Clinical efficacy of IDH1 mutation in temozolomide chemotherapy for glioma patients and its impact on immune cytokines and prognosis.

Objective: To study clinical efficacy of isocitrate dehydrogenase 1 (IDH1) mutation on temozolomide chemotherapy for glioma patients and its impact on immune cytokines and prognosis. Methods; A total of 134 patients with glioma who underwent surgical resection and were confirmed by pathology in Dushu Lake Hospital Affiliated to Sooehow University from October 2021 to October 2022 were selected as research subjects. 1DH1 mutation status was measured by direct sequencing method, and 1DH1 expression rate in glioma tissue was determined by immunohistochemistry. All patients with brain glioma were treated with temozolomide chemotherapy. Effects of 1DH1 mutation on clinical efficacy, immune cytokines (IFN-γ, IL-2, 1L-4, IL-10) and prognosis of glioma were analyzed. Results; Seventy-nine cases out of 134 cases of glioma tissue had IDH1 mutations, mostly at R132, with a mutation rate of 58.96%, significantly higher than normal brain tissue (χ²=48.066, P<0.05). Immunohistochemistry showed strong positive expression of 1DH1 in 56 out of 134 glioma tissues. Proportion of WHO grade IV in IDH1 mutant group was lower than 1DH1 wild type group [11.39% (9/79) vs 63.64% (35/55),Z=41.020, P<0.05], Proportion of low differentiation in IDH1 mutant group was higher than IDH1 wild type group [50.63%(40/79) vs 20.00%(11/55),/=12.907,P<0.05], Total effective rate in IDH1 mutant group was higher than IDH1 wild type group [91.14%(72/79) ps 76.36%(42/55),χ²=5.575,P<0.05], IFN-γ and IL-2 levels were higher than IDH1 wild type group [ (28.98±3.25) pg/ml vs (20.15±2.54) pg/ml, (33.42±4.25) pg/ml ts (25.23±3.52) pg/ml, 1=16.870, 11.750, P< 0.05], IL-4 and 1L-10 levels were lower than 1DH1 wild type group [ (7.90±1.02) pg/ml t;s (12.38+1.66) pg/ml, (8.79+1.00) pg/ml vs (15.26+1.23) pg/ml,f=19.330,33.500,P<0.05], 1DH1 mutation was positively correlated with IFN-γ and IL-2 levels after temozolo- mide chemotherapy (r=0.845, 0.772, P<0.05), and negatively correlated with IL-4 and IL-10 levels after temozolomide chemotherapy (r=-0.786,-0.685, P<0.05). Survival rate after chemotherapy in IDH1 mutant group was higher than 1DH1 wild type group [89.87% (71/79) vs 72.70%(40/55), Log Rank test χ²=5.208,P<0.05], Cox regression analysis found that WHO grade III (RR= 1.342), poorly differentiated (RR=1.783), IFN-γ III (RR= 1.808), IL-2 (RR=2.112), IL-4 (RR=2.342), IL-10 (RR=1.342) as risk factors, temozolomide chemotherapy efficacy (RR=0.653), IDH1 mutation (RR=0.895) as protective factors affect prognosis of temozolomide chemotherapy in glioma patients (P<0.05). Conclusion; IDH1 mutation is related to disease grade and differentiation degree of glioma patients, and can affect efficacy of temozolomide chemotherapy and expressions of immune cytokines, which is a protective factor for prognosis and survival after temozolomide chemotherapy. [ABSTRACT FROM AUTHOR]