RESUMO
AIM: To assess the distribution of genetic polymorphisms of killer cell immunoglobulin-like receptors (KIRs) to predict the clinical course of glioblastoma, report on the genetic mechanisms, and provide guidance on potential therapeutic methods. MATERIAL AND METHODS: Our study included 31 adult patients who were admitted to the Department of Neurosurgery at our institution and diagnosed with glioblastoma between October 2013 and January 2014 together with 50 control subjects. RESULTS: The mean age of the patients was 53.5 vs. 53.9 years, respectively, and the gender distribution (male/female: 64.5/35.5% vs. 64/36%, respectively) was comparable among patients and controls (p > 0.05). Sixteen different KIR genes including inhibitory, activating, and pseudogenes were investigated for each sample, and the framework genes including KIR2DL4, 3DL2, 3DL3, and 3DP1 were present in all patients and controls. In addition, the inhibitory KIR genes and the 2DL3 gene were significantly more common in patients compared to controls (p < 0.05). CONCLUSION: This study demonstrated that the inhibitory KIR gene 2DL3 has a predisposition for glioblastoma. Identifying the potential link between glioblastoma cells and immune system genetics is critical in predicting familial predisposition and early diagnosis. In addition, this clue may be a key factor in developing post-surgery individual immunotherapy models in the future.
Assuntos
Neoplasias Encefálicas/genética , Glioblastoma/genética , Polimorfismo Genético/genética , Receptores KIR/genética , Adulto , Neoplasias Encefálicas/diagnóstico , Feminino , Frequência do Gene/genética , Genótipo , Glioblastoma/diagnóstico , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
BACKGROUND: Perimesencephalic nonaneurysmal hemorrhage is a benign form of subarachnoid hemorrhage with a low risk of rebleeding. The authors conducted a retrospective study to investigate the prognosis, possible prognostic factors, and long-term natural history in perimesencephalic nonaneurysmal subarachnoid hemorrhage (PNSH). METHODS: This report contains a retrospective analysis of 29 patients with PNSH who were followed from 1 month to 8 years with an average follow-up period of 5.4 years. We evaluated computed tomography (CT) scan features; clinical grade; loss of consciousness during hemorrhage; ventricular ratio; angiographic spasm; complications such as ischemic complications, early rebleeding, late rebleeding, epilepsy, hydrocephalus, and fixed ischemic deficit; and outcome. RESULTS: There were 7 men and 22 women, and the ages ranged from 22 to 69 years (mean 49.5 years). In the group with PNSH 93% of the patients were in grade I-II, as compared to 70.8% of patients with non-PNSH according to the Hunt and Hess system. Loss of consciousness during hemorrhage was detected in 9 patients (31%). We observed acute hydrocephalus in 4 patients (13.7%). The first cerebral four-vessel angiograms disclosed vasospasm in 3 patients (10.3%). Patients with PNSH have the best outcome according to the activities of daily living (ADL) grading system when compared with other groups of patients with negative angiogram (aneurysmal pattern and invisible blood). CONCLUSION: This study provides evidence that patients with PNSH have an uncomplicated course and a particularly favorable outcome.