Prognosis Evaluation Of High-grade Glioma Patients With IDH1 Mutation

Objective: By detecting isocitrate dehydrogenase-1(IDH1)mutations of high grade gliomas,the significance of IDH1 gene mutation in clinical treatment of patients with high grade glioma and the value of prognostic judgment were studied.Meanwhile,the correlation between IDH1 gene mutation and high grade glioma temozolomide chemotherapy was studied.Methods: Clinical,pathological data and prognosis of 70 patients with high grade glioma were retrospectively analyzed from neurosurgery of Liao ning province cancer hospital between January 2015 and September 2017.All patients underwent surgery for total tumor resection,and the pathology showed high grade glioma.All patients were treated with radiotherapy and(or)chemotherapy,chemotherapy mainly used temozolomide.All patients with IDH1 mutations were analyzed by Sanger sequencing and clinical follow-up was performed to compare the survival of IDH1 mutants with wild-type patients.At the same time,patients with IDH1 mutations can be divided into two groups,one with standardized temozolomide chemotherapy and the other without chemotherapy.According to clinical follow-up,the prognosis and survival of chemotherapy were analyzed.Patients with wild-type IDH1 gene can be divided into two groups,one with standardized temozolomide chemotherapy and the other without chemotherapy.According to clinical follow-up,the prognosis and survival of chemotherapy were analyzed.Results: In the 70 patients with high-grade glioma,20 had IDH1 mutations with a mutation rate of 28.6%(20/70),all of which were IDHR132 H mutations.The distribution of IDH1 gene mutations in high-grade gliomas was statistically significant in different pathological grades(P=0.013).There was no statistically significant difference in the distribution of IDH1 gene mutations in high-grade gliomas at different ages(P=0.88)and gender(P=0.069).The median survival time of high-grade gliomapatients with IDH1 mutation was 25 months,and the median survival time of IDH1wild-type patients was 12 months.The difference was statistically significant(P<0.05).In the IDH1 gene mutation group,the median survival time of patients with standardized treatment was 25 months,which was significantly longer than the other groups.The difference was statistically significant(P<0.05).The median survival time of patients undergoing standardized treatment in the wild-type of IDH1 gene was 17 months,and the median survival time of patients without standardized treatment was 12 months.The difference was not statistically significant(P>0.05).Conclusion: The IDH1 gene mutation has a significant effect on the survival time of patients with high-grade glioma,and the prognosis of IDH1 mutation is good.IDH1 gene mutation can be used as one of the important indicators for the high-grade glioma temozolomide chemotherapy correlation and prognosis,which can provide new ideas for the treatment of subsequent high-grade glioma.