异柠檬酸脱氢酶-1突变与胶质瘤化疗疗效关系的初步研究  

The relationship between isocitrate dehydrogenase gene mutation and chemotherapy in gliomas:a preliminary study

作　　者：韩松[1] 陆宇[1] 董韬[1] 于春泳[1] 李晓明[1] 潘冬生[1] 冯思哲[1] 

机构地区：[1]沈阳军区总医院神经外科,辽宁沈阳110016

出　　处：《中华神经外科疾病研究杂志》2017年第3期212-216,共5页Chinese Journal of Neurosurgical Disease Research

摘　　要：目的回顾性研究人脑胶质瘤患者46例中异柠檬酸脱氢酶-1(IDH1)R132H变异与其化疗疗效的关系。方法采用建立的MGB双荧光探针实时荧光定量聚合酶链式反应(PCR)方法检测患者IDH1基因R132H突变,同时根据临床随访获得患者化疗预后情况,比较IDH1基因132位点突变与野生型患者化疗预后及生存分析。结果单因素分析IDH1基因突变的继发性胶质母细胞瘤(sGBM)患者化疗后有更长的无进展生存期(PFS)和总体生存期(OS)(P<0.001),患者年龄小于50岁,行为状态评分(KPS)大于80均有较长的PFS和OS;多因素分析(COX回归分析)中,IDH1基因突变与PFS和OS呈显著正相关(P<0.001);TMZ化疗显示IDH1基因突变中有效组患者为47.2%,IDH1基因野生型中有效组患者为10.0%,两组间差异具有统计学意义(P<0.001)。生存分析显示替莫唑胺(TMZ)化疗患者IDH1基因突变有更长的PFS。结论本实验结果分析显示IDH1基因R132H突变是s GBM患者TMZ化疗疗效的敏感指标之一,为后续s GBM治疗提供新的参考选择。Objective The relationship between IDH1 R132H variation in 46 patients with glioma and the chemotherapy efficacy was invesigated. Methods The real-time fluorescence quantitative PCR （MGB） method was used to detect the R132H mutation of IDH1 gene. At the same time, the prognosis of patients with chemotherapy was obtained by clinical follow-up. The prognosis of chemotherapy and survival analysis was compared between the patients with IDH1 R132H variation and the wild-type patients. Results Univariate analysis showed that the patients with secondary glioblastoma （sGBM） with IDH1 mutations had longer PFS and OS after chemotherapy （P 〈0. 001 ）; the patients younger than 50 years and with KPS scores 〉 80 had longer PFS and OS （P 〈 0. 001 ）. Multivariate analysis （COX regression analysis） showed that IDH1 gene mutation was positively correlated with PFS and OS （P 〈0.001）. Effective group of patients with IDH1 gene mutation and wild-type was 47.2% and 10.0%, respectively. The difference between two groups was statistically significant （P 〈0. 001 ）. Survival analysis showed that TMZ patients with IDH1 gene mutations had longer PFS. Conclusion The results of this study show that IDH1 gene R132H mutation is a sensitive indicator of TMZ chemotherapy in patients with sGBM, which provides a new reference for subsequent treatment of sGBM.

关 键 词：胶质瘤 IDH1突变 诊断 治疗 

分 类 号：R739[医药卫生—肿瘤]