摘要
目的探究胶质瘤分子病理与组织病理结果的一致性及分子病理对胶质瘤组织病理诊断的修正作用。方法回顾分析2017年1月-2018年5月解放军总医院第一医学中心神经外科手术治疗的89例胶质瘤患者(低级别胶质瘤25例,高级别胶质瘤64例)的分子病理及组织病理结果,对相应指标进行诊断一致性分析。结果分子病理与组织病理在胶质瘤级别的诊断一致率为79.8%,在判定IDH-1突变、MGMT甲基化、ATRX突变时,组织病理与分子病理的诊断一致率分别为93.3%、57.3%、79.8%,分子病理对组织病理的以上三项检测指标的诊断修正率分别为6.7%、42.7%、20.2%。低级别胶质瘤组与高级别胶质瘤组相比,只在用两种方法检测MGMT甲基化时出现诊断一致率的差异(76.0%vs 50.0%,P=0.026);而在检测综合病理诊断类型、IDH-1突变、ATRX突变方面,两组诊断一致率无差异。结论组织病理与分子病理对胶质瘤的诊断一致率在IDH-1突变方面较高;而在胶质瘤类型的综合诊断、MGMT甲基化的诊断、ATRX突变的诊断方面,分子病理更为准确。
Objective To explore the consistency of results of molecular pathology and histopathology in patients with glioma and the role of molecular pathology in improving the accuracy of pathological diagnosis in glioma. Methods Eighty-nine patients with glioma(25 low-grade gliomas, 64 high-grade gliomas) were treated in neurosurgery department of the First Medical Center of Chinese PLA General Hospital from January 2017 to May 2018, and their molecular pathological and histopathological results were retrospectively analyzed. Then diagnostic consistency of the corresponding indicators between two groups was investigated.Patients with gliomas were divided into high-grade glioma group and low-grade glioma group, and the molecular and pathological diagnosis consistency rates of the two groups were statistically analyzed. Results The consistency rate of molecular pathology and histopathology in diagnosis of glioma grade was 79.8%. The diagnostic agreement rates of histopathology and molecular pathology were 93.3% and 57.3%, 79.8%, respectively. In terms of judging IDH-1 mutation, MGMT methylation and ATRX mutation, the accuracy were improved by 6.7%, 42.7%, and 20.2%, respectively. There was signi?cant difference in the diagnostic agreement rate of MGMT methylation between high-grade glioma group and low-grade glioma group(76.0% vs 50.0%, P=0.026), but no difference in comprehensive pathological diagnosis type, IDH-1 mutation, ATRX mutation. Conclusion The diagnostic agreement rate of histopathology and molecular pathology is higher for IDH-1 mutation of glioma. While molecular pathology is more accurate in the comprehensive diagnosis of glioma grade, the diagnosis of MGMT methylation and ATRX mutations.
作者
崔萌
朱巍
张猛
马晓东
CUI Meng;ZHU Wei;ZHANG Meng;MA Xiaodong(Department of Neurosurgery, the First Medical Center, Chinese PLA General Hospital, Beijing 100853, China)
出处
《解放军医学院学报》
CAS
2019年第2期162-165,共4页
Academic Journal of Chinese PLA Medical School
基金
首都临床特色应用研究(Z151100004015191)~~
关键词
胶质瘤
分子病理
组织病理
免疫组化
glioma
molecular pathology
histopathology
immunohistochemistry
