Erschienen in:
01.12.2014 | Clinical Study
1p/19q-driven prognostic molecular classification for high-grade oligodendroglial tumors
verfasst von:
Haihui Jiang, Zhe Zhang, Xiaohui Ren, Wei Zeng, Wenqing Jia, Junmei Wang, Song Lin
Erschienen in:
Journal of Neuro-Oncology
|
Ausgabe 3/2014
Einloggen, um Zugang zu erhalten
Abstract
The subjectivity in pathological diagnosis of anaplastic oligoastrocytoma (AOA) and uncertainty in designation of glioblastoma with oligodendroglioma component (GBMO) were two major dilemmas which puzzled neuro-pathologists and neurosurgeons. The present study was designed to project a molecular classification scheme based on the status of chromosome 1p and 19q. Patients (n = 117) with histological diagnosis of primary high-grade oligodendroglial tumors (HGOs) enrolled in the study. Fluorescence in situ hybridization (FISH) for chromosomes 1p and 19q was performed. Univariate analysis showed that higher tumor grade, 1p/19q maintenance and 1q/19p co polysomy were confirmed as risk factors in HGOs (P < 0.01). Accordingly, patients with HGOs were divided into four subtypes which conferred remarkably distinct prognosis based on the number of risk factors (0 risk factor: HGOs-1, 1 risk factor: HGOs-2, 2 risk factors: HGOs-3, 3 risk factors: HGOs-4). Cox regression model revealed that the tumor grade was no longer independently associated with survival, while the molecular classification scheme showed a marked prognostic significance (HR = 0.359, 95 % CI 0.261–0.494, P < 0.001 for progression-free survival (PFS); HR = 0.393, 95 % CI 0.283–0.546, P < 0.001 for overall survival (OS)). The classification scheme incorporating traditional pathology with molecular information can be served as a supplement of the current WHO classification system and contribute to the personalized treatment decision-making.