Prognostic Role Of TERT And MGMT Genes In Malignant IDH Wild-type Glioma

Objective:To explore the survival and prognostic value of Telomerase reverse transcriptase(Telomerase reverse transcriptase,TERT)mutations and O6-methylguanine-DNA methyltransferase(O6-methylguanine-DNA methyltransferase,MGMT)in patients with malignant Isocitrate dehydrogenase(Isocitrate dehydrogenase,IDH)wild-type glioma.Methods:We collected the clinical information regarding the patients which were diagnosed as WHO grade Ⅲ and WHO grade Ⅳ glioma,detect the status of IDH、TERT and MGMT.We ruled out IDH-mut type patients.According to the results,we classified the 61 patients according to their status of TERT and MGMT promotor.By comparing the difference between survival over the subgroups to analyzed the impact of genetic alterations.Results:Among the 61 patients with malignant glioma,there was no significant difference in the expression of TERT mutation and MGMT promoter methylation in IDH wild-type glioma(P>0.05).The median survival of TERT mut-type was15 months,and that of patients with wild-type TERT was 17 months.The difference was not statistically significant(P>0.05).The median survival was 28 months for patients with MGMT methylation and about 13 months for those with MGMT non-methylation,and the difference was statistically significant(P <0.05).The analysis of the two molecular status indicated that under the MGMT methylation state,the TERT mutation showed a significant improvement in survival compared to TERT wild-type patients(P<0.05),but in patients without MGMT mutation,the TERT promoter mutation indicated a worse prognosis(P<0.05).Conclusion:MGMT promoter methylation indicates a better prognosis compared to unmethylated patients.Although TERT mutations have no direct effect on patient prognosis.However,in combination with MGMT status,TERT mutation are associated with better survival in patients with MGMT methylation,while mutations in patients with MGMT unmethylated indicate a poor prognosis.