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背景与目的:胶质母细胞瘤(GBM)是一种恶性程度最高的星形细胞瘤,其主要的治疗方法是外科手术和放射疗法,2005年批准使用替莫唑胺,化学疗法的效果才得以确定。本文比较中国香港原发性GBM患者接受同期放化治疗或单纯放疗的生存时间,探讨GBM肿瘤组织中O6-甲基鸟嘌呤-DNA甲基转移酶(MGMT)的甲基化状态在预后评价的价值。方法:回顾性分析2005年3月至2007年6月期间35例经手术后病理确诊并接受过同期放化治疗或单纯放疗的中国香港GBM患者的资料,从石蜡包埋的GBM肿瘤组织中分离出基因组DNA,采用甲基化特异性聚合酶链反应方法(MSP)检测基因MGMT甲基化状态。采用Kaplan Meier方法计算总生存时间(OS)和无进展生存时间(PFS),比较同期放化治疗或单纯放疗和MGMT甲基化或非甲基化状态对生存时间的影响。结果:35例患者中,男性27例,女性8例,平均年龄50.4岁。35例患者的中位PFS和中位OS分别是4.7个月(3.1~6.2个月)和11.7个月(6.5~16.6个月),其中18例仅接受单纯放疗患者的中位PFS和中位OS分别是4.2个月(3.4~5.0个月)和5.8个月(2.0~9.6个月),17例接受同期放化治疗患者的中位PFS和中位OS分别是6.0个月(2.0~10个月)和13.2个月(8.1~18.3个月),P值>0.05。15例(43%)肿瘤组织中存在MGMT甲基化,MGMT甲基化和非甲基化患者的中位OS分别是16.9个月(12.7~21.1个月)和10个月(5.8~14.1个月),P值>0.05。结论:尽管差异无统计学意义,但与单纯放疗比较,接受了同期放化治疗的GBM患者显示出了更长的总体生存趋势,MGMT甲基化可能是GBM的明显预后较好的因素。
BACKGROUND & OBJECTIVE: Glioblastoma (GBM) is the most malignant astrocytoma. Its main treatment is surgery and radiotherapy. The effect of chemotherapy was confirmed only when temozolomide was approved in 2005. This article compares the survival of patients with GBM in Hong Kong during the same period of radiotherapy or radiotherapy, and explores the methylation status of O6-methylguanine-DNA methyltransferase (MGMT) in GBM tumor tissue in prognosis evaluation value. Methods: From March 2005 to June 2007, 35 patients with pathologically confirmed GBM in Hong Kong, China, who underwent concurrent radiochemotherapy or radiotherapy alone, were retrospectively analyzed and isolated from paraffin-embedded GBM tumor tissues The genomic DNA was extracted and the methylation status of MGMT gene was detected by methylation specific polymerase chain reaction (MSP). The Kaplan-Meier method was used to calculate the overall survival time (OS) and progression-free survival time (PFS). The effects of concurrent radiotherapy or radiotherapy and MGMT methylation or unmethylation status on survival were compared. Results: Of 35 patients, 27 were male and 8 were female, with an average age of 50.4 years. The median PFS and median OS were 4.7 months (3.1 to 6.2 months) and 11.7 months (6.5 to 16.6 months) in 35 patients, respectively, of whom 18 had median PFS and median OS were 4.2 months (3.4-5.0 months) and 5.8 months (2.0-9.6 months) respectively. The median PFS and median OS of the 17 patients receiving concurrent radiochemotherapy were 6.0 months Months), 13.2 months (8.1-18.3 months), P values> 0.05.15 cases (43%). The median OS of MGMT methylation, MGMT methylated and unmethylated patients were Was 16.9 months (12.7-21.1 months) and 10 months (5.8-14.1 months) with P values> 0.05. CONCLUSION: Although the difference was not statistically significant, GBM patients who received concurrent radiochemotherapy showed a longer overall survival trend than MG alone. MGMT methylation may be a good prognostic factor for GBM.