药后,证实了这种病毒疗法作为针对脑肿瘤的新型药物的前景-高度致命的疾病迫切需要有效的先进疗法。
    Here we introduce a first-in-class microRNA-sensitive oncolytic Zika virus (ZIKV) for virotherapy application against central nervous system (CNS) tumors. The described methodology produced two synthetic modified ZIKV strains that are safe in normal cells, including neural stem cells, while preserving brain tropism and oncolytic effects in tumor cells. The microRNA-sensitive ZIKV introduces genetic modifications in two different virus sites: first, in the established 3\'UTR region, and secondly, in the ZIKV protein coding sequence, demonstrating for the first time that the miRNA inhibition systems can be functional outside the UTR RNA sites. The total tumor remission in mice bearing human CNS tumors, including metastatic tumor growth, after intraventricular and systemic modified ZIKV administration, confirms the promise of this virotherapy as a novel agent against brain tumors-highly deadly diseases in urgent need of effective advanced therapies.
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  • 文章类型: Journal Article
    中枢神经系统(CNS)肿瘤是严重的健康状况,近年来发病率不断增加。不同的生物,环境和临床因素被认为在其流行病学中具有重要作用,然而,这仍然不清楚。
    这项初步研究的目的是根据这些信息确定中枢神经系统肿瘤患者的亚型,并检验与肿瘤恶性肿瘤的相关性。
    IRCCSNeuromed神经外科室招募了90例疑似诊断为中枢神经系统肿瘤的患者。患者接受记忆和临床评估,确定已知或可疑的危险因素,包括生活方式,社会经济,临床和心理测量特征。我们对这些暴露进行了分层聚类分析,以识别具有相似风险模式的潜在患者组,并测试了这些聚类是否与脑肿瘤恶性肿瘤相关。
    在67例确诊中枢神经系统肿瘤的患者中,我们确定了28例非恶性肿瘤和39例恶性肿瘤。这些亚型在性别(男性更频繁地诊断为癌症;p=6.0×10-3)和家庭年收入(非恶性肿瘤患者更频繁地收入≥25k欧元/年;p=3.4×10-3)方面存在显着差异。聚类分析显示存在两组患者:一组(N=41)更专业活跃,受过教育,更富有和更健康的患者,另一个大多是退休的,不太健康的男人,吸烟者的频率更高,心血管疾病和癌症熟悉的个人病史,主要是久坐不动的生活方式和一般较低的收入,教育和认知表现。前一组显示出与疾病恶性的保护性关联,中枢神经系统恶性肿瘤的普遍风险降低了74(14-93)%,与其他集群相比(p=0.026)。
    这些初步数据表明,通过无监督机器学习方法进行的患者分析可能以某种方式帮助预测受恶性形式影响的风险。如果在更大的独立队列中得到进一步分析的证实,这些发现可能有助于为治疗优先级创建潜在的智能排名系统,克服了肿瘤组织病理学信息和分子诊断的缺乏,这通常是不可用的,直到手术的时候。
    UNASSIGNED: Central nervous system (CNS) tumors are severe health conditions with increasing incidence in the last years. Different biological, environmental and clinical factors are thought to have an important role in their epidemiology, which however remains unclear.
    UNASSIGNED: The aim of this pilot study was to identify CNS tumor patients\' subtypes based on this information and to test associations with tumor malignancy.
    UNASSIGNED: 90 patients with suspected diagnosis of CNS tumor were recruited by the Neurosurgery Unit of IRCCS Neuromed. Patients underwent anamnestic and clinical assessment, to ascertain known or suspected risk factors including lifestyle, socioeconomic, clinical and psychometric characteristics. We applied a hierarchical clustering analysis to these exposures to identify potential groups of patients with a similar risk pattern and tested whether these clusters associated with brain tumor malignancy.
    UNASSIGNED: Out of 67 patients with a confirmed CNS tumor diagnosis, we identified 28 non-malignant and 39 malignant tumor cases. These subtypes showed significant differences in terms of gender (with men more frequently presenting a diagnosis of cancer; p = 6.0 ×10-3) and yearly household income (with non-malignant tumor patients more frequently earning ≥25k Euros/year; p = 3.4×10-3). Cluster analysis revealed the presence of two clusters of patients: one (N=41) with more professionally active, educated, wealthier and healthier patients, and the other one with mostly retired and less healthy men, with a higher frequency of smokers, personal history of cardiovascular disease and cancer familiarity, a mostly sedentary lifestyle and generally lower income, education and cognitive performance. The former cluster showed a protective association with the malignancy of the disease, with a 74 (14-93) % reduction in the prevalent risk of CNS malignant tumors, compared to the other cluster (p=0.026).
    UNASSIGNED: These preliminary data suggest that patients\' profiling through unsupervised machine learning approaches may somehow help predicting the risk of being affected by a malignant form. If confirmed by further analyses in larger independent cohorts, these findings may be useful to create potential intelligent ranking systems for treatment priority, overcoming the lack of histopathological information and molecular diagnosis of the tumor, which are typically not available until the time of surgery.
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