Histopathological grading affects survival in patients with isocitrate dehydrogenase-wildtype gliomas.

IF 3.5 3区 医学 Q2 ONCOLOGY
Frontiers in Oncology Pub Date : 2025-09-16 eCollection Date: 2025-01-01 DOI:10.3389/fonc.2025.1570941
Ziming Hou, Dongyuan Liu, Zhe Hou, Hongbing Zhang, Hao Wang
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Abstract

Background: The World Health Organization (WHO) Classification of Tumors of the Central Nervous System (2021) defines lower-grade (WHO grade II/III) isocitrate dehydrogenase (IDH) wild-type astrocytoma as glioblastoma, IDH-wildtype, WHO grade 4. However, this definition is conditional. Notably, the traditional histopathological grade is no longer used, and the independent prognostic factor of tumor grade in IDH wild-type gliomas remains unclear. In this study, we aimed to determine if histopathological grade is an independent prognostic factor.

Methods: The clinical data and pathological information of 647 patients with IDH wild-type gliomas from the Chinese Glioma Genome Atlas (CGGA) database (2006-2019) were retrospectively analyzed. All patients were stratified according to histopathological grade and its prognostic significance in IDH wild-type gliomas. Univariate and Cox's multivariate analyses were used to determine the prognostic significance.

Results: The median follow-up time was 100.4 months, and the median survival time was 20.3 months. The histopathological grade was an important independent prognostic factor in the univariate and multivariate analyses, and a higher grade was associated with poor overall survival and progression-free survival. After further stratification by the extent of resection and postoperative adjuvant treatment, the histopathological grade remained a significant prognostic factor.

Conclusions: In this study, histopathological grade affected survival in IDH-wild-type gliomas. This effect appears to be independent of the extent of resection and postoperative treatment. Thus, we suggest that clinical treatment of patients with IDH wild-type gliomas should continue to consider histopathological grade along with the molecular characteristics of the tumors.

组织病理学分级影响异柠檬酸脱氢酶野生型胶质瘤患者的生存。
背景:世界卫生组织(WHO)中枢神经系统肿瘤分类(2021)将低级别(WHO分级II/III)异柠檬酸脱氢酶(IDH)野生型星形细胞瘤定义为胶质母细胞瘤,IDH野生型,WHO分级4。然而,这个定义是有条件的。值得注意的是,传统的组织病理学分级已不再使用,IDH野生型胶质瘤中肿瘤分级的独立预后因素尚不清楚。在这项研究中,我们旨在确定组织病理学分级是否是一个独立的预后因素。方法:回顾性分析中国胶质瘤基因组图谱(CGGA)数据库2006-2019年647例IDH野生型胶质瘤患者的临床资料和病理信息。根据IDH野生型胶质瘤的组织病理分级及其预后意义对所有患者进行分层。采用单因素和Cox多因素分析确定预后意义。结果:中位随访时间为100.4个月,中位生存时间为20.3个月。在单因素和多因素分析中,组织病理学分级是一个重要的独立预后因素,较高的分级与较差的总生存期和无进展生存期相关。在通过切除程度和术后辅助治疗进一步分层后,组织病理学分级仍然是一个重要的预后因素。结论:在本研究中,组织病理学分级影响idh野生型胶质瘤的生存。这种影响似乎与切除的程度和术后治疗无关。因此,我们建议IDH野生型胶质瘤患者的临床治疗应继续考虑组织病理学分级以及肿瘤的分子特征。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Frontiers in Oncology
Frontiers in Oncology Biochemistry, Genetics and Molecular Biology-Cancer Research
CiteScore
6.20
自引率
10.60%
发文量
6641
审稿时长
14 weeks
期刊介绍: Cancer Imaging and Diagnosis is dedicated to the publication of results from clinical and research studies applied to cancer diagnosis and treatment. The section aims to publish studies from the entire field of cancer imaging: results from routine use of clinical imaging in both radiology and nuclear medicine, results from clinical trials, experimental molecular imaging in humans and small animals, research on new contrast agents in CT, MRI, ultrasound, publication of new technical applications and processing algorithms to improve the standardization of quantitative imaging and image guided interventions for the diagnosis and treatment of cancer.
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