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The molecular signature and prognosis of glioma with preoperative intratumoral hemorrhage: a retrospective cohort analysis

Authors :
Yixin Shi
Xiaoman Kang
Yulu Ge
Yaning Cao
Yilin Li
Xiaopeng Guo
Wenlin Chen
Siying Guo
Yaning Wang
Delin Liu
Yuekun Wang
Hao Xing
Yu Xia
Junlin Li
Jiaming Wu
Tingyu Liang
Hai Wang
Qianshu Liu
Shanmu Jin
Tian Qu
Huanzhang Li
Tianrui Yang
Kun Zhang
Feng Feng
Yu Wang
Hui You
Wenbin Ma
Source :
BMC Neurology, Vol 24, Iss 1, Pp 1-14 (2024)
Publication Year :
2024
Publisher :
BMC, 2024.

Abstract

Abstract Background Intratumoral hemorrhage, though less common, could be the first clinical manifestation of glioma and is detectable via MRI; however, its exact impacts on patient outcomes remain unclear and controversial. The 2021 WHO CNS 5 classification emphasised genetic and molecular features, initiating the necessity to establish the correlation between hemorrhage and molecular alterations. This study aims to determine the prevalence of intratumoral hemorrhage in glioma subtypes and identify associated molecular and clinical characteristics to improve patient management. Methods Integrated clinical data and imaging studies of patients who underwent surgery at the Department of Neurosurgery at Peking Union Medical College Hospital from January 2011 to January 2022 with pathological confirmation of glioma were retrospectively reviewed. Patients were divided into hemorrhage and non-hemorrhage groups based on preoperative magnetic resonance imaging. A comparison and survival analysis were conducted with the two groups. In terms of subgroup analysis, we classified patients into astrocytoma, IDH-mutant; oligodendroglioma, IDH-mutant, 1p/19q-codeleted; glioblastoma, IDH-wildtype; pediatric-type gliomas; or circumscribed glioma using integrated histological and molecular characteristics, according to WHO CNS 5 classifications. Results 457 patients were enrolled in the analysis, including 67 (14.7%) patients with intratumoral hemorrhage. The hemorrhage group was significantly older and had worse preoperative Karnofsky performance scores. The hemorrhage group had a higher occurrence of neurological impairment and a higher Ki-67 index. Molecular analysis indicated that CDKN2B, KMT5B, and PIK3CA alteration occurred more in the hemorrhage group (CDKN2B, 84.4% vs. 62.2%, p = 0.029; KMT5B, 25.0% vs. 8.9%, p = 0.029; and PIK3CA, 81.3% vs. 58.5%, p = 0.029). Survival analysis showed significantly worse prognoses for the hemorrhage group (hemorrhage 18.4 months vs. non-hemorrhage 39.1 months, p = 0.01). In subgroup analysis, the multivariate analysis showed that intra-tumoral hemorrhage is an independent risk factor only in glioblastoma, IDH-wildtype (162 cases of 457 overall, HR = 1.72, p = 0.026), but not in other types of gliomas. The molecular alteration of CDK6 (hemorrhage group p = 0.004, non-hemorrhage group p

Details

Language :
English
ISSN :
14712377
Volume :
24
Issue :
1
Database :
Directory of Open Access Journals
Journal :
BMC Neurology
Publication Type :
Academic Journal
Accession number :
edsdoj.941dd464d7354ca282a36099b708ff3a
Document Type :
article
Full Text :
https://doi.org/10.1186/s12883-024-03703-2