Telomerase

端粒酶
  • 文章类型: Journal Article
    端粒酶在85-90%的肿瘤中被激活或过表达,保持端粒的长度,已成为重要的抗癌靶点。越来越多的临床和临床前数据表明,端粒酶靶向的癌症免疫治疗可以在体内有效杀死肿瘤细胞。本文就端粒酶靶向肿瘤免疫治疗在临床和临床前试验中的研究进展作一综述,旨在为癌症的进一步临床研究和治疗提供参考。
    我们从四个电子数据库中调查了端粒酶免疫治疗近20年的研究进展。
    随着免疫肿瘤学新时代的兴起,端粒酶靶向免疫疗法得到了发展。包括肽疫苗,DNA疫苗,树突状细胞(DC),过继细胞转移(ACT)疗法,抗体,等。其中一些已被食品和药物管理局(FDA)批准接受临床试验,用于治疗各种癌症,比如胰腺癌,非小细胞肺癌,黑色素瘤,白血病.在所有的治疗方式中,疫苗是主要的治疗方法,其中一些甚至已进入III期临床试验。端粒酶疫苗的主要临床应用方向是与其他药物和治疗方式的结合,包括与其他针对人端粒酶逆转录酶(hTERT)的疫苗的组合,传统的化疗药物和免疫抑制剂。我们还总结了针对hTERT的免疫治疗的最新发现,关注各种疫苗和相关临床试验的现状。我们进一步讨论了优势,各种端粒酶靶向免疫疗法的缺点和潜在的发展方向。
    端粒酶靶向癌症免疫治疗在提高患者预期生存率方面具有良好的前景。本综述可为该领域的所有研究人员和制药企业提供数据支持和设计思路。
    UNASSIGNED: Telomerase is activated or overexpressed in 85-90% of tumors, which maintains the length of telomere and has become an important anti-cancer target. Increasing clinical and preclinical data suggest that telomerase-targeted cancer immunotherapy could achieve effective killing of tumor cells in vivo. This article reviews the research progress of telomerase targeted cancer immunotherapy in clinical and pre-clinical trials, aiming to provide a reference for further clinical research and treatment of cancers.
    UNASSIGNED: We investigated the research progress of telomerase immunotherapy in the last 20 years from four electronic databases.
    UNASSIGNED: Telomerase-targeted immunotherapies have been developed with the arising of a new era in immuno-oncology, including peptide vaccines, DNA vaccines, dendritic cells (DCs), adoptive cell transfer (ACT) therapies, antibodies, etc. Some of them have been approved for undergoing clinical trials by the Food and Drug Administration (FDA) for the treatment of various cancers, such as pancreatic cancer, non-small cell lung cancer, melanoma, leukaemia. Of all the treatment modalities, vaccines are the primary treatment methods, some of which have been even entered into phase III clinical trials. The main clinical application direction of telomerase vaccine is the combination with other drugs and treatment modalities, including combination with other vaccines targeting human telomerase reverse transcriptase (hTERT), traditional chemotherapy drugs and immunosuppressors. We also summarized the recent findings of immunotherapy targeting hTERT, focusing on various vaccines and the current status of associated clinical trials. We further discussed the advantages, disadvantages and potential developmental directions of various telomerase-targeted immunotherapies.
    UNASSIGNED: Telomerase-targeted cancer immunotherapy has promising prospects in improving patient survival expectancy. This review may provide data support and design ideas for all researchers and pharmaceutical enterprises in this field.
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  • 文章类型: Journal Article
    端粒酶逆转录酶启动子(TERTp)突变经常是靶向肿瘤标志物,然而,它们居住在GC含量高的地区,这在使用简单的分子技术甚至下一代测序(NGS)进行检查时提出了挑战。在膀胱癌(BC)中,TERTp突变尤其频繁,然而,现有的工具均未显示通过简单的非侵入性技术检测TERTp突变的有效性.因此,我们开发了一种新的基于PCR的方法来检测两种最常见的TERTp突变,并证明了其在BC样本分析中的用途.开发的SHARD-PCRTERTp突变检测技术需要PCR和限制性消化步骤,即使在设备较少的实验室中也很容易实现。具有已知突变状态的细胞系用于方法开发。对来自BC患者的匹配尿液和肿瘤组织样本进行分析,结果通过下一代测序进行验证。通过SHARD-PCR对18个尿液和相应的肿瘤组织样本进行分析,发现样本对完全匹配,与相应的NGS结果平行:14个样本在-124位置显示突变,两个样本在-146位置显示突变,在两个样本中没有检测到突变。我们的研究是一个概念验证,受到样本量小的限制,尽管如此,它证明了SHARD-PCR是一种简单的,检测TERTp突变的经济和高度可靠的方法,这在不同类型的癌症中很常见。对于膀胱癌,SHARD-PCR可以使用非侵入性样品进行,并且可以替代或补充当前使用的技术。
    Telomerase reverse transcriptase promoter (TERTp) mutations are frequently targeted tumor markers, however, they reside in regions with high GC content, which poses challenges when examined with simple molecular techniques or even with next-generation sequencing (NGS). In bladder cancer (BC), TERTp mutations are particularly frequent, however, none of the available tools have demonstrated efficacy in detecting TERTp mutations via a simple noninvasive technique. Therefore, we developed a novel PCR-based method for the detection of the two most common TERTp mutations and demonstrated its use for the analysis of BC samples. The developed SHARD-PCR TERTp mutation detection technique requires PCR and restriction digestion steps that are easily implementable even in less well-equipped laboratories. Cell lines with known mutational status were utilized for method development. Matching urine and tumor tissue samples from BC patients were analyzed, and the results were validated by next-generation sequencing. Analysis of eighteen urine and corresponding tumor tissue samples by SHARD-PCR revealed perfect matches in sample pairs, which paralleled the corresponding NGS results: fourteen samples exhibited mutations at the -124 position, two samples showed mutations at the -146 position, and no mutations were detected in two samples. Our study serves as a proof-of-concept and is limited by its small sample size, nonetheless, it demonstrates that SHARD-PCR is a simple, economic and highly reliable method for detecting TERTp mutations, which are common in different cancer types. For bladder cancer, SHARD-PCR can be performed with the use of noninvasive samples and could replace or complement currently used techniques.
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  • 文章类型: Journal Article
    胶质母细胞瘤(GBM)是一种高度异质性的疾病,临床预后较差。为了全面剖析GBM的分子景观和GBM进展中的异质巨噬细胞簇,这项研究整合了单细胞和批量转录组数据,以识别与GBM预后显著相关的独特的前肿瘤巨噬细胞簇,并开发GBM预后标志以促进以前的亚型.利用神经胶质瘤单细胞测序数据,我们确定了一个新的促肿瘤巨噬细胞亚群,以S100A9为标志,可能与内皮细胞相互作用,通过血管生成促进肿瘤进展。进一步有利于临床应用,利用与肿瘤前巨噬细胞相关的基因建立了预后特征.属于高危人群的患者,其特征是与肿瘤进展相关的功能富集,包括上皮-间质转化和缺氧,在TERT启动子区域显示升高的突变,MGMT启动子区域的甲基化减少,较差的预后,对替莫唑胺治疗的反应减弱,从而有效区分GBM患者的预后结果。我们的研究揭示了神经胶质瘤复杂的微环境,并确定了开发新治疗方法的潜在分子靶标。
    Glioblastoma (GBM) is a highly heterogeneous disease with poor clinical outcomes. To comprehensively dissect the molecular landscape of GBM and heterogeneous macrophage clusters in the progression of GBM, this study integrates single-cell and bulk transcriptome data to recognize a distinct pro-tumor macrophage cluster significantly associated with the prognosis of GBM and develop a GBM prognostic signature to facilitate prior subtypes. Leveraging glioma single-cell sequencing data, we identified a novel pro-tumor macrophage subgroup, marked by S100A9, which might interact with endothelial cells to facilitate tumor progression via angiogenesis. To further benefit clinical application, a prognostic signature was established with the genes associated with pro-tumor macrophages. Patients classified within the high-risk group characterized with enrichment in functions related to tumor progression, including epithelial-mesenchymal transition and hypoxia, displays elevated mutations in the TERT promoter region, reduced methylation in the MGMT promoter region, poorer prognoses, and diminished responses to temozolomide therapy, thus effectively discriminating between the prognostic outcomes of GBM patients. Our research sheds light on the intricate microenvironment of gliomas and identifies potential molecular targets for the development of novel therapeutic approaches.
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  • 文章类型: Journal Article
    转移是恶性肿瘤的重要标志,和端粒酶通常在这些肿瘤中表现出高表达。监测端粒酶的实时动态将为其与肿瘤转移的关联提供有价值的见解。在这项研究中,我们描述了一种基于差异细胞侵袭性筛选高转移性亚系的微流体系统,研究了端粒酶在肿瘤转移过程中的表达,并探讨了参与肿瘤转移的基因和信号通路。具有不同转移能力的细胞被有效地分类到不同的通道,荧光成像显示转移能力较高的细胞具有较强的端粒酶活性。此外,我们仅通过使用该系统进行一轮筛选,就成功地从人类结直肠癌LoVo细胞系中建立了高转移能力LoVo亚系(命名为LoVo-H)和低转移能力LoVo亚系(命名为LoVo-L)。结果显示,与LoVo-L细胞相比,LoVo-H细胞显示出优异的增殖和侵袭性。此外,通过转录组测序鉴定了与LoVo-L相比的6776个差异表达的LoVo-H基因。与端粒酶活性相关的基因,LoVo-H中细胞迁移和上皮向间充质转化上调,和PI3K-Akt信号通路,LoVo-H显著富集了细胞外基质-受体相互作用和Rap1信号通路。该微流体系统是用于选择高转移性亚系的高效工具,并且通过该系统建立的LoVo-H亚系为肿瘤转移研究提供了有希望的模型。此外,这项工作初步揭示了肿瘤转移过程中端粒酶的表达,为研究肿瘤转移和癌症诊断提供了新的策略。
    Metastasis is an important hallmark of malignant tumors, and telomerase often exhibits high expression in these tumors. Monitoring the real-time dynamics of telomerase will provide valuable insights into its association with tumor metastasis. In this study, we described a microfluidic system for screening highly metastatic sublines based on differential cell invasiveness, investigated telomerase expression in the process of tumor metastasis and explored the genes and signaling pathways involved in tumor metastasis. Cells with different metastasis abilities were efficiently classified into different channels, and the fluorescence imaging visually demonstrates that cells with higher metastasis ability have stronger telomerase activity. In addition, we successfully established the high-metastasis-ability LoVo subline (named as LoVo-H) and low-metastasis-ability LoVo subline (named as LoVo-L) from the human colorectal cancer LoVo cell lines through only one round of selection using the system. The results show that the LoVo-H cells display superior proliferation and invasiveness compared to LoVo-L cells. Furthermore, 6776 differentially expressed genes of LoVo-H compared with LoVo-L were identified by transcriptome sequencing. The genes associated with telomerase activity, cell migration and the epithelial to mesenchymal transition were up-regulated in LoVo-H, and PI3K-Akt signaling pathway, extracellular matrix-receptor interaction and Rap1 signaling pathway were significantly enriched in LoVo-H. This microfluidic system is a highly effective tool for selecting highly metastatic sublines and the LoVo-H subline established through this system presents a promising model for tumor metastasis research. Furthermore, this work preliminarily reveals telomerase expression during tumor metastasis and provides a new strategy for studying tumor metastasis and cancer diagnosis.
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  • 文章类型: Journal Article
    了解端粒生物学的复杂动力学对于衰老与癌症之间的紧密联系很重要。端粒,染色体末端的保护帽,是这方面的核心参与者。虽然它们由于复制而逐渐缩短,通过触发DNA修复机制限制了肿瘤的扩张,它还促进染色体内的致癌变化,从而维持肿瘤发生。端粒酶,负责维持端粒长度,在这种情况下,它是一个核心参与者。它在癌细胞中的表达有利于端粒的保存,允许它们规避短端粒的生长限制效应。有趣的是,端粒酶的影响超出了端粒的维持,它通过替代途径参与促进细胞生长。在这种情况下,炎症加速端粒缩短,导致端粒功能障碍,端粒元素也在调节炎症反应中发挥作用。对这种相互作用的认识促进了以端粒酶抑制为中心的新型治疗方法的发展。这篇综述提供了该领域的全面概述,强调知识的最新进展和对癌症生物学理解的意义。
    Understanding the complex dynamics of telomere biology is important in the strong link between aging and cancer. Telomeres, the protective caps at the end of chromosomes, are central players in this connection. While their gradual shortening due to replication limits tumors expansion by triggering DNA repair mechanisms, it also promotes oncogenic changes within chromosomes, thus sustaining tumorigenesis. The enzyme telomerase, responsible for maintaining telomere length, emerges as a central player in this context. Its expression in cancer cells facilitates the preservation of telomeres, allowing them to circumvent the growth-limiting effects of short telomeres. Interestingly, the influence of telomerase extends beyond telomere maintenance, as evidenced by its involvement in promoting cell growth through alternative pathways. In this context, inflammation accelerates telomere shortening, resulting in telomere dysfunction, while telomere elements also play a role in modulating the inflammatory response. The recognition of this interplay has promoted the development of novel therapeutic approaches centered around telomerase inhibition. This review provides a comprehensive overview of the field, emphasizing recent progress in knowledge and the implications in understanding of cancer biology.
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  • 文章类型: Journal Article
    骨骼肌,主要由多核肌纤维组成,在维持身体运动和能量代谢中起着关键作用。成肌细胞,作为分化和融合成肌纤维的前体细胞,在探索与胚胎肌肉发育相关的功能基因方面至关重要。然而,原代成肌细胞的体外增殖固有地受到限制。在这项研究中,通过导入外源鸡端粒酶逆转录酶(chTERT)基因成功建立鸡成肌细胞系,随后进行严格的G418介导的压力筛选。这种新开发的细胞系,被指定为chTERT成肌细胞,在形态上与原代成肌细胞非常相似,并且在至少20代种群倍增的培养中表现出明显的稳定性,而没有发生恶性转化。此外,我们进行了详尽的分析,包括细胞增殖,分化,和转染特性。我们的发现揭示了chTERT成肌细胞具有增殖的能力,区分,并在多轮人口倍增后进行转染。这一成就不仅为研究胚胎肌肉发育提供了有价值的均质禽类细胞材料来源,但也为建立原代细胞系提供了有价值的见解和方法。
    Skeletal muscle, which is predominantly constituted by multinucleated muscle fibers, plays a pivotal role in sustaining bodily movements and energy metabolism. Myoblasts, which serve as precursor cells for differentiation and fusion into muscle fibers, are of critical importance in the exploration of the functional genes associated with embryonic muscle development. However, the in vitro proliferation of primary myoblasts is inherently constrained. In this study, we achieved a significant breakthrough by successfully establishing a chicken myoblast cell line through the introduction of the exogenous chicken telomerase reverse transcriptase (chTERT) gene, followed by rigorous G418-mediated pressure screening. This newly developed cell line, which was designated as chTERT-myoblasts, closely resembled primary myoblasts in terms of morphology and exhibited remarkable stability in culture for at least 20 generations of population doublings without undergoing malignant transformation. In addition, we conducted an exhaustive analysis that encompassed cellular proliferation, differentiation, and transfection characteristics. Our findings revealed that the chTERT-myoblasts had the ability to proliferate, differentiate, and transfect after multiple rounds of population doublings. This achievement not only furnished a valuable source of homogeneous avian cell material for investigating embryonic muscle development, but also provided valuable insights and methodologies for establishing primary cell lines.
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  • 文章类型: Journal Article
    持续的高风险人乳头瘤病毒(HRHPV)感染导致宫颈细胞鳞状上皮内病变的发展,可能导致癌症。端粒长度,端粒酶活性,和阴道微生物组的物种组成可能会影响变化的动态和癌变的过程。在本研究中,我们分析了相对端粒长度(RTL),宫颈涂片细胞和阴道微生物组中的相对hTERT表达(端粒酶成分-逆转录酶基因)。从以下组的109例患者的组织样本中分离总RNA和DNA:对照组,承运人,低度或高度鳞状上皮内病变(LSIL和HSIL,分别),和癌症。采用定量PCR方法检测端粒长度和端粒酶表达。使用形态类型标准将阴道微生物组细菌分为群落状态类型。证实了组织病理学组之间的相对端粒长度和相对hTERT表达的显着差异(分别为p<0.001和p=0.001)。在携带者和HSIL组之间发现了RTL的显着差异(padj<0.001),以及载体和LSIL基团之间(padj=0.048)。在这两种情况下,运营商的RTL较低。在HSIL组中记录到最高的相对hTERT表达水平,在携带者和HSIL组之间记录到最高的相对hTERT表达水平(p<0.001)。对于基因型16+A,鉴定了基因型和生物期之间的相关性(p<0.001)。结果表明,HPV感染的鉴定,端粒长度评估,和hTERT表达测量一起可能比单独进行的这些分析中的每一个更具预测性。
    Persistent high-risk human papillomaviruses (HR HPVs) infection leads to the development of squamous intraepithelial lesions in cervical cells that may lead to cancer. The telomere length, telomerase activity, and species composition of the vaginal microbiome may influence the dynamic of changes and the process of carcinogenesis. In the present study, we analyze relative telomere length (RTL), relative hTERT expression (gene for the telomerase component-reverse transcriptase) in cervical smear cells and vaginal microbiomes. Total RNA and DNA were isolated from tissue samples of 109 patients from the following groups: control, carrier, low-grade or high-grade squamous intraepithelial lesion (L SIL and H SIL, respectively), and cancer. The quantitative PCR method was used to measure telomere length and telomerase expression. Vaginal microbiome bacteria were divided into community state types using morphotype criteria. Significant differences between histopathology groups were confirmed for both relative telomere length and relative hTERT expression (p < 0.001 and p = 0.001, respectively). A significant difference in RTL was identified between carriers and H SIL (p adj < 0.001) groups, as well as between carriers and L SIL groups (p adj = 0.048). In both cases, RTL was lower among carriers. The highest relative hTERT expression level was recorded in the H SIL group, and the highest relative hTERT expression level was recorded between carriers and the H SIL group (p adj < 0.001). A correlation between genotype and biocenosis was identified for genotype 16+A (p < 0.001). The results suggest that identification of HPV infection, telomere length assessment, and hTERT expression measurement together may be more predictive than each of these analyses performed separately.
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  • 文章类型: Journal Article
    背景:端粒是染色体末端的核蛋白复合物,受遗传和环境触发因素的控制。加速的端粒缩短与疾病发病率的增加有因果关系。地中海饮食最近被认为是一种可以预防疾病的饮食。这篇综述旨在确定地中海饮食的每个组成部分对端粒长度动力学的影响。突出了潜在的分子机制。
    方法:搜索PubMed以确定相关研究,以提取数据进行叙述性综述。
    结果:地中海饮食可减轻许多疾病的临床表现。专注于自身免疫性疾病,地中海饮食可以预防炎症,线粒体功能障碍,端粒酶活性异常。此外,每个地中海饮食成分似乎通过端粒长度的维持或延长来减轻衰老,提供对潜在分子机制的见解。多酚,维生素,矿物,脂肪酸似乎在端粒体内平衡中是必不可少的,因为它们抑制炎症反应,DNA损伤,氧化应激,线粒体功能障碍,和细胞死亡并诱导端粒酶活化。
    结论:地中海饮食有利于维持端粒动力学和减轻与年龄有关的疾病。这篇综述全面概述了横截面,观察,以及关于地中海饮食中每种成分对端粒长度和慢性疾病管理的有益影响的随机对照试验。
    BACKGROUND: Telomeres are nucleoprotein complexes at the ends of chromosomes that are under the control of genetic and environmental triggers. Accelerated telomere shortening is causally implicated in the increasing incidence of diseases. The Mediterranean diet has recently been identified as one that confers protection against diseases. This review aimed to identify the effect of each component of the Mediterranean diet on telomere length dynamics, highlighting the underlying molecular mechanisms.
    METHODS: PubMed was searched to identify relevant studies to extract data for conducting a narrative review.
    RESULTS: The Mediterranean diet alleviates clinical manifestations in many diseases. Focusing on autoimmune diseases, the Mediterranean diet can be protective by preventing inflammation, mitochondrial malfunction, and abnormal telomerase activity. Also, each Mediterranean diet constituent seems to attenuate aging through the sustenance or elongation of telomere length, providing insights into the underlying molecular mechanisms. Polyphenols, vitamins, minerals, and fatty acids seem to be essential in telomere homeostasis, since they inhibit inflammatory responses, DNA damage, oxidative stress, mitochondrial malfunction, and cell death and induce telomerase activation.
    CONCLUSIONS: The Mediterranean diet is beneficial for maintaining telomere dynamics and alleviating age-related illnesses. This review provides a comprehensive overview of cross-sectional, observational, and randomized controlled trials regarding the beneficial impact of every constituent in the Mediterranean diet on telomere length and chronic disease management.
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  • 文章类型: Journal Article
    结构变化严重影响癌症的分子格局,部分通过影响DNA甲基化介导的转录调控。这里,使用涉及儿童脑肿瘤网络中不同组织学的超过2400个小儿脑和中枢神经系统肿瘤的多组学数据集,我们报告了数百个基因和相关的CpG岛(CGI),其附近存在的体细胞结构变异(SV)断点与改变的表达或DNA甲基化有关。分别,包括肿瘤抑制基因ATRX和CDKN2A。增强子附近改变的DNA甲基化与附近的体细胞SV断点相关,包括MYC和MYCN。具有SV-CGI甲基化关联的基因子集也与患者生存具有表达关联。包括BCOR,TERT,RCOR2和PDLIM4。与同一患者的初始肿瘤相比,复发性或进行性肿瘤中的DNA甲基化变化可以预测儿科和成人癌症的生存率。我们的全面和全组织学基因组分析揭示了影响癌症基因的非编码改变的机制。
    Structural variation heavily influences the molecular landscape of cancer, in part by impacting DNA methylation-mediated transcriptional regulation. Here, using multi-omic datasets involving >2400 pediatric brain and central nervous system tumors of diverse histologies from the Children\'s Brain Tumor Network, we report hundreds of genes and associated CpG islands (CGIs) for which the nearby presence of somatic structural variant (SV) breakpoints is recurrently associated with altered expression or DNA methylation, respectively, including tumor suppressor genes ATRX and CDKN2A. Altered DNA methylation near enhancers associates with nearby somatic SV breakpoints, including MYC and MYCN. A subset of genes with SV-CGI methylation associations also have expression associations with patient survival, including BCOR, TERT, RCOR2, and PDLIM4. DNA methylation changes in recurrent or progressive tumors compared to the initial tumor within the same patient can predict survival in pediatric and adult cancers. Our comprehensive and pan-histology genomic analyses reveal mechanisms of noncoding alterations impacting cancer genes.
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  • 文章类型: Case Reports
    高级别脑膜瘤占脑膜瘤的比例相对较小,这是成人最常见的原发性颅内肿瘤之一。虽然罕见,相当一部分高级别脑膜瘤是由良性脑膜瘤的恶性转化引起的。2021年世界卫生组织(WHO)分类标准在中枢神经系统(CNS)肿瘤的诊断和分级中引入了分子标志物,并将某些基因组突变分配给3级脑膜瘤。我们报告了一例54岁的男性患者,该患者在10年内经历了从WHO1级到3级的逐步恶性转变的脑膜瘤,在五次手术的过程中,随后进行了辅助立体定向放射外科和放射疗法。我们对最新的3级脑膜瘤标本进行了下一代测序(NGS),发现它带有端粒酶逆转录酶启动子(TERTp)突变(c。-124C>T)符合2021年WHO3级脑膜瘤标准。然后,我们回顾性检查了以前的1级和2级标本,发现它们具有相同的突变。我们回顾了分子标志物在脑膜瘤诊断中的意义。与它们的恶性转化相关的可能的遗传改变,以及考虑NGS的发现,可以采取哪些措施来有效管理脑膜瘤。
    High-grade meningiomas make up a relatively minor proportion of meningiomas, which are one of the most common types of primary intracranial tumors in adults. Though rare, a considerable portion of high-grade meningiomas arise from malignant transformation of benign meningiomas. The 2021 World Health Organization (WHO) classification criteria introduced molecular markers in the diagnosis and grading of central nervous system (CNS) tumors and assigned certain genomic mutations to grade 3 meningiomas. We report a case of a 54-year-old male patient who underwent stepwise malignant transformation of meningioma from WHO grade 1 to grade 3 within 10 years, during the course of five surgeries followed by adjuvant stereotactic radiosurgery and radiotherapy. We performed next-generation sequencing (NGS) on the most recent grade 3 meningioma specimen and found that it carried a telomerase reverse transcriptase promoter (TERTp) mutation (c.-124C>T) in accordance with the 2021 WHO criteria for grade 3 meningiomas. We then retrospectively examined the previous grade 1 and 2 specimens and found them to have the same mutation. We reviewed the significance of molecular markers in the diagnosis of meningiomas, possible genetic alterations associated with their malignant transformation, and what measures could be taken to effectively manage meningiomas considering NGS findings.
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