| 多发高级别胶质瘤的病理特征及复发模式 |
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| 引用本文： | 赵永瑞,王雷明,陈怡东,高 莹,徐建堃.多发高级别胶质瘤的病理特征及复发模式[J].现代肿瘤医学,2023,0(5):843-847. |
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| 作者姓名： | 赵永瑞 王雷明 陈怡东 高 莹 徐建堃 |
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| 作者单位： | 1.首都医科大学宣武医院放射治疗科;2.病理科，北京 100053 |
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| 摘 要： | 目的:探讨多发高级别胶质瘤（multiple high-grade gliomas,M-HGGs）的病理特征及复发模式。方法:回顾性分析2020年08月至2022年04月于我院放射治疗科诊疗的26例M-HGGs患者，分析其病理特征、影像特征、治疗方式及复发模式。结果:本组26例患者均行手术治疗，术后病理示IDH野生型24例，IDH突变型2例，8例（30.8%）患者伴有MGMT启动子甲基化，免疫组化显示25例p53过表达，1例阴性；Ki-67均值为（40.19±6.99）%。24例患者术后行辅助治疗，2例行保守治疗。随访时间3~20个月，19例患者复发，14例（73.7%）局部复发，5例脑部远地部位复发；复发时间1~14个月，中位无进展生存期（progression-free survival，PFS）6个月。Kaplan-Meier生存分析显示手术切除程度及术后辅助治疗与较好的PFS相关（P=0.001，P=0.000）；多变量分析同样提示手术切除程度及术后辅助治疗是改善PFS的预后因素（P=0.006，P=0.031）。结论:M-HGGs多为IDH野生型，且伴有p53过表达和高Ki-67增殖指数等不良预后指标；局部复发仍是M-HGGs最常见的复发模式，手术切除程度和术后辅助治疗可能影响M-HGGs患者的预后。
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| 关 键 词： | 高级别胶质瘤 多发 病理 复发 |
Pathological features and recurrence patterns of multiple high-grade gliomas |
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| ZHAO Yongrui,WANG Leiming,CHEN Yidong,GAO Ying,XU Jiankun.Pathological features and recurrence patterns of multiple high-grade gliomas[J].Journal of Modern Oncology,2023,0(5):843-847. |
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| Authors: | ZHAO Yongrui WANG Leiming CHEN Yidong GAO Ying XU Jiankun |
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| Affiliation: | 1.Department of Radiation Oncology;2.Department of Pathology,Xuanwu Hospital,Capital Medical University,Beijing 100053,China. |
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| Abstract: | Objective:To explore the pathological characteristics and recurrence patterns of multiple high-grade gliomas(M-HGGs).Methods:Twenty-six patients with M-HGGs who underwent treatment from August 2020 to April 2022 were retrospectively analyzed,including pathological features radiological features treatment methods recurrence patterns.Results:All 26 cases underwent surgical treatment.Pathology showed 24 cases of IDH wild-type and 2 cases of IDH mutation.There were 8 cases(30.8%) of patients withs MGMT promoter methylation.Immunohistochemistry showed that 25 cases were p53 overexpression and 1 case was negative.The average of Ki-67(40.19±6.99)%.Twenty-four patients received postoperative adjuvant therapy,and two patients received conservative treatment.The follow-up time was 3~20 months.Nineteen patients experienced recurrence with a median progression-free survival(PFS) of 6 months,of which 14 patients(73.7%) had local recurrence and five patients had distant recurrence in the brain.The extent of surgical resection and postoperative adjuvant therapy were associated with a longer PFS in Kaplan-Meier survival analyses(P=0.001,P=0.000).Multivarate analysis also showed that the extent of surgical recsection and postoperative adjuvant therapy were prognostic factor of improving PFS(P=0.006,P=0.031).Conclusion:M-HGGs are mostly IDH wild-type and usually have poor prognostic indicators such as p53 overexpression,and a high Ki-67 index.The most common recurrence pattern of M-HGGs is local recurrence,the extent of surgical resection and postoperative adjuvant therapy may affect the survival of patients with M-HGGs. |
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| Keywords: | high-grade glioma multiple pathology recurrence |
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