A Study About The Prognostic And Clinical Value Of Glioma-related Molecular Features

Objective:With the progress of research on the molecular characteristics of gliomas in recent years,the new edition of the 2021 World Health Organization(WHO)Classification of the Central Nervous System(WHO CNS5)has divided tumors into more biological and molecular pathological types,and introduced new tumor types and subtypes,especially for pediatric patients.To study the expression of some related molecular features in different grades of gliomas,the relationship between these molecular features and clinical related factors of gliomas,as well as their predictive and prognostic value,and to re-classify the sample gliomas,so as to understand the classification and grading of glioma patients and their prognostic value.Therefore,the individualized diagnosis and treatment plan for glioma patients can be formulated,and the direction for the follow-up diagnosis and treatment of patients can be provided.Methods:A total of 116 patients who underwent surgical treatment and were pathologically diagnosed with glioma in Shandong Provincial Hospital from January 2019 to January 2021 were included in this study.Immunohistochemistry and second-generation sequencing and other technologies were used to detect the mutations of related molecular features in 116 patients with glioma.The obtained data were statistically analyzed.Chi-square test and Logistic regression analysis were used to compare the correlation between different clinical factors and these molecular features,and the correlation between different molecular features.Results:IDH mutation was correlated with WHO grade(P<0.001),and age(P=0.047<0.05).There was no significant correlation between IDH mutation,gender,concomitant epilepsy and initial onset.The lp/19q combined deletion was associated with WHO grade in glioma patients(P=0.019<0.05);There was no significant correlation between 1p/19q co-deleted and sex,age,epilepsy,and initial onset;The proportion of 1p/19q combined deletion in IDH mutant patients was significantly higher than that in IDH wild type patients(P<0.001).There was a clear correlation between TERT promoter mutation and age of glioma patients(P<0.001));TERT promoter mutation was no significantly correlated with WHO grade,sex,concomitant epilepsy and initial onset.The frequency of TERT promoter mutation in patients with ATRX mutation was significantly lower than that in patients with ATRX wild type(P<0.001).MGMT promoter methylation was significantly correlated with WHO grade(P=0.014<0.05)of glioma patients;There was no correlation between MGMT promoter methylation and gender,age,conmitant epilepsy and primary or recurrent glioma.The proportion of MGMT promoter methylation in IDH mutant patients was significantly higher than that in IDH wild-type patients(P<0.001).The positive rate of MGMT promoter methylation in 1p/19q co-deleted group was significantly higher than in 1p/19q without codeletion group(P=0.002<0.05).ATRX mutation was significantlty correlated with WHO grade(P=0.023<0.05),and age(P<0.001).ATRX mutation is not associated with gender,concomitant epilepsy and initial onset.The proportion of ATRX mutation in IDH mutant patients was much higher than that in IDH wild type patients(P<0.001).The TP53 gene mutation showed no obvious correlation with all clinical factors.Mutations in BRAF and H3F3A/HIST1H3B/HIST1H3C were only associated with age(P<0.05),but not with other clinical factors.Conclusion:IDH,1p/19q,TERT,MGMT promoter methylation,ATRX,TP53,BRAF,H3 K27/G34 mutations are important for the pathological diagnosis of gliomas,the evaluation of the malignant degree of tumors,and the development of individualized treatment and subsequent treatment.