High grade gliomas are always the research focus in the field of neurosurgery due to their poor prognosis despite the current standard therapeutic regimen of surgical resection followed by radiation therapy and chemot...High grade gliomas are always the research focus in the field of neurosurgery due to their poor prognosis despite the current standard therapeutic regimen of surgical resection followed by radiation therapy and chemotherapy. Alkylating agent temozolomide has been established as the standard chemotherapy while its resistance inevitable during treatment. This phenomenon seriously influences the prognosis of patients suffering from high grade gliomas. This review aims to elucidate temozolomide chemoresistance mechanisms through three chapters including O^6-methylguanine-DNA methyltransferase(MGMT) methylation, mismatch repair mutation and epigenetic regulation consisting of p21, chromatin and histone, Y-box binding protein-1 and micro RNAs.展开更多
The evaluation on prognosis of glioma patients is critical for the individualized treatment.Despite of the widely used mRNA expression level and methylation status of prognostic genes in predicting the patients’progn...The evaluation on prognosis of glioma patients is critical for the individualized treatment.Despite of the widely used mRNA expression level and methylation status of prognostic genes in predicting the patients’prognosis,the clinical application of high-throughput sequencing technology is still limited.Thus,this study aimed to construct a visual and reliable nomogram based on the common clinicopathological parameters for predicting the prognosis of patients diagnosed with high grade glioma(HGG).Notably,age,histopathology,IDH status,1p/19q status,radiotherapy status,chemotherapy status,and tumor recurrence were identified as seven independent prognostic factors for HGG patients.A comprehensive nomogram based on the seven identified factors was subsequently constructed with the remarkable C-index of 0.732.Calibrations for nomogram showed great consistency between the predictive values and the actual values in 1-,3-,and 5-year survival rates.Besides,the areas under the ROC curve(AUC)for predicting 1-,3-,and 5-year survival rates of patients had the values of 0.796(95%CI:0.759-0.833),0.809(95%CI:0.770-0.848),and 0.820(95%CI:0.771-0.869),respectively.Furthermore,an external cohort(n=89)was used to validate the nomogram.In conclusion,age,histopathology,IDH status,1p/19q sta-tus,radiotherapy status,chemotherapy status,and tumor progression were identified as independent prognostic factors,on which a visual predictive model was constructed with powerful predictive value.展开更多
High‑grade gliomas are the most common type of brain tumors.Of these,glioblastoma account for 60-70%and despite treatment carries a dismal prognosis.Postoperative surgical site infection has been associated with prolo...High‑grade gliomas are the most common type of brain tumors.Of these,glioblastoma account for 60-70%and despite treatment carries a dismal prognosis.Postoperative surgical site infection has been associated with prolonged survival.Herewith,we present a case of glioblastoma and a case of anaplastic oligoastrocytoma that developed postoperative infection of the surgical site and had prolonged survival.A thorough literature review is also presented.展开更多
The last fifteen years have seen the application of the cancer stem cell hypothesis to tumors of the central nervous system,in particular to high grade glioma(HGG),the most aggressive and common brain cancer in adults...The last fifteen years have seen the application of the cancer stem cell hypothesis to tumors of the central nervous system,in particular to high grade glioma(HGG),the most aggressive and common brain cancer in adults.Seminal studies have shown that cancer stem cells(alternatively named tumor-initiating cells)are capable of self-renew and multipotency,similar to their normal counterpart.More importantly they give rise to tumors that closely mimic the phenotype and genotype of human HGG.The identification of neurogenic niches in adult rodent and human brain has further reinforced the hypothesis that HGG might derive from the malignant transformation occurring in these areas,especially in the sub-ventricular zone(SVZ),the largest and most well characterised stem cell niche.Following from evidence of animal model studies supporting this hypothesis,recently we investigated the role of the SVZ in neuro-oncogenesis using tissue material derived from HGG patients.We also described response to conventional chemo-therapies of cancer stem cells isolated from the SVZ and the tumor mass(T)of the same patients and reconstructed tumor evolution.In this review,such findings will be discussed in the context of the current literature on the biology of the SVZ in the normal and disease brain.展开更多
基金Scientific Research Project of Science and Technology Committee of Shanghai Municipality, 14DZ1930303
文摘High grade gliomas are always the research focus in the field of neurosurgery due to their poor prognosis despite the current standard therapeutic regimen of surgical resection followed by radiation therapy and chemotherapy. Alkylating agent temozolomide has been established as the standard chemotherapy while its resistance inevitable during treatment. This phenomenon seriously influences the prognosis of patients suffering from high grade gliomas. This review aims to elucidate temozolomide chemoresistance mechanisms through three chapters including O^6-methylguanine-DNA methyltransferase(MGMT) methylation, mismatch repair mutation and epigenetic regulation consisting of p21, chromatin and histone, Y-box binding protein-1 and micro RNAs.
文摘The evaluation on prognosis of glioma patients is critical for the individualized treatment.Despite of the widely used mRNA expression level and methylation status of prognostic genes in predicting the patients’prognosis,the clinical application of high-throughput sequencing technology is still limited.Thus,this study aimed to construct a visual and reliable nomogram based on the common clinicopathological parameters for predicting the prognosis of patients diagnosed with high grade glioma(HGG).Notably,age,histopathology,IDH status,1p/19q status,radiotherapy status,chemotherapy status,and tumor recurrence were identified as seven independent prognostic factors for HGG patients.A comprehensive nomogram based on the seven identified factors was subsequently constructed with the remarkable C-index of 0.732.Calibrations for nomogram showed great consistency between the predictive values and the actual values in 1-,3-,and 5-year survival rates.Besides,the areas under the ROC curve(AUC)for predicting 1-,3-,and 5-year survival rates of patients had the values of 0.796(95%CI:0.759-0.833),0.809(95%CI:0.770-0.848),and 0.820(95%CI:0.771-0.869),respectively.Furthermore,an external cohort(n=89)was used to validate the nomogram.In conclusion,age,histopathology,IDH status,1p/19q sta-tus,radiotherapy status,chemotherapy status,and tumor progression were identified as independent prognostic factors,on which a visual predictive model was constructed with powerful predictive value.
文摘High‑grade gliomas are the most common type of brain tumors.Of these,glioblastoma account for 60-70%and despite treatment carries a dismal prognosis.Postoperative surgical site infection has been associated with prolonged survival.Herewith,we present a case of glioblastoma and a case of anaplastic oligoastrocytoma that developed postoperative infection of the surgical site and had prolonged survival.A thorough literature review is also presented.
文摘The last fifteen years have seen the application of the cancer stem cell hypothesis to tumors of the central nervous system,in particular to high grade glioma(HGG),the most aggressive and common brain cancer in adults.Seminal studies have shown that cancer stem cells(alternatively named tumor-initiating cells)are capable of self-renew and multipotency,similar to their normal counterpart.More importantly they give rise to tumors that closely mimic the phenotype and genotype of human HGG.The identification of neurogenic niches in adult rodent and human brain has further reinforced the hypothesis that HGG might derive from the malignant transformation occurring in these areas,especially in the sub-ventricular zone(SVZ),the largest and most well characterised stem cell niche.Following from evidence of animal model studies supporting this hypothesis,recently we investigated the role of the SVZ in neuro-oncogenesis using tissue material derived from HGG patients.We also described response to conventional chemo-therapies of cancer stem cells isolated from the SVZ and the tumor mass(T)of the same patients and reconstructed tumor evolution.In this review,such findings will be discussed in the context of the current literature on the biology of the SVZ in the normal and disease brain.
