1
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Bruhn H, Blystad I, Milos P, Malmström A, Dahle C, Vrethem M, Henriksson R, Lind J. Initial cognitive impairment predicts shorter survival of patients with glioblastoma. Acta Neurol Scand 2022; 145:94-101. [PMID: 34514585 DOI: 10.1111/ane.13529] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 08/24/2021] [Accepted: 08/26/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVES Seizures as presenting symptom of glioblastoma (GBM) are known to predict prolonged survival, whereas the clinical impact of other initial symptoms is less known. Our main objective was to evaluate the influence of different presenting symptoms on survival in a clinical setting. We also assessed lead times, tumour size and localization. METHODS Medical records of 189 GBM patients were reviewed regarding the first medical appointment, presenting symptom/s, date of diagnostic radiology and survival. Tumour size, localization and treatment data were retrieved. Overall survival was calculated using Kaplan-Meier and Mann-Whitney U test. Cox regression was used for risk estimation. RESULTS Cognitive impairment as the initial symptom was often misinterpreted in primary health care leading to a delayed diagnosis. Initial global symptoms (66% of all patients) were associated with reduced survival compared to no global symptoms (median 8.4 months vs. 12.6 months). Those with the most common cognitive dysfunctions: change of behaviour, memory impairment and/or disorientation had a reduced median survival to 6.4 months. In contrast, seizures (32%) were associated with longer survival (median 11.2 months vs. 8.3 months). Global symptoms were associated with larger tumours than seizures, but tumour size had no linear association with survival. The setting of the first medical appointment was evenly distributed between primary health care and emergency units. CONCLUSION Patients with GBM presenting with cognitive symptoms are challenging to identify, have larger tumours and reduced survival. In contrast, epileptic seizures as the first symptom are associated with longer survival and smaller tumours.
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Affiliation(s)
- Helena Bruhn
- Department of Neurology Region Jönköping County Jönköping Sweden
- Department of Biomedical and Clinical Sciences Linköping University Linköping Sweden
| | - Ida Blystad
- Department of Radiology in Linköping and Department of Health, Medicine and Caring Sciences Linköping University Linköping Sweden
- Centre for Medical Image Science and Visualization (CMIV) Linköping University Linköping Sweden
| | - Peter Milos
- Department of Biomedical and Clinical Sciences Linköping University Linköping Sweden
- Department of Neurosurgery Linköping University Hospital Linköping Sweden
| | - Annika Malmström
- Department of Biomedical and Clinical Sciences Linköping University Linköping Sweden
- Department of Advanced Home Care Linköping University Linköping Sweden
| | - Charlotte Dahle
- Department of Biomedical and Clinical Sciences Linköping University Linköping Sweden
| | - Magnus Vrethem
- Department of Biomedical and Clinical Sciences Linköping University Linköping Sweden
| | - Roger Henriksson
- Department of Radiation Sciences Umeå University Hospital Umeå Sweden
| | - Jonas Lind
- Department of Neurology Region Jönköping County Jönköping Sweden
- Department of Biomedical and Clinical Sciences Linköping University Linköping Sweden
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2
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Liu L, Jia L, Shao J, Liu H, Wu Q, Wu X. Circular RNA circNF1 siRNA Silencing Inhibits Glioblastoma Cell Proliferation by Promoting the Maturation of miR-340. Front Neurol 2021; 12:658076. [PMID: 34589042 PMCID: PMC8475906 DOI: 10.3389/fneur.2021.658076] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 08/10/2021] [Indexed: 11/25/2022] Open
Abstract
It has been reported that circNF1, a type of circular RNA (circRNA), promotes gastric cancer. This study aimed to analyze the role of circNF1 in glioblastoma (GBM). The expression of circNF1, mature miR-340, and miR-340 precursor in paired GBM and non-cancer tissues from GBM patients (n = 50) was analyzed by RT-qPCR. GBM cells were transfected with circNF1 siRNA, followed by the analysis of the expression of mature miR-340 and miR-340 precursor, to study the effects of circNF1 knockdown on the maturation of miR-340. The CCK-8 assay was carried out to explore the role of circNF1 and miR-340 in the proliferation of GBM cells. circNF1 expression was found to be upregulated in GBM and was correlated with patient survival. In glioma tissue, circNF1 was inversely correlated with mature miR-340, but not with the miR-340 precursor. In GBM cells, circNF1 siRNA silencing resulted in the upregulation of mature miR-340, but not the miR-340 precursor. The cell proliferation assay showed that circNF1 siRNA silencing and miR-340 overexpression decreased the proliferation of GBM cells. In addition, the miR-340a inhibitor suppressed the role of circNF1 siRNA silencing in cell proliferation. Therefore, circNF1 siRNA silencing may inhibit GBM cell proliferation by promoting the maturation of miR-340.
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Affiliation(s)
- Li Liu
- Taizhou First People's Hospital, Taizhou, China
| | - Li Jia
- Department of Urology, Yidu Central Hospital of Weifang City, Weifang, China
| | - Jun Shao
- Jinshan Branch of Shanghai Sixth People's Hospital, Shanghai, China.,Shanghai Jinshan District Central Hospital, Shanghai, China
| | - Hanhua Liu
- Jinshan Branch of Shanghai Sixth People's Hospital, Shanghai, China.,Shanghai Jinshan District Central Hospital, Shanghai, China
| | - Qinke Wu
- Jinshan Branch of Shanghai Sixth People's Hospital, Shanghai, China.,Shanghai Jinshan District Central Hospital, Shanghai, China
| | - Xudong Wu
- Jinshan Branch of Shanghai Sixth People's Hospital, Shanghai, China.,Shanghai Jinshan District Central Hospital, Shanghai, China
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3
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Nanoribbon-Based Electronic Detection of a Glioma-Associated Circular miRNA. BIOSENSORS-BASEL 2021; 11:bios11070237. [PMID: 34356707 PMCID: PMC8301916 DOI: 10.3390/bios11070237] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 07/08/2021] [Accepted: 07/09/2021] [Indexed: 12/29/2022]
Abstract
Nanoribbon chips, based on “silicon-on-insulator” structures (SOI-NR chips), have been fabricated. These SOI-NR chips, whose surface was sensitized with covalently immobilized oligonucleotide molecular probes (oDNA probes), have been employed for the nanoribbon biosensor-based detection of a circular ribonucleic acid (circRNA) molecular marker of glioma in humans. The nucleotide sequence of the oDNA probes was complimentary to the sequence of the target oDNA. The latter represents a synthetic analogue of a glioma marker—NFIX circular RNA. In this way, the detection of target oDNA molecules in a pure buffer has been performed. The lowest concentration of the target biomolecules, detectable in our experiments, was of the order of ~10−17 M. The SOI-NR sensor chips proposed herein have allowed us to reveal an elevated level of the NFIX circular RNA in the blood of a glioma patient.
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4
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Gregory TA, Henson JW. Cortical T2-hyperintense lesions as the initial MRI finding in glioblastoma. INTERDISCIPLINARY NEUROSURGERY 2021. [DOI: 10.1016/j.inat.2020.100993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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5
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Roux A, Tran S, Edjlali M, Saffroy R, Tauziede-Espariat A, Zanello M, Gareton A, Dezamis E, Dhermain F, Chretien F, Lechapt-Zalcman E, Oppenheim C, Pallud J, Varlet P. Prognostic relevance of adding MRI data to WHO 2016 and cIMPACT-NOW updates for diffuse astrocytic tumors in adults. Working toward the extended use of MRI data in integrated glioma diagnosis. Brain Pathol 2020; 31:e12929. [PMID: 33336392 PMCID: PMC8412115 DOI: 10.1111/bpa.12929] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 12/08/2020] [Accepted: 12/14/2020] [Indexed: 11/27/2022] Open
Abstract
Assess the contribution of preoperative MRI data in improving grading of adult astrocytomas reclassified according to the WHO 2016 and cIMPACT-NOW update 3. Retrospective unicentric cohort study of 679 adult patients treated for newly diagnosed diffuse astrocytic and oligodendroglial tumors (January 2006-December 2016). We first systematically compared radiological (contrast enhancement present [CE+] vs. absent [CE-]) and histopathological findings (microvascular proliferation present [MPV+] vs. absent [MPV-]) to validate whether this comparing step of neoangiogenesis represents an efficient method to appreciate the representativity of the tumoral sampling. We focused on 629 cases of astrocytomas for radio-histological integrated analyses. In 598 cases (95.1%), neoangiogenesis evaluated by MRI or histology (CE+/MPV+ or CE-/MPV-) was identical. For the CE+/MPV- and CE-/MPV+ groups (23 cases), the radio-histological face-to-face evaluation allowed us to assess that for 13 cases (56.5%) the reason for this discrepancy was an undersampled tumor. We analyzed the group of CE+/MPV- (n = 8) and CE-/MPV+ (n = 2) in verified image-guided tumoral samples. Finally, we identified three new prognostic subgroups for molecular glioblastomas: (1) "non-representative sampling" (n = 9), (2) "Non neoangiogenic glioblastoma at the time of diagnosis, without contrast enhancement and microvascular proliferation" (n = 8), and (3) "contrast enhancing glioblastoma but without microvascular proliferation in a representative sample" (n = 4). Neoangiogenesis processes should be assessed to improve the prognosis accuracy of the current integrated diagnosis. We suggest adding imaging analyses during the neuropathological analysis of astrocytomas in adults.
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Affiliation(s)
- Alexandre Roux
- Service de Neurochirurgie, GHU Paris-Psychiatrie et Neurosciences-Hôpital Sainte-Anne, Paris, France.,Université de Paris, Sorbonne Paris Cité, Paris, France.,Inserm, UMR1266, IMA-Brain, Institut de Psychiatrie et Neurosciences de Paris, Paris, France
| | - Stéphane Tran
- Service de Neuropathologie, GHU Paris-Psychiatrie et Neurosciences-Hôpital Sainte-Anne, Paris, France
| | - Myriam Edjlali
- Université de Paris, Sorbonne Paris Cité, Paris, France.,Inserm, UMR1266, IMA-Brain, Institut de Psychiatrie et Neurosciences de Paris, Paris, France.,Service de Neuroradiologie, GHU Paris-Psychiatrie et Neurosciences-Hôpital Sainte-Anne, Paris, France
| | - Raphaël Saffroy
- Service de Biochimie, Hôpital Paul-Brousse, AP-HP, Villejuif, France
| | - Arnault Tauziede-Espariat
- Université de Paris, Sorbonne Paris Cité, Paris, France.,Inserm, UMR1266, IMA-Brain, Institut de Psychiatrie et Neurosciences de Paris, Paris, France.,Service de Neuropathologie, GHU Paris-Psychiatrie et Neurosciences-Hôpital Sainte-Anne, Paris, France
| | - Marc Zanello
- Service de Neurochirurgie, GHU Paris-Psychiatrie et Neurosciences-Hôpital Sainte-Anne, Paris, France.,Université de Paris, Sorbonne Paris Cité, Paris, France.,Inserm, UMR1266, IMA-Brain, Institut de Psychiatrie et Neurosciences de Paris, Paris, France
| | - Albane Gareton
- Université de Paris, Sorbonne Paris Cité, Paris, France.,Service de Neuropathologie, GHU Paris-Psychiatrie et Neurosciences-Hôpital Sainte-Anne, Paris, France
| | - Edouard Dezamis
- Service de Neurochirurgie, GHU Paris-Psychiatrie et Neurosciences-Hôpital Sainte-Anne, Paris, France.,Université de Paris, Sorbonne Paris Cité, Paris, France.,Inserm, UMR1266, IMA-Brain, Institut de Psychiatrie et Neurosciences de Paris, Paris, France
| | - Frédéric Dhermain
- Département d'Oncologie Radiothérapie, Gustave Roussy Cancer Campus Grand Paris, Villejuif, France
| | - Fabrice Chretien
- Université de Paris, Sorbonne Paris Cité, Paris, France.,Inserm, UMR1266, IMA-Brain, Institut de Psychiatrie et Neurosciences de Paris, Paris, France.,Service de Neuropathologie, GHU Paris-Psychiatrie et Neurosciences-Hôpital Sainte-Anne, Paris, France
| | - Emmanuèle Lechapt-Zalcman
- Université de Paris, Sorbonne Paris Cité, Paris, France.,Inserm, UMR1266, IMA-Brain, Institut de Psychiatrie et Neurosciences de Paris, Paris, France.,Service de Neuropathologie, GHU Paris-Psychiatrie et Neurosciences-Hôpital Sainte-Anne, Paris, France
| | - Catherine Oppenheim
- Université de Paris, Sorbonne Paris Cité, Paris, France.,Inserm, UMR1266, IMA-Brain, Institut de Psychiatrie et Neurosciences de Paris, Paris, France.,Service de Neuroradiologie, GHU Paris-Psychiatrie et Neurosciences-Hôpital Sainte-Anne, Paris, France
| | - Johan Pallud
- Service de Neurochirurgie, GHU Paris-Psychiatrie et Neurosciences-Hôpital Sainte-Anne, Paris, France.,Université de Paris, Sorbonne Paris Cité, Paris, France.,Inserm, UMR1266, IMA-Brain, Institut de Psychiatrie et Neurosciences de Paris, Paris, France
| | - Pascale Varlet
- Université de Paris, Sorbonne Paris Cité, Paris, France.,Inserm, UMR1266, IMA-Brain, Institut de Psychiatrie et Neurosciences de Paris, Paris, France.,Service de Neuropathologie, GHU Paris-Psychiatrie et Neurosciences-Hôpital Sainte-Anne, Paris, France
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6
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Wei RL, Zhang LW, Li JG, Yang FD, Xue YK, Wei XT. Behavior-Oriented Nomogram for the Stratification of Lower-Grade Gliomas to Improve Individualized Treatment. Front Oncol 2020; 10:538133. [PMID: 33392065 PMCID: PMC7774016 DOI: 10.3389/fonc.2020.538133] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 11/11/2020] [Indexed: 02/05/2023] Open
Abstract
Secondary glioblastomas (sGBM) are derived from previously lower-grade [World Health Organization (WHO) grades II or III] gliomas. Lower-grade benign-behaving gliomas may retain their former grade following recurrence, or may become malignant higher-grade glioblastomas. Prediction of tumor behavior in lower-grade gliomas is critical for individualized glioma therapy. A total of 89 patients were included between January 2000 and January 2019 in the present study to establish a nomogram via univariate and multivariate logistic regression analyses. Nomogram predictive performance was tested in the validation group. We then analyzed 36 O-6-methylguanine-DNA methyltransferase (MGMT) unmethylated lower-grade gliomas from patients seen at West China Hospital of Sichuan University. Survival statistics were calculated with the Kaplan-Meier method. Two clinical factors (molecular diagnosis and WHO grade), five radiological factors (location, cortical involvement, multicentricity, uniformity, and margin enhancement), one biomarker (1p19q codeletion), and a combination of three biomarkers (IDH+/ATRX-/TP53-) were associated with glioma upgrading. Nomograms positive for these prognostic factors had an AUC of 0.880 in the derivation group and 0.857 in the validation group. The calibration and score-stratified survival curves for the derivation group and validation group were good. An operational nomogram was published at https://warrenwrl.shinyapps.io/DynNomapp/. The overall survival of secondary gliomas in the MGMT-unmethylated cohort were influenced independently by the use of temozolomide during the treatment of formerly low-grade gliomas (p=0.00096). Clinical and radiological factors and biomarker-based behavior-oriented nomograms may offer a feasible identification tool for the detection of sGBM precursors. This method may further assist neurosurgeons with the stratification of lower-grade glioma cases and thus the development of better, more individualized treatment plans.
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Affiliation(s)
- Ruo-Lun Wei
- Department of Neurosurgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Li-Wei Zhang
- Department of Neurosurgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jian-Guo Li
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, China
| | - Feng-Dong Yang
- Department of Neurosurgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Ya-Ke Xue
- Department of Neurosurgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xin-Ting Wei
- Department of Neurosurgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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7
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Frosina G, Marubbi D, Marcello D, Vecchio D, Daga A. The efficacy and toxicity of ATM inhibition in glioblastoma initiating cells-driven tumor models. Crit Rev Oncol Hematol 2019; 138:214-222. [PMID: 31092378 DOI: 10.1016/j.critrevonc.2019.04.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 04/05/2019] [Accepted: 04/13/2019] [Indexed: 02/08/2023] Open
Abstract
The Ataxia Telangiectasia Mutated (ATM)-mediated DNA damage response (DDR) is a major mechanism of resistance of glioblastoma (GB) - initiating cells (GICs) to radiotherapy. The closely related Ataxia Telangiectasia and Rad3-related protein (ATR) is also involved in tumor resistance to radio- and chemotherapy. It has been shown that pharmacological inhibition of ATM protein may overcome the DDR-mediated resistance in GICs and significantly radiosensitize GIC-driven GB. Albeit not essential for life as shown by the decade-long lifespan of AT patients, the ATM protein may be involved in a number of important functions other than the response to DNA damage. We discuss our current knowledge about the toxicity of pharmacologic inhibition of ATM and ATR proteins.
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Affiliation(s)
- Guido Frosina
- Mutagenesis & Cancer Prevention, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy.
| | - Daniela Marubbi
- Regenerative Medicine, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy; Department of Experimental Medicine (DIMES), University of Genova, 16132 Genova, Italy.
| | - Diana Marcello
- Mutagenesis & Cancer Prevention, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy.
| | - Donatella Vecchio
- Mutagenesis & Cancer Prevention, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy.
| | - Antonio Daga
- Regenerative Medicine, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy.
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8
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Abstract
Early-stage glioblastoma has few identifiable findings; clinical significance of its early diagnosis and treatment remains unclear as no report has described treatment and long-term follow-up for early-stage glioblastoma. Here, we report a case of a 69-year-old woman with early-stage glioblastoma treated by microsurgical resection and chemoradiotherapy. Magnetic resonance imaging (MRI) revealed a small high-intensity lesion in the right temporal lobe on T2-weighted imaging. Contrast-enhanced T1-weighted MRI revealed ring enhancement. On magnetic resonance spectroscopy, the lesion demonstrated increased choline and reduced N-acetyl-aspartate levels compared with the normal brain. Positron emission tomography with 11C-methionine (MET) revealed 11C-methionine uptake in the lesion. Microsurgical resection was performed, and glioblastoma was pathologically diagnosed. The patient was treated with local radiotherapy and temozolomide chemotherapy postoperatively. Eight years postoperatively, the patient is surviving without tumor recurrence, but progressive cognitive impairment developed 6 years’ postoperatively. Aggressive treatment of early-stage glioblastoma may improve its extremely poor prognosis. Conversely, cognitive impairment may become a significant medical and social problem when effective therapies for glioblastoma are developed.
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Affiliation(s)
- Makoto Hishii
- Department of Neurosurgery, Juntendo University Nerima Hospital, Tokyo, Japan
| | | | - Hajime Arai
- Department of Neurosurgery, Juntendo University School of Medicine, Juntendo University, Tokyo, Japan
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9
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Identification of the Gene Expression Rules That Define the Subtypes in Glioma. J Clin Med 2018; 7:jcm7100350. [PMID: 30322114 PMCID: PMC6210469 DOI: 10.3390/jcm7100350] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Revised: 10/09/2018] [Accepted: 10/11/2018] [Indexed: 11/16/2022] Open
Abstract
As a common brain cancer derived from glial cells, gliomas have three subtypes: glioblastoma, diffuse astrocytoma, and anaplastic astrocytoma. The subtypes have distinctive clinical features but are closely related to each other. A glioblastoma can be derived from the early stage of diffuse astrocytoma, which can be transformed into anaplastic astrocytoma. Due to the complexity of these dynamic processes, single-cell gene expression profiles are extremely helpful to understand what defines these subtypes. We analyzed the single-cell gene expression profiles of 5057 cells of anaplastic astrocytoma tissues, 261 cells of diffuse astrocytoma tissues, and 1023 cells of glioblastoma tissues with advanced machine learning methods. In detail, a powerful feature selection method, Monte Carlo feature selection (MCFS) method, was adopted to analyze the gene expression profiles of cells, resulting in a feature list. Then, the incremental feature selection (IFS) method was applied to the obtained feature list, with the help of support vector machine (SVM), to extract key features (genes) and construct an optimal SVM classifier. Several key biomarker genes, such as IGFBP2, IGF2BP3, PRDX1, NOV, NEFL, HOXA10, GNG12, SPRY4, and BCL11A, were identified. In addition, the underlying rules of classifying the three subtypes were produced by Johnson reducer algorithm. We found that in diffuse astrocytoma, PRDX1 is highly expressed, and in glioblastoma, the expression level of PRDX1 is low. These rules revealed the difference among the three subtypes, and how they are formed and transformed. These genes are not only biomarkers for glioma subtypes, but also drug targets that may switch the clinical features or even reverse the tumor progression.
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10
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Abstract
The detection of glioblastoma (GBM) in biofluids offers potential advantages over existing paradigms for the diagnosis and therapeutic monitoring of glial tumors. Biofluid-based detection of GBM focuses on detecting tumor-specific biomarkers in the blood and CSF. Current clinical research concentrates on studying 3 distinct tumor-related elements: extracellular macromolecules, extracellular vesicles, and circulating tumor cells. Investigations into these 3 biological classifications span the range of locales for tumor-specific biomarker discovery, and combined, have the potential to significantly impact GBM diagnosis, monitoring for treatment response, and surveillance for recurrence. This review highlights the recent advancements in the development of biomarkers and their efficacy for the detection of GBM.
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11
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Mu L, Wang Y, Wang Y, Zhang H, Shang D, Tan F, Li Y, Chen X. Tumor Location and Survival Outcomes in Adult Patients with Supratentorial Glioblastoma by Levels of Toll-Like Receptor 9 Expression. World Neurosurg 2016; 97:279-283. [PMID: 27744078 DOI: 10.1016/j.wneu.2016.10.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2016] [Revised: 10/02/2016] [Accepted: 10/04/2016] [Indexed: 12/25/2022]
Abstract
BACKGROUND Toll-like receptor 9 (TLR9) is a key immunotherapy target for glioblastoma (GBM). This study explored the correlation of TLR9 expression with tumor location and survival outcomes in patients with supratentorial GBM. METHODS We retrospectively identified 46 patients with supratentorial GBMs and divided them into those with high TLR9 (TRL9High) and low TLR9 (TRL9Low) levels. The 2 groups were compared by patients' ages, sex, preoperative Karnofsky Performance Scale (KPS) score, resection extent, tumor location, progression-free survival (PFS), and overall survival (OS). RESULTS The TLR9 expression percentages for the GBM specimens were TRL9High: 72% (33/46) and TRL9Low: 28% (13/46). The 2 groups showed no differences in patient age (P = 0.147) and sex (χ2 = 0.002, P = 0.966), preoperative KPS score (χ2 = 0.033, P = 0.855), or resection extent (χ2 = 2.405, P = 0.121). Location differed significantly, with 85% (11/13) of TRL9Low tumors in the left hemisphere and 45% (15/33) of TRL9High tumors on the same side (χ2 = 5.82, P = 0.016). The TRL9Low group had a median PFS of 612 days (range, 77-926 days), significantly longer than the TRL9High group (355 days; range, 105-861 days; P = 0.042). Median OS of the TRL9Low group (733 days; range, 163-969 days) was also significantly longer than in the TRL9High group (396 days; range, 135-1024 days; P = 0.020). CONCLUSIONS Patients with TRL9Low supratentorial GBM tend to have longer survival than those with higher TLR9 expression. Such tumors show a location preference for the left hemisphere.
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Affiliation(s)
- Linsen Mu
- Department of Neurosurgery, Affiliated Brain Hospital, Guangzhou Medical University (Guangzhou Huiai Hospital), Fangcun, Liwan District, Guangdong Province, P. R. China
| | - Yongzhi Wang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, P. R. China
| | - Yonggang Wang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, P. R. China
| | - Hongbo Zhang
- Department of Neurosurgery, Hubei Provincal Hospital of Integrated Chinese and Western Medicine, Wuhan, P. R. China
| | - Dewei Shang
- Department of Pharmacy, Affiliated Brain Hospital, Guangzhou Medical University (Guangzhou Huiai Hospital), Fangcun, Liwan District, Guangdong Province, P. R. China
| | - Fuqiang Tan
- Department of Neurosurgery, Affiliated Brain Hospital, Guangzhou Medical University (Guangzhou Huiai Hospital), Fangcun, Liwan District, Guangdong Province, P. R. China
| | - Yan Li
- Department of Neurosurgery, Affiliated Brain Hospital, Guangzhou Medical University (Guangzhou Huiai Hospital), Fangcun, Liwan District, Guangdong Province, P. R. China
| | - Xuzhu Chen
- Department of Neuroimaging, Beijing Tiantan Hospital, Capital Medical University, Beijing, P. R. China.
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12
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Frosina G. Limited advances in therapy of glioblastoma trigger re-consideration of research policy. Crit Rev Oncol Hematol 2015; 96:257-61. [PMID: 26052048 DOI: 10.1016/j.critrevonc.2015.05.013] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Revised: 05/06/2015] [Accepted: 05/19/2015] [Indexed: 11/28/2022] Open
Abstract
Glioblastoma (GB - WHO grade IV) is the most frequent and lethal primary brain tumour with median overall survival of 7-15 months after diagnosis. As in other cancer research areas, an overwhelming amount of pre-clinical research acquisitions in the GB field have not been translated to patients' benefit, potentially due to inappropriate treatment schedules and/or trial designs in the clinical setting. The recent failure of promising anti-VEGF bevacizumab to improve GB patients' overall survival recapitulates this sense of frustration. The following measures are proposed.
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Affiliation(s)
- Guido Frosina
- Mutagenesis Unit, IRCCS Azienda Ospedaliera Universitaria San Martino - IST Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy.
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13
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Wasserman JK, Nicholas G, Yaworski R, Wasserman AM, Woulfe JM, Jansen GH, Chakraborty S, Nguyen TB. Radiological and pathological features associated with IDH1-R132H mutation status and early mortality in newly diagnosed anaplastic astrocytic tumours. PLoS One 2015; 10:e0123890. [PMID: 25849605 PMCID: PMC4388816 DOI: 10.1371/journal.pone.0123890] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Accepted: 02/26/2015] [Indexed: 01/14/2023] Open
Abstract
Background Glioblastoma can occur either de novo or by the transformation of a low grade tumour; the majority of which harbor a mutation in isocitrate dehydrogenase (IDH1). Anaplastic tumours are high-grade gliomas that may represent the final step in the evolution of a secondary glioblastoma or the initial presentation of an early primary glioblastoma. We sought to determine whether pathological and/or radiological variables exist that can reliably distinguish IDH1-R132H-positive from IDH1-R132H-negative tumours and to identify variables associated with early mortality. Methods Patients diagnosed with anaplastic astrocytic tumours were included. Magnetic resonance imaging was performed and immunohistochemistry was used to identify tumours with the IDH1-R132H mutation. Survival was assessed 12 months after diagnosis. Variables associated with IDH1-R132H status were identified by univariate and ROC analysis. Results 37 gliomas were studied; 18 were positive for the IDH1-R132H mutation. No tumours demonstrated a combined loss of chromosomes 1p/19q. Patients with IDH1-R132H-positive tumours were less likely to die within 12 months of diagnosis (17% vs. 47%; p=0.046), more likely to have tumours located in the frontal lobe (55% vs. 16%; p=0.015), and have a higher minimum apparent diffusion coefficient (1.115 x 10-3 mm2/sec vs. 0.838 x 10-3 mm2/sec; p=0.016), however, these variables demonstrated only moderate strength for predicting the IDH1-R132H mutation status (AUC=0.735 and 0.711, respectively). The Ki-67 index was significantly lower in IDH1-R132H-positive tumours (0.13 vs. 0.21; p=0.034). An increased risk of death was associated with contrast-enhancement ≥ 5 cm3 in patients with IDH1-R132H-positive tumours while edema ≥ 1 cm beyond the tumour margin and < 5 mitoses/mm2 were associated with an increased risk of death in patients with IDH1-R132H-negative tumours. Conclusions IDH1-R132H-positive and -negative anaplastic tumours demonstrate unique features. Factors associated with early mortality are also dependent on IDH1-R132H status and can be used to identify patients at high risk for death.
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Affiliation(s)
- Jason K. Wasserman
- Division of Laboratory Medicine, Department of Anatomical Pathology, Ottawa, Ontario, Canada
- University of Ottawa, Ottawa, Ontario, Canada
- The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Garth Nicholas
- The Ottawa Hospital Cancer Centre, Ottawa, Ontario, Canada
- University of Ottawa, Ottawa, Ontario, Canada
- The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Rebecca Yaworski
- Division of Laboratory Medicine, Department of Anatomical Pathology, Ottawa, Ontario, Canada
| | | | - John M. Woulfe
- Division of Laboratory Medicine, Department of Anatomical Pathology, Ottawa, Ontario, Canada
- University of Ottawa, Ottawa, Ontario, Canada
- The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Gerard H. Jansen
- Division of Laboratory Medicine, Department of Anatomical Pathology, Ottawa, Ontario, Canada
- University of Ottawa, Ottawa, Ontario, Canada
- The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Santanu Chakraborty
- Division of Neuro-imaging, Department of Medical Imaging, Ottawa, Ontario, Canada
- University of Ottawa, Ottawa, Ontario, Canada
- The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Thanh B. Nguyen
- Division of Laboratory Medicine, Department of Anatomical Pathology, Ottawa, Ontario, Canada
- University of Ottawa, Ottawa, Ontario, Canada
- The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- * E-mail:
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