Clinical Data And Differential Proteomics Of Intracranial Germ Cell Tumors

Background:Central diabetes insipidus is one of the common symptoms in neurosurgery and endocrinology, with 33%-37% of patients appearing pituitary stalk enlargement in MRI. The etiological spectrum of these lesions is broad. Intracranial germ cell tumors are the most malignant disease with the most progressive and worst prognosis among all the lesions. Intracranial germ cell tumors are low-grade malignant tumors with more invasive growth. It is so difficult to diagnose preoperatively so far that the intracranial biopsy is the gold standard. However, brain tissue biopsy causes traumatic damage, poor patient compliance, postoperative complications and overwrought nursing. So, we need to find a new kind of noninvasive detection of intracranial germ cell tumors.Objectives:To discuss the clinical features and prognostic factors of icGCTs; To find the potential signaling pathways and new disease markers in icGCTs.Methods:Clinical data of 73 patients with histological confirmed icGCTs were collected from September 2008 to December 2015; 66 patients did follow-ups.8 intracranial germinomas were collected. Differential proteins were identified by LMD/MS.Results:Patients with the most diameters more than 15mm had a higher rate of bad prognosis (OR 8.96; CI 2.54-31.66). Patients with OCT positive had a higher rate of bad prognosis (OR 4.33; CI 1.18-15.89). Patients with NGGCTs had a higher rate of bad prognosis (OR 6.56; CI 1.62-26.58). Patients who received chemotherapy combined with radiation have a lower rate of bad prognosis (OR 0.20; CI 0.06-0.67). Compared to tumor adjacent tissue group,175 differential proteins were found in tumor group with all proteins up-regulation and involved in 42 related signaling pathways. Compared to control group,45 differential proteins were found in tumor group with 38 proteins up-regulation and 7 proteins down-regulation and involved in 33 related signaling pathways.Conclusions:The worse outcomes occurred in patients with the most diameters more than 15mm, OCT positive or NGGCTs. The better outcomes occurred in patients with chemotherapy combined with radiation. Intracranial germinomas may be facilitated through the activation of eIF2 signaling pathway and PI3K/Akt signaling pathway.