背景:高级别神经胶质瘤(HGs)复发迅速,生存期短。研究已经确定了许多与无进展生存期(PFS)和过生存期(OS)相关的临床特征和生物标志物。然而,尚未对首次进展(SAP)后的生存率进行全面研究。
方法:来自CGGA和TCGA,319和308个HGS被确认为第一个进展。根据OS对临床特征和生物标志物的数据进行分析,PFS,和SAP。
结果:对来自CGGA的319例患者的分析,改善OS/PFS/SAP的重要预测因素是WHO等级,MGMT启动子甲基化,和Ki-67在单因素分析中的表达。进一步多因素分析显示MGMT启动子甲基化和Ki-67表达是独立预测因子。然而,对来自TCGA的308例患者的分析发现MGMT启动子甲基化是唯一的预后标志物.在标准放化疗后,在具有甲基化MGMT启动子的患者中观察到更长的SAP。在我们的数据中,HGG可以分为低位,中间,和SAP高危人群的MGMT甲基化和Ki-67表达。
结论:MGMT启动子甲基化的患者在标准放化疗后SAP的病情延长。HGG可以分为低位,中间,并根据MGMT状态和Ki-67表达情况选择SAP高危人群。
BACKGROUND: High-grade gliomas (HGGs) have a rapid relapse and short survival. Studies have identified many clinical characteristics and biomarkers associated with progression-free survival (PFS) and over-survival (OS). However, there has not yet a comprehensive study on survival after the first progression (SAP).
METHODS: From CGGA and TCGA, 319 and 308 HGGs were confirmed as the first progression. The data on clinical characteristics and biomarkers were analyzed in accordance with OS, PFS, and SAP.
RESULTS: Analysis of 319 patients from CGGA, significant predictors of improved OS/PFS/SAP were WHO grade, MGMT promoter methylation, and Ki-67 expression in univariate analysis. Further multivariate analysis showed MGMT promoter methylation and Ki-67 expression were independent predictors. However, an analysis of 308 patients from TCGA found MGMT promoter methylation is the only prognostic marker. A longer SAP was observed in patients with methylated MGMT promoter after standard chemoradiotherapy. In our data, HGGs could be divided into low, intermediate, and high-risk groups for SAP by MGMT methylation and Ki-67 expression.
CONCLUSIONS: Patients with MGMT promoter methylation have a prolonger SAP after standard chemoradiotherapy. HGGs could be divided into low, intermediate, and high-risk groups for SAP according to MGMT status and Ki-67 expression.