Clinical Significance And Prognosis Of MGMT Promoter Methylation And IDH1 Gene Mutation In Gliomas

Objective: To discuss the clinical significance and prognosis of MGMT promoter methylation and IDH1 gene mutation in gliomas.Methods: From March 2011 to December 2016,142 cases with tumor tissue and blood samples were collected from the patients with glioma underwent surgery in ShenYang PLA general Hospital.All patients' tumors were totally resected under the microscope and postoperative pathology confirmed glioma.The MGMT promoter methylation and IDH1 gene mutation were detected by PCR sequencing analysis.Meanwhile,we collected clinical data,including age,gender,KPS score,pathological grade,p53 expression and Ki67 expression.The chi-square test was used to test the association between MGMT promoter methylation or IDH1 mutation and the prognosis in gliomas.Then analyze the clinical significance and prognosis of MGMT promoter methylation and IDH1 gene mutation in gliomas.Results: 1.Among 142 cases,there were 83 cases(58.45%)with MGMT promoter methylation found.The MGMT promoter methylation was not associated with age(P=0.731)? Gender(P=0.442)?KPS score(P=0.569)? pathological grade(P=0.120),p53 expression(P=0.267),Ki67 expression(P=0.838).In addition,MGMT promoter methylation in high-grade and low-grade gliomas was not associated with age(P=0.405,P=0.976),Gender(P=0.267,P=0.054),KPS score(P=1.000,P=0.170),p53 expression(P=0.777,P=0.113),Ki67 expression(P=0.405,P=0.271),but it shows significant difference with pathological grade(P=0.014)in high-grade gliomas.Underwent radiochemotherapy treatment,patients of high-grade gliomas with MGMT promoter methylation showed a longer OS than patients without it(P<0.05).2.Among 142 cases,there were 24 cases(16.90%)with IDH1 gene mutation were found.The IDH1 gene mutation was associated with age(P=0.024),Ki67 expression(P=0.044),pathological grade(P=0.041)and KPS score(P=0.016).In addition,IDH1 gene mutation of high-grade gliomas was only associated with Different age(P=0.048).But it was not associated with Gender(P=0.533)KPS score(P=0.348)pathological grade(P=0.533)p53 expression(P=0.755)Ki67 expression(P=0.683).Meanwhile,IDH1 gene mutation of low-grade gliomas was only associated with Ki67 expression(P=0.025),but not associated with age(P=0.423)Gender(P=0.749)KPS score(P=0.078)p53 expression(P=0.624).In the high-grade group,patients with IDH1 gene mutation showed a longer OS than patients without it(P<0.05).3.Whether in overall gliomas or in low-grade gliomas,the distribution of the difference between MGMT promoter methylation and IDH1 gene mutation was not statistically significant(P=0.370,0.749).There was no correlation between the two.(?= 0.075,-0.044).But in the high-grade gliomas,statistically significant correlation was found between them(P=0.043,?=0.214).Conclusion: In high-grade gliomas,patients with IDH1 gene mutation showed a longer OS than patients without it.But in low-grade gliomas,there was no significant difference been found between the two groups.Patients of malignant gliomas were all treated with radiotherapy and chemotherap after operating treatmen.In malignant gliomas,patients with MGMT promoter methylation showed a longer OS than patients without MGMT promoter methylation.So,the MGMT promoter methylation and IDH1 gene mutation could be used as important indexes for Human glioma patients Chemotherapy sensitivity and prognosis.Developing testing technology,increasing the targets and improving mutation detection rate have important reference value for guiding the clinical medication and judging the prognosis of patients with glioma.