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Molecular Classification of Gliomas is Associated with Seizure Control: A Retrospective Analysis
NeuroMolecular Medicine ( IF 3.5 ) Pub Date : 2020-11-18 , DOI: 10.1007/s12017-020-08624-0
Teresa P Easwaran 1 , Nicola Lancki 2 , Mario Henriquez 3 , Alexander O Vortmeyer 4 , Nicholas M Barbaro 5 , Denise M Scholtens 2 , Atique U Ahmed 6 , Mahua Dey 3
Affiliation  

Classically, histologic grading of gliomas has been used to predict seizure association, with low-grade gliomas associated with an increased incidence of seizures compared to high-grade gliomas. In 2016, WHO reclassified gliomas based on histology and molecular characteristics. We sought to determine whether molecular classification of gliomas is associated with preoperative seizure presentation and/or post-operative seizure control across multiple glioma subtypes. All gliomas operated at our institution from 2007 to 2017 were identified based on ICD 9 and 10 billing codes and were retrospectively assessed for molecular classification of the IDH1 mutation, and 1p/19q codeletion. Logistic regression models were performed to assess associations of seizures at presentation as well as post-operative seizures with IDH status and the new WHO integrated classification. Our study included 376 patients: 82 IDH mutant and 294 IDH wildtype. The presence of IDH mutation was associated with seizures at presentation [OR 3.135 (1.818–5.404), p < 0.001]. IDH-mutant glioblastomas presented with seizures less often than other IDH-mutant glioma subtypes grade II and III [OR 0.104 (0.032–0.340), p < 0.001]. IDH-mutant tumors were associated with worse post-operative seizure outcomes, demonstrated by Engel Class [OR 2.666 (1.592–4.464), p < 0.001]. IDH mutation in gliomas is associated with an increased risk of seizure development and worse post-operative seizure control, in all grades except for GBM.



中文翻译:

神经胶质瘤的分子分类与癫痫控制相关:回顾性分析

传统上,神经胶质瘤的组织学分级已被用来预测癫痫发作相关性,与高级别神经胶质瘤相比,低级别神经胶质瘤与癫痫发作发生率增加相关。2016年,世界卫生组织根据组织学和分子特征对神经胶质瘤进行了重新分类。我们试图确定神经胶质瘤的分子分类是否与多种神经胶质瘤亚型的术前癫痫发作和/或术后癫痫控制相关。我们机构从 2007 年至 2017 年手术的所有胶质瘤均根据 ICD 9 和 10 计费代码进行识别,并回顾性评估IDH1突变和1p/19q编码缺失的分子分类。采用逻辑回归模型来评估就诊时以及术后癫痫发作与 IDH 状态和新的 WHO 综合分类的关联。我们的研究包括 376 名患者:82 名 IDH 突变型患者和 294 名 IDH 野生型患者。IDH突变的存在与就诊时的癫痫发作相关 [OR 3.135 (1.818–5.404), p  < 0.001]。IDH -突变胶质母细胞瘤癫痫发作的频率低于其他IDH -突变胶质瘤亚型 II 级和 III 级 [OR 0.104 (0.032–0.340),p  < 0.001]。Engel Class 证明,IDH突变肿瘤与较差的术后癫痫结果相关 [OR 2.666 (1.592–4.464),p  < 0.001]。胶质瘤中的IDH突变与癫痫发作风险增加和术后癫痫发作控制较差有关,除了 GBM 之外的所有级别均如此。

更新日期:2020-11-18
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