Clinical efficacy of IDH1 mutation in temozolomide chemotherapy for glioma patients and its impact on immune cytokines and prognosis
10.3969/j.issn.1000-484X.2024.11.022
- VernacularTitle:IDH1突变对替莫唑胺化疗治疗脑胶质瘤患者的临床疗效及其对免疫细胞因子、预后的影响
- Author:
Xuewen ZHANG
1
;
Yu WANG
;
Jie WU
;
Chen WANG
Author Information
1. 苏州大学附属独墅湖医院,苏州 215000
- Keywords:
Glioma of brain;
IDH1 mutation;
Temozolomide chemotherapy;
Immune cytokines;
Prognosis
- From:
Chinese Journal of Immunology
2024;40(11):2373-2379
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To study clinical efficacy of isocitrate dehydrogenase 1(IDH1)mutation on temozolomide chemotherapy for glioma patients and its impact on immune cytokines and prognosis.Methods:A total of 134 patients with glioma who underwent surgical resection and were confirmed by pathology in Dushu Lake Hospital Affiliated to Soochow University from October 2021 to October 2022 were selected as research subjects.IDH1 mutation status was measured by direct sequencing method,and IDH1 expres-sion rate in glioma tissue was determined by immunohistochemistry.All patients with brain glioma were treated with temozolomide chemotherapy.Effects of IDH1 mutation on clinical efficacy,immune cytokines(IFN-γ,IL-2,IL-4,IL-10)and prognosis of glioma were analyzed.Results:Seventy-nine cases out of 134 cases of glioma tissue had IDH1 mutations,mostly at R132,with a mutation rate of 58.96%,significantly higher than normal brain tissue(χ2=48.066,P<0.05).Immunohistochemistry showed strong positive expression of IDH1 in 56 out of 134 glioma tissues.Proportion of WHO grade Ⅳ in IDH1 mutant group was lower than IDHI wild type group[11.39%(9/79)vs 63.64%(35/55),Z=41.020,P<0.05].Proportion of low differentiation in IDH1 mutant group was higher than IDHI wild type group[50.63%(40/79)vs 20.00%(11/55),χ2=12.907,P<0.05].Total effective rate in IDH1 mutant group was higher than IDH1 wild type group[91.14%(72/79)vs 76.36%(42/55),χ2=5.575,P<0.05],IFN-γ and IL-2 levels were higher than IDH1 wild type group[(28.98±3.25)pg/ml vs(20.15±2.54)pg/ml,(33.42±4.25)pg/ml vs(25.23±3.52)pg/ml,t=16.870,11.750,P<0.05],IL-4 and IL-10 levels were lower than IDH1 wild type group[(7.90±1.02)pg/ml vs(12.38±1.66)pg/ml,(8.79±1.00)pg/ml vs(15.26±1.23)pg/ml,t=19.330,33.500,P<0.05].IDH1 mutation was positively correlated with IFN-γ and IL-2 levels after temozolo-mide chemotherapy(r=0.845,0.772,P<0.05),and negatively correlated with IL-4 and IL-10 levels after temozolomide chemotherapy(r=-0.786,-0.685,P<0.05).Survival rate after chemotherapy in IDH1 mutant group was higher than IDH1 wild type group[89.87%(71/79)vs 72.70%(40/55),Log Rank test χ2=5.208,P<0.05].Cox regression analysis found that WHO grade Ⅲ(RR=1.342),poorly differentiated(RR=1.783),IFN-γ(RR=1.808),IL-2(RR=2.112),IL-4(RR=2.342),IL-10(RR=1.342)as risk factors,temozolo-mide chemotherapy efficacy(RR=0.653),IDH1 mutation(RR=0.895)as protective factors affect prognosis of temozolomide chemo-therapy in glioma patients(P<0.05).Conclusion:IDH1 mutation is related to disease grade and differentiation degree of glioma patients,and can affect efficacy of temozolomide chemotherapy and expressions of immune cytokines,which is a protective factor for prognosis and survival after temozolomide chemotherapy.
