Epidemiological Analysis Of Recurrent Glioma And Study On Drug Resistance Of Temozolomide

Background:Glioma is the most common progressive malignant tumor,accounting for about50%-60% of primary intracranial tumors.Since glioma is characterized by invasive growth,it is difficult to ensure the total resection of the tumor,which accelerates the recurrence of the tumor and other adverse consequences.At present,the treatment of glioma is combined with radiotherapy and chemotherapy after surgical resection to prolong the survival time of patients.Currently,however,the prognosis of glioblastoma patients is still not satisfying,and the overall survival is only 14 months.As a kind of oral alkalization agent,temozolomide has become a first-line drug in the world.However,due to the resistance of glioma cells to TMZ,its chemotherapy effect is reduced,which eventually leads to the failure of chemotherapy and the recurrence of glioma.Objective:Compare the differences in the expression of important drug-resistant proteins in gliomas of different pathological grades between the primary and recurrent gliomas,and analyze the epidemiological characteristics of gliomas by retrospective analysis,so as to determine the relationship between the recurrence of glioma and drug resistance.Methods:Collect tumor specimens from 8 patients with glioma(including 4 patients with primary glioma and 4 patients with recurrent glioma),and then Western Blot detection was performed on the expression levels of common drug-resistant proteins in primaryglioma and recurrent glioma at different pathological grades.Secondly,collect clinical data of glioma patients in the five years from January 2015 to December 2019,and analyze their clinical characteristics,then compare and analyze the epidemiological characteristics of glioma related to the existing literature.Among them,the focus was on the patients with recurrent glioma.According to the relationship between progression-free survival of patients with recurrent glioma and gender,age,pathological grade of glioma and the growth site of glioma,we use the SPSS data analysis software to do one-way analysis of variance.Results:According to Western Blot detection,MGMT protein,NF-kappa B protein,MRP1 protein and p-gp protein in cytoplasm were more significantly expressed in recurrent gliomas,and their expression levels were higher in grade IV gliomas than in grade III gliomas.The expression levels of MGMT protein and NF-B protein in the nucleus were more significant in recurrent gliomas and higher in grade IV gliomas than in grade III gliomas.After statistical analysis,it was found that the PFS in elderly patients(age ?50years)was shorter than that in younger patients(age < 50 years)(p = 0.000166).Gender was independent of PFS in glioma patients(p = 0.199).Tumor sites were not correlated with glioma recurrence,because there was no statistical significance(p = 0.094).The pathological grade of glioma was significantly correlated with the PFS(p < 0.000001).Conclusion:The resistance to TMZ increases after the recurrence of glioma.High grade glioma is more resistant to TMZ than low grade glioma.The recurrence of glioma was not related to the tumor growth site or the patient's gender(P > 0.05),but was related to the pathological grade of the tumor and the age of the patient at the time of onset(P < 0.05).The pathological grade of most gliomas tends to increase after recurrence.