Molecular markers of postoperative recurrence and malignant transformation in low-grade gliomas and their predictive value
Objective To identify the risk factors for recurrence and malignant transformation(MT)in patients with low-grade glioma(LGG)after surgery.Methods The data of 163 patients who underwent LGG resection and subsequent follow-up from March 2009 to April 2019 were retrospectively collected.Patients who did not experience recurrence or MT after surgery were included in the control group(85 cases),those who experienced recurrence after surgery were included in the observation 1 group(44 cases),and those who experienced MT after surgery were included in the observation 2 group(34 cases).Based on the clinical data of the three groups of patients,their clinical characteristics were analyzed,and the risk factors and predictive value for recurrence and MT were explored using Logistic regression model and receiver operating characteristic(ROC)curve.Results There were significant differences between the control group and the observation 1 group in preoperative seizure,preoperative Karnofsky performance status(KPS)score,and surgical approach(P＜0.05).There were significant differences between the control group and the observation 2 group in gender,preoperative KPS score,tumor size,and surgical approach(P＜0.05).There were significant differences between the control group and the observation 1 group in isocitrate dehydrogenase(IDH)mutation,proliferating cell nuclear antigen(PCNA),matrix metalloproteinase-9(MMP-9),cancer-testis antigen OY-TES-1,OY-TES-1 mRNA protein,tumor suppressor protein p53,mouse double minute 2(MDM2),vascular endothelial growth factor(VEGF),or epidermal growth factor receptor(EGFR)(P＜0.05).There were significant differences between the control group and the observation 2 group in PCNA,MMP-9,cancer-testis antigen OY-TES-1,OY-TES-1 mRNA protein,or VEGF(P＜0.05).Logistic regression analysis showed that IDH mutation,MMP-9,and PCNA were independent risk factors for LGG recurrence(P＜0.05),while VEGF,MMP-9,and PCNA were independent risk factors for LGG MT(P＜0.05).The area under curve(AUC)of PCNA,MMP-9 and IDH mutation for predicting LGG MT after surgery was 0.744,0.790,and 0.799,respectively.The AUC of PCNA,MMP-9,and VEGF for predicting LGG recurrence after surgery was 0.729,0.750,and 0.900,respectively.Conclusion This study found that IDH mutation,MMP-9 and PCNA were independent risk factors for LGG recurrence,while VEGF,MMP-9 and PCNA were independent risk factors for LGG MT by retrospectively analyzing the clinical data and protein expression of 163 patients with LGG after surgery.These proteins have high accuracy in predicting LGG recurrence and MT after surgery.Therefore,the proteins may play an important role in the biological behavior and treatment effect of LGG,and can be used as reference indicators for prognosis evaluation and individualized treatment of LGG patients after surgery.
万方数据
维普
