Expression Of ATF5 And Prognosis Significance In Glioma

Objective: We aimed to investigate the expression of ATF5 and its clinical significance in Glioma,furthermore we explore the correlation between the expression of ATF5 and related clinical characteristics with the prognosis of patients with glioma.Methods: A total of 52 cases of glioma tissue specimens confirmed and documented by the department of pathology,were obtained from neurosurgery the Affiliated Hospital of Zunyi Medical College from April 2014 to August 2018.Another normal specimens of brain were selected as negative controls.The expression level of ATF5 in glioma tissues and normal brain tissues was detected by immunohistochemistry(IHC).Simultaneously,we collected the clinical pathological data of patients,such like gender,age,tumor size,tumor location,treatment methods.We conducted telephone and outpatient follow-up,and further analyzed single-factor and multi-factor analysis of ATF5 and glioma clinical cases.Next,we explored the correlation between the relevant clinical indicators with the prognosis of glioma,and the factors affecting the prognosis of patients with glioma by univariate and multivariate analysis.Results: ATF5 was significantly over-expressed than matched normal brain tissues in WHO Ⅰ~IV grade glioma tissues,there was statistical difference between the two groups(P<0.01).ATF5 in grade IV glioma was significantly over-expressed than that in grade I~III,and the difference was statistically significant(P < 0.05),but there was no significant difference in the expression of ATF5 between grade I and grade III glioma tissues.(P>0.05).Chi-square test analysis showed that ATF5 expression level was positively correlated with glioma pathological grade(P < 0.05),ATF5 expression level in How-grade glioma(HGG)tissue was significantly higher than low-grade glioma(LGG)tissue.Another characteristic including age,gender,tumor size and location,show no significant correlation with expression level of ATF5(P<0.01).Kaplan-Meier survival analysis indicated that the OS of patients with high ATF5 protein expression was significantly inferior to that of patients with low ATF5 expression,there was statistical difference significant(P<0.05);The PFS of glioma patients with high expression of ATF5 protein was also inferior to ATF5 low-expression patients,and the difference was statistically significant(P<0.05).KaplanMeier survival analysis also demonstrated that OS in patients with aged ≥50 years and HGG was significantly inferior to patients with aged<50 years and LGG(both P<0.05);The OS in 32 months of whom patients with surgery combined with concurrent chemoradiotherapy was significantly longer than patients with surgery alone(P<0.05),however,it remained no significant difference for long-term outcome(P>0.05).There was no significant correlation between patient prognosis with the gender,tumor size,and tumor location.COX multivariate analysis showed that the age(hazard ratio 0.089;P=0.004)and treatment method(hazard ratio 0.193;P=0.041)were independent prognostics factors for glioma patients.Conclusion: 1.ATF5 is over-expressed in glioblastoma tissues,meanwhile it is probably correlated with pathological grade of glioma.The OS for patients of glioma with over-expressed ATF5 is significantly inferior to the patients with low expression of ATF5.2.The age,pathological grade and treatment methods of glioma patients are potential risk factors for the prognosis of glioma patients.The age and treatment method of patients are also independent prognostic risk factors.3.The expression level of ATF5 can provide certain clinical reference for the prognosis of glioma patients.