IDH1R132H Mutation In Glioma-associated Epileptioma And Its Relationship With Postoperative Seizure Recurrence In Patients

Background and ObjectiveGlioma is often associated with epilepsy.Although surgical treatment has good control of epilepsy in the case of complete resection of the lesion and epileptogenic focus,postoperative epilepsy may continue to exist.Seizure recurrence severely affects the patient's nervous system,Function and quality of life.Studies have shown that in patients with grade II-IV glioma-related epilepsy,the Isocitrate dehydrogenase 1(IDH1)R132H mutation is closely related to preoperative seizures in patients.Therefore,we detected the mutation of IDH1R132H in the tumor tissue of patients with glioma-related epilepsy,and explored the relationship between the mutation and postoperative seizure recurrence.MethodsThe tumor tissues of 90 patients with glioma-related epilepsy who underwent surgery from March 2012 to March 2017 at the Fifth Affiliated Hospital of Zhengzhou University were selected.Of the 90 patients,27 were grade II,18 were grade III,and 45 were grade IV.The mutation of IDH1R132H in tumor tissues of 90patients was detected by immunohistochemical staining,two independent sample t-tests were used to analyze the age difference between patients with and without mutations;?~2 test was used to analyze the relationship between IDH1R132H mutation and clinical pathological parameters(sex,WHO classification,pathological type,tumor diameter,preoperative KPS score,involvement of functional area,tumor location,postoperative tumor recurrence,postoperative anti-epileptic dose),patients Relationship between postoperative seizure status and various parameters(sex,WHO classification,pathological type,tumor diameter,preoperative KPS score,involvement of functional area,tumor location,postoperative tumor recurrence,postoperative anti-obesity,IDH1R132H mutation);Cox multivariate regression model was established to analyze independent risk factors affecting postoperative seizure recurrence in patients.Results1.IDH1R132H mutation in tumor tissue of patients with glioma-related epilepsy:There are different levels of brown or yellowish brown positive signal expression in the cytoplasm of tumor cells.There were 32 cases of mutation and 58 cases of wild type,The overall mutation rate was 35.6%.The mean age of the mutant patients was(37.1±11.6)years,and the mean age of the wild-type patients was(57.2±11.6)years,There was a statistically significant difference between the two groups(t=11.547,P<0.001).The IDH1R132H mutation in tumor tissues was associated with tumor WHO classification(?~2=32.845,P<0.001),and the mutations mainly occurred in grade II and III gliomas.The IDH1R132H mutation in tumor tissues was also associated with tumor pathological typing(?~2=36.811,P<0.001),The results showed that the mutation was mostly in oligodendroglioma,oligodendroglioma and anaplastic astrocytoma,It is the least in glioblastoma multiforme,accounting for only 6.7%.2.Relationship between IDH1R132H mutation and other clinicopathological factors in tumor tissues:Other clinical and pathological factors that may be related to the mutation were included.After the chi-square test,the IDH1R132H mutation in the tumor tissues was related to the postoperative tumor recurrence(?~2=16.016,P<0.001)and the number of anti-epileptic drugs in the patient(?~2=15.415,P<0.001),That is,there are more IDH1R132H mutations in the tumor tissues of patients with more antiepileptic drugs(?3 species)and postoperative tumor recurrence;The mutation was unrelated to the patient's gender(?~2=0.395,P=0.659),tumor diameter(?~2=1.018,P=0.380),preoperative KPS score(?~2=0.224,P=0.653),involvement of the functional area(?~2=0.052,P=0.828),and the location of the tumor(?~2=2.963,P=0.229)(All P>0.05).3.The factors that may affect the recurrence of postoperative epilepsy in this study:age,gender,WHO classification,tumor diameter,preoperative KPS score,tumor involvement functional area,tumor location,postoperative tumor recurrence,number of anti-epileptic drugs taken after surgery and IDH1R132H mutations were included in the Cox regression model for multivariate analysis:The IDH1R132H mutation(HR=3.796,95%Cl:1.872-8.705),the location of the tumor(HR=3.197,95%Cl:1.527-6.693),Postoperative tumor recurrence(HR=3.069,95%Cl:1.234~8.142)and tumor involvement function area(HR=2.031,95%Cl:1.369~3.010)were independent risk factors for postoperative epilepsy recurrence(All P<0.05).Conclusions1.The IDH1R132H mutation in tumor tissues of patients with glioma-related epilepsy mainly occurs in grade II and III tumors,and the average age of patients with mutations is smaller than that of patients without mutation,this mutation may provide predictive and guiding significance for postoperative tumor recurrence and postoperative anti-epileptic drugs(?3).2.The IDH1R132H mutation has an adverse effect on the control of postoperative seizure recurrence in patients with glioma-related epilepsy,and such patients may need to adopt more rigorous comprehensive treatment measures,this mutation is expected to be a new molecular target for judging the biological characteristics of glioma-related epilepsy and evaluating postoperative seizure recurrence in patients.