O^6-甲基鸟嘌呤-DNA甲基转移酶甲基化状态和同期放化治疗与中国香港胶质母细胞瘤患者生存的相关性研究  

Association of Molecular Marker O^6-Methylguanine DNA Methyltransferase and Concomitant Chemo-radiotherapy with Survival in Southern Chinese Glioblastoma Patients

作　　者：陈达明[1] 谭海斌[1] 潘伟生[1] 甘冠明[2] 马碧如[2] 吴志萍[1] 彭颂先[3] 刘嘉怡[1] 萧容媛[4] 伍兆龙[1] 朱献伦[1] 陈功[1] 吴浩强[3] 

机构地区：[1]香港中文大学附属威尔斯亲王医院外科脑肿瘤中心 [2]香港中文大学附属威尔斯亲王医院临床肿瘤科 [3]香港中文大学附属威尔斯亲王医院解剖和细胞病理科 [4]香港中文大学附属威尔斯亲王医院器官影像和放射诊断科

出　　处：《中国神经肿瘤杂志》2011年第1期12-16,共5页Chinese Journal of Neuro-Oncology

摘　　要：背景与目的:胶质母细胞瘤(GBM)是一种恶性程度最高的星形细胞瘤,其主要的治疗方法是外科手术和放射疗法,2005年批准使用替莫唑胺,化学疗法的效果才得以确定。本文比较中国香港原发性GBM患者接受同期放化治疗或单纯放疗的生存时间,探讨GBM肿瘤组织中O6-甲基鸟嘌呤-DNA甲基转移酶(MGMT)的甲基化状态在预后评价的价值。方法:回顾性分析2005年3月至2007年6月期间35例经手术后病理确诊并接受过同期放化治疗或单纯放疗的中国香港GBM患者的资料,从石蜡包埋的GBM肿瘤组织中分离出基因组DNA,采用甲基化特异性聚合酶链反应方法(MSP)检测基因MGMT甲基化状态。采用Kaplan Meier方法计算总生存时间(OS)和无进展生存时间(PFS),比较同期放化治疗或单纯放疗和MGMT甲基化或非甲基化状态对生存时间的影响。结果:35例患者中,男性27例,女性8例,平均年龄50.4岁。35例患者的中位PFS和中位OS分别是4.7个月(3.1~6.2个月)和11.7个月(6.5~16.6个月),其中18例仅接受单纯放疗患者的中位PFS和中位OS分别是4.2个月(3.4~5.0个月)和5.8个月(2.0~9.6个月),17例接受同期放化治疗患者的中位PFS和中位OS分别是6.0个月(2.0~10个月)和13.2个月(8.1~18.3个月),P值>0.05。15例(43%)肿瘤组织中存在MGMT甲基化,MGMT甲基化和非甲基化患者的中位OS分别是16.9个月(12.7~21.1个月)和10个月(5.8~14.1个月),P值>0.05。结论:尽管差异无统计学意义,但与单纯放疗比较,接受了同期放化治疗的GBM患者显示出了更长的总体生存趋势,MGMT甲基化可能是GBM的明显预后较好的因素。BACKGROUND OBJECTIVE： Glioblastoma Multiforme（GBM） is the most common malignant primary brain tumor.The utilization of temozolomide has been shown to be effective in the treatment of GBM.In this study,we compared the survival of concomitant chemotherapy and radiotherapy with radiotherapy alone in Chinese primary glioblastoma and determined the methylation status of O6-methylguanine DNA methyltransferase（MGMT） in Chinese primary glioblastoma.We also assessed the prognostic value of MGMT methylation status in Chinese primary glioblastoma.METHODS PATIENTS： Patients diagnosed with primary glioblastoma by histological proof in the period of March 2005 to June 2007 were recruited.Genomic DNA was isolated from formalin-fixed and paraffin-embedded sections of glioblastoma tissues.Methylation-specific polymerase chain reaction（MSP） for MGMT was performed.Patients＇ information at presentation was collected（age,performance status,steroid use,extent of resection,complications,radiotherapy data,use of chemotherapy）.Primary outcome was measured by Overall survival（OS） while secondary outcome was measured by Progress-free survival（PFS）.Overall survival（OS） and Progress-free survival（PFS） are estimated by Kaplan Meier technique.Outcomes were assessed for groups with and without concomitant chemo-radiotherapy and for groups with and without MGMT-methylation.RESULTS： A total of 35 glioblastoma patients were recruited.There were 27 male and 8 female patients.Their mean age was 50.4 years old.Seventeen patients received concomitant chemo-radiotherapy.18 patients received radiotherapy only.The median OS was 11.7 months（6.5-16.6months） and the median PFS was 4.7months（3.1-6.2months） in the series.In the radiotherapy alone group,the median PFS and OS was 4.2 months（3.4-5.0） and 5.8 months（2.0-9.6） respectively.In the concomitant radio-chemotherapy group,the median PFS and OS was 6.0 months（2.0-10） and 13.2 months（8.1-18.3） respectively.Fifteen（43%） tumour samples showe

关 键 词：胶质母细胞瘤 分子标志 O6-甲基鸟嘌呤-DNA甲基转移酶(MGMT) 替莫唑胺 

分 类 号：R739.41[医药卫生—肿瘤]