Research On The Clinical And Pathological Features That Have Impacts On The Relapse Of High-grade Glioma

Background Gliomas are the most common primary tumor of malignant brain and central nervous system(CNS).Nowadays,the main therapy methods of glioma are the following three kinds:surgery,radiotherapy,chemotherapy and several experimental procedures,such as immunotherapy,use of angiogenesis inhibitors and gene/antibody therapy.Despite those improved therapeutic methods,the median survival time of high-grade gliomas is still very low,with 88%of high-grade glioma patients dying within ’3 years.Otherwise,relapse is universal and the median survival is 3-6 months,which is lower than that of the primary one.Objective The primary aim of our study was to assess the role of some clinicopathological characteristics and MCP1-CCR2 axis in predicting recurrence in high-grade glioma patients.Methods We retrospectively analyzed data of 104 patients with recurrent high-grade glioma and detected the expression of MCP1 and CCR2 using immunohistochemistry(IHC)technique.Results PFS and OS of older patients((?)=50 years)were significantly shorter than those<50 years(PFS:p= 0.000002;OS:p=0.000032).Patients those accepted postoperative-radiotherapy had a longer PFS than those who didn’t accept(p= 0.009),however,the OS of these two kind of patients are not obviously different(p= 0.876).Otherwise,gender and tumor location rarely have an obvious relationship with PFS or OS.More over,the expressions of MCP1 and CCR2 of the recurrence were significantly higher than that of the initial diagnosis respectively(MCP1:Z=-5,3,p<0.05;CCR2:Z=-3.857,p<0.05)and both PFS and OS of higher expression of MCP1(++/+++)were significantly shorter than that of lower expression of MCP1(-/+)(PFS:p 0.001;OS:p=0.006).But the relationship of the expression of CCR2 and both of PFS and OS was not obvious,Multivariate analysis showed that age for PFS and OS remained independent prognostic factors(PFS:p=0.000093;OS:p=0.001);the expression of MCP1 for PFS and OS remained an independent prognostic factor(PFS:p= 0.012;OS:p=0.041).Conclusions1.The grade of the initial glioma was higher than that of the relapse ones;The expressions of MCP1/CCR2 in the initial glioma were more than those in the relapse glioma;2.Our results indicate that age and MCP1 may play a critical role in forecasting the relapse of high-grade glioma,and post-operational radiotherapy play a heavy mission respectively.Age and MCP1 may have a critical influence on the survival rate of the patients.3.Thus,for those patients who are elder or a higher expression of MCP1 in his tumor tissues when he was diagnosed as high-grade glioma,a timely and regular review is critical for the early detection and treatment of the relapse of high-grade glioma.4.The MCP1/CCR2 axis plays an important role in the recurrence of high-grade glioma,which has the potential to be the target of therapy,and it could guide the treatment of high-grade glioma efficiently.Overall,it is worth our further studying.