1. Prognostic molecular markers with no impact on decision-making: the paradox of gliomas based on a prospective study
- Author
-
Pierre Levillain, C.J. Larsen, Lucie Karayan-Tapon, Joelle Guilhot, Philippe Rigoard, Philippe Menei, Serge Milin, J.-L. Blanc, F. Duthe, B. Bataille, F. Lapierre, Dominique Bonneau, Sophie Michalak, Michel Wager, Micro et Nanomédecines Biomimétiques (MINT), Université d'Angers (UA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Bretagne Loire (UBL), Centre Scientifique et Technique du Bâtiment (CSTB), Unité d'épidémiologie, biostatistique et registre des cancers [Poitou-Charentes], Institut Charles Gerhardt Montpellier - Institut de Chimie Moléculaire et des Matériaux de Montpellier (ICGM ICMMM), Ecole Nationale Supérieure de Chimie de Montpellier (ENSCM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Université Montpellier 1 (UM1)-Université Montpellier 2 - Sciences et Techniques (UM2)-Institut de Chimie du CNRS (INC), Photomécanique et analyse expérimentale en Mécanique des solides (PEM), Département Génie Mécanique et Systèmes Complexes (GMSC), Institut Pprime (PPRIME), Université de Poitiers-ENSMA-Centre National de la Recherche Scientifique (CNRS)-Université de Poitiers-ENSMA-Centre National de la Recherche Scientifique (CNRS)-Institut Pprime (PPRIME), Université de Poitiers-ENSMA-Centre National de la Recherche Scientifique (CNRS)-Université de Poitiers-ENSMA-Centre National de la Recherche Scientifique (CNRS), Centre hospitalier universitaire de Poitiers (CHU Poitiers), Mitochondrie : Régulations et Pathologie, Université d'Angers (UA)-Institut National de la Santé et de la Recherche Médicale (INSERM), Cellules souches leucémiques et thérapeuthiques, Université de Poitiers-Centre hospitalier universitaire de Poitiers (CHU Poitiers), Univ Angers, Okina, Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM), INSERM CIC 0802 (INSERM - CHU de Poitiers), and Université de Poitiers-Centre hospitalier universitaire de Poitiers (CHU Poitiers)-Institut National de la Santé et de la Recherche Médicale (INSERM)
- Subjects
Oncology ,Cancer Research ,Pathology ,Multivariate analysis ,[SDV]Life Sciences [q-bio] ,Loss of Heterozygosity ,markers ,0302 clinical medicine ,80 and over ,LOH ,Prospective Studies ,Prospective cohort study ,Promoter Regions, Genetic ,DNA Modification Methylases ,Telomerase ,Aged, 80 and over ,0303 health sciences ,Univariate analysis ,biology ,Brain Neoplasms ,Glioma ,Middle Aged ,DNA Repair Enzymes/genetics ,Prognosis ,3. Good health ,[SDV] Life Sciences [q-bio] ,030220 oncology & carcinogenesis ,Cohort ,DNA Modification Methylases/genetics ,Promoter Regions (Genetics) ,Adult ,medicine.medical_specialty ,Tumour heterogeneity ,Decision Making ,RT-PCR ,Tumor Suppressor Proteins/genetics ,outcome prediction ,03 medical and health sciences ,Cyclin-Dependent Kinase Inhibitor p16/genetics ,Glioma/genetics/mortality ,Internal medicine ,medicine ,PTEN ,Humans ,neoplasms ,Molecular Diagnostics ,Cyclin-Dependent Kinase Inhibitor p16 ,030304 developmental biology ,Aged ,Proportional hazards model ,Tumor Suppressor Proteins ,decision-making ,DNA Methylation ,medicine.disease ,Telomerase/genetics ,DNA Repair Enzymes ,Brain Neoplasms/genetics/mortality ,Multivariate Analysis ,biology.protein ,adult gliomas - Abstract
International audience; This study assessed the prognostic value of several markers involved in gliomagenesis, and compared it with that of other clinical and imaging markers already used. Four-hundred and sixteen adult patients with newly diagnosed glioma were included over a 3-year period and tumour suppressor genes, oncogenes, MGMT and hTERT expressions, losses of heterozygosity, as well as relevant clinical and imaging information were recorded. This prospective study was based on all adult gliomas. Analyses were performed on patient groups selected according to World Health Organization histoprognostic criteria and on the entire cohort. The endpoint was overall survival, estimated by the Kaplan-Meier method. Univariate analysis was followed by multivariate analysis according to a Cox model. p14(ARF), p16(INK4A) and PTEN expressions, and 10p 10q23, 10q26 and 13q LOH for the entire cohort, hTERT expression for high-grade tumours, EGFR for glioblastomas, 10q26 LOH for grade III tumours and anaplastic oligodendrogliomas were found to be correlated with overall survival on univariate analysis and age and grade on multivariate analysis only. This study confirms the prognostic value of several markers. However, the scattering of the values explained by tumour heterogeneity prevents their use in individual decision-making.
- Published
- 2008