Bridge-layered decompression technique for vertebral artery-involved hemifacial spasm: technical note.

BACKGROUND: Hemifacial spasm (HFS) is most effectively treated with microvascular decompression (MVD). However, there are certain challenges in performing MVD for HFS when the vertebral artery (VA) is involved in compressing the facial nerve (VA-involved). This study aimed to introduce a "bridge-layered" decompression technique for treating patients with VA-involved HFS and to evaluate its efficacy and safety to treat patients with HFS. METHODS: A single-center retrospective analysis was conducted on the clinical data of 62 patients with VA-involved HFS. The tortuous trunk of VA was lifted by a multi-point "bridge" decompression technique to avoid excessive traction of the cerebellum and reduce the risk of damage to the facial-acoustic nerve complex. To fully decompress all the responsible vessels, the branch vessels of VA were then isolated using the "layered" decompression technique. RESULTS: Among the 62 patients, 59 patients were cured immediately after the surgery, two patients were delayed cured after two months, and one had occasional facial muscle twitching after the surgery. Patients were followed up for an average of 19.5 months. The long-term follow-up results showed that all patients had no recurrence of HFS during the follow-up period, and no patients developed hearing loss, facial paralysis, or other permanent neurological damage complications. Only two patients developed tinnitus after the surgery. CONCLUSION: The "bridge-layered" decompression technique could effectively treat VA-involved HFS with satisfactory safety and a low risk of hearing loss. The technique could be used as a reference for decompression surgery for VA-involved HFS.

Mechanistic insight into glioma through spatially multidimensional proteomics.

Characterizing the tumor microenvironment at the molecular level is essential for understanding the mechanisms of tumorigenesis and evolution. However, the specificity of the blood proteome in localized region of the tumor and its linkages with other systems is difficult to investigate. Here, we propose a spatially multidimensional comparative proteomics strategy using glioma as an example. The blood proteome signature of tumor microenvironment was specifically identified by in situ collection of arterial and venous blood from the glioma region of the brain for comparison with peripheral blood. Also, by integrating with different dimensions of tissue and peripheral blood proteomics, the information on the genesis, migration, and exchange of glioma-associated proteins was revealed, which provided a powerful method for tumor mechanism research and biomarker discovery. The study recruited multidimensional clinical cohorts, allowing the proteomic results to corroborate each other, reliably revealing biological processes specific to gliomas, and identifying highly accurate biomarkers.

A nomogram based on clinical multivariate factors predicts delayed cure after microvascular decompression for hemifacial spasm.

BACKGROUND: The course of disease after microvascular decompression (MVD) in patients with hemifacial spasm (HFS) is variable. The purpose of this study was to develop and validate a nomogram to predict the probability of delayed cure after microvascular decompression in patients with hemifacial spasms based on clinical multivariate factors. METHODS: A retrospective data collection was performed on 290 patients with HFS undergoing MVD at our center from January 2017 to January 2022. The patients were randomly assigned to the training cohort (n = 232) and validation cohort (n = 58) at a ratio of 8:2. Retrospective analysis was performed of information on clinical, radiological, and intraoperative findings and clinical outcomes. Univariate and multivariate analyses were performed in the training cohort, and a nomogram was constructed using a stepwise logistic regression approach. The receiver operating characteristic (ROC) was calculated to evaluate the reliability of the nomogram model. Decision curve analysis (DCA) was used to assess the clinical application value of the nomogram model. RESULTS: In the training cohorts, 73 patients (73/232) had a delayed cure. In the validation cohorts, 18 patients (18/58) had a delayed cure. We developed a novel nomogram model to predict the risk of delayed cure after MVD in HFS patients based on the presence of vertebral artery compression, venous compression, absence of LSR, degree of facial nerve indentation, degree of neurovascular compression, and internal auditory canal vascular looThe area under the curve (AUC) of the nomogram model was 0.9483 in the training cohort and 0.9382 in the validation cohort. The calibration curve showed good correspondence between the predicted and actual probabilities in the training and validation groups. The decision curve showed that the nomogram model had good performance in clinical applications. CONCLUSIONS: We developed and validated a preoperative and intraoperative multivariate factors nomogram to predict the possibility of delayed cure after MVD in HFS patients, which may help clinicians in the comprehensive management of HFS.

Early lateral spread response loss during microvascular decompression for hemifacial spasm: its preoperative predictive factors and impact on surgical outcomes.

When early lateral spread response (LSR) loss before decompression in HFS surgery happens, the value of intraoperative monitoring of LSR for locating neurovascular conflicts and confirming adequate decompression was considered to be reduced. This study aimed to identify preoperative parameters predicting early LSR loss and figure out the impact of early LSR loss on prognosis. Hemifacial spasm (HFS) patients who received microvascular decompression (MVD) under intraoperative electrophysiological monitoring during the period of March 2013-January 2021 were reviewed retrospectively. The patients were divided into two groups according to the disappearance of their LSR before or after decompression. Preoperative clinical and radiological predictors for early LSR loss were evaluated using logistic regression. The relationship between early LSR loss and surgical outcomes was statistically analyzed. A total of 523 patients were included in the study, and the disappearance of their LSR before decompression occurred in 129 patients. In the multivariate analysis, three independent factors predicting early LSR loss were identified: (1) smaller vessel compression; (2) milder nerve deviation; (3) lower posterior fossa crowdedness index (PFCI, calculated as hindbrain volume (HBV)/the posterior fossa volume (PFV) using 3D Slicer software). The median follow-up time was about five years, and no significant differences in the spasm relief and complication rates were found between the 2 groups. Smaller responsible vessels, milder nerve deviation, and more spacious posterior cranial fossa are associated with early LSR loss. However, early LSR loss seems to have no significant adverse effect on MVD outcomes in skilled hands.

Study on the relationship between obesity and complications of Pediatric Epilepsy surgery.

OBJECTIVE: Studies have shown that obesity has a significant impact on poor surgical outcomes. However, the relationship between obesity and pediatric epilepsy surgery has not been reported. This study aimed to explore the relationship between obesity and complications of pediatric epilepsy surgery and the effect of obesity on the outcome of pediatric epilepsy surgery, and to provide a reference for weight management of children with epilepsy. METHODS: A single-center retrospective analysis of complications in children undergoing epilepsy surgery was conducted. Body mass index (BMI) percentiles were adjusted by age and used as a criterion for assessing obesity in children. According to the adjusted BMI value, the children were divided into the obese group (n = 16) and nonobese group (n = 20). The intraoperative blood loss, operation time, and postoperative fever were compared between the two groups. RESULTS: A total of 36 children were included in the study, including 20 girls and 16 boys. The mean age of the children was 8.0 years old, ranging from 0.8 to 16.9 years old. The mean BMI was 18.1 kg/m2, ranging from 12.4 kg/m2 to 28.3 kg/m2. Sixteen of them were overweight or obese (44.4%). Obesity was associated with higher intraoperative blood loss in children with epilepsy (p = 0.04), and there was no correlation between obesity and operation time (p = 0.21). Obese children had a greater risk of postoperative fever (56.3%) than nonobese children (55.0%), but this was statistically nonsignificant (p = 0.61). The long-term follow-up outcomes showed that 23 patients (63.9%) were seizure-free (Engel grade I), 6 patients (16.7%) had Engel grade II, and 7 patients (19.4%) had Engel grade III. There was no difference in long-term seizure control outcomes between obese and nonobese groups (p = 0.682). There were no permanent neurological complications after surgery. CONCLUSION: Compared with nonobese children with epilepsy, obese children with epilepsy had a higher intraoperative blood loss. It is necessary to conduct early weight management of children with epilepsy as long as possible.

Autologous bone fragments for skull reconstruction after microvascular decompression.

BACKGROUND: Various methods are used to reconstruct the skull after microvascular decompression, giving their own advantages and disadvantages. The objective of this study was to evaluate the efficacy of using autologous bone fragments for skull reconstruction after microvascular decompression. METHODS: The clinical and follow-up data of 145 patients who underwent microvascular decompression and skull reconstruction using autologous bone fragments in our hospital from September 2020 to September 2021 were retrospectively analyzed. RESULTS: Three patients (2.06%) had delayed wound healing after surgery and were discharged after wound cleaning. No patient developed postoperative cerebrospinal fluid leakage, incisional dehiscence, or intracranial infection. Eighty-five (58.62%) patients underwent follow-up cranial computed tomography at 1 year postoperatively, showed excellent skull reconstruction. And, the longer the follow-up period, the more satisfactory the cranial repair. Two patients underwent re-operation for recurrence of hemifacial spasm, and intraoperative observation revealed that the initial skull defect was filled with new skull bone. CONCLUSION: The use of autologous bone fragments for skull reconstruction after microvascular decompression is safe and feasible, with few postoperative wound complications and excellent long-term repair results.

Hybrid surgery for coexistence of cerebral arteriovenous malformation and primitive trigeminal artery: A case report and literature review.

The primitive trigeminal artery (PTA), an abnormal carotid-basilar anastomosis, forms the vascular anomaly connection between the internal carotid artery and vertebrobasilar system. Rarely, PTA can be complicated by several other cerebrovascular disease, including arteriovenous malformations (AVMs), intracranial aneurysms, moyamoya disease, and carotid-cavernous malformations. Herein, we reported a rare case of PTA combined with an AVM in a male patient. The patient was a 28-year-old male with epileptic seizures at the onset of symptoms. Magnetic resonance imaging showed abnormal signal foci and localized softening foci formation with gliosis in the right parietal temporal lobe. Furthermore, using a digital subtraction angiogram (DSA), it was found that an abnormal carotid-basilar anastomosis had developed through a PTA originating from the cavernous portion of the right internal carotid artery (ICA) and a large AVM on the surface of the right carotid artery. The lesion of AVM tightly developed and draining into superior sagittal sinus. A hybrid operating room was used for the surgery. The main feeding arteries of the AVM originating from three major arteries, including the right middle cerebral artery, the right anterior cerebral artery, and the right posterior cerebral artery, were clipped and subsequently, then the AVM was thoroughly removed. The intraoperative DSA showed that the AVM had been resected completely. Postoperative pathological examination of the resected specimen indicated the presence of an AVM. The patient recovered well after surgery and has been symptom-free for more than 3 months. In summary, the pathogenesis of the coexistence of PTA and AVM remains unknown. As highlighted in this case report, hybrid surgery can be used to remove AVMs and can improve the patients' prognosis. To our best knowledge, this is the first case in the literature of successful AVM treatment using hybrid surgery.

Molecular and clinical features of a potential immunotherapy target ELK3 in glioma.

Glioma represents the most prevalent malignant primary brain cancer, and its treatment remains a tremendous challenge. Novel and efficient molecular targets are therefore required for improving diagnosis, survival prediction, and treatment outcomes. Additionally, some studies have shown that immunity is highly associated with glioma progression. Our study aimed to investigate the clinicopathological features, prognostic significance, and immunotherapeutic targetability of ELK3, a member of the erythroblast transformation-specific transcription factor family, in glioma using bioinformatics analyses. ELK3 transcript levels in glioma tissues were evaluated using the Gene Expression Omnibus and The Cancer Genome Atlas databases. Clinical and transcriptomic data of The Cancer Genome Atlas glioma patients were analyzed to identify the molecular and clinical characterizations of ELK3. The prognostic significance of ELK3 was assessed using Cox regression and Kaplan-Meier analysis. The biological pathways related to ELK3 expression were identified by gene set enrichment analysis. The relationships between ELK3 and inflammatory responses, immune cell infiltration, and immune checkpoints were explored using canonical correlation analysis and gene set variation analysis. ELK3 was upregulated in gliomas, and its high expression was correlated with advanced clinicopathologic features and unfavorable prognosis. Gene set enrichment analysis revealed that several immune-related pathways were tightly linked to high ELK3 expression. gene set variation analysis and correlograms demonstrated that ELK3 was robustly associated with inflammatory and immune responses. Correlation analyses indicated that ELK3 was positively associated with infiltrating immune cells and synergistic with several immune checkpoints. ELK3 may serve as a novel marker of poor prognosis and a potential immunotherapeutic target in glioma.

Intraoperative Findings of Inferior Petrosal Vein During Microvascular Decompression for Hemifacial Spasm: A Single-Surgeon Experience.

Objective: This study aims to evaluate the impact of the inferior petrosal veins (IPVs) on operational exploration and to analyze related anatomic features. Methods: A total of 317 patients were retrospectively studied. Surgical outcomes and postoperative complications were analyzed, and patients were divided into two groups according to whether the IPV was sacrificed or preserved. The diameter of the IPV was also recorded during operation. Furthermore, the position where the IPV drained into the jugular bulb was recorded in each patient, and the influence of different injection points on the operation was analyzed. Results: IPVs were conclusively identified in 242/317 (76.3%) of patients, with 110/242 (45.5%) of patients categorized as "IPV sacrifice" versus 132/242 (54.5%) categorized as "IPV preservation." IPV diameter was observed to be <0.5 mm in 58 cases (23.9%), 0.5 mm-1.0 mm (≥0.5 mm and ≤1.0 mm) in 145 cases (59.9%), and >1 mm in 39 cases (16.2%). The position of IPV drainage into the jugular bulb was at the level of the accessory nerve in 163 cases (67.3%), the level of the vagus nerve in 42 cases (17.4%), and the level of the glossopharyngeal nerve or above in 37 cases (15.3%). The diameters of IPV in the sacrifice group were mainly less than 1 mm (94.5% vs. 75%, P < 0.01), and the cases with draining points near the glossopharyngeal nerve were more than that in the preservation group (27.3% vs. 5.3%, P < 0.01). Conclusion: IPV is an obstructive structure in MVD for HFS, with considerable variations in diameters and draining points. IPV near the glossopharyngeal nerve significantly impacts surgical exposure and is often sacrificed for a better view of the operation field. Meanwhile, it is feasible to maintain IPVs with a diameter >1 mm.

Microvascular decompression as a second step treatment for trigeminal neuralgia in patients with failed two-isocentre gamma knife radiosurgery.

OBJECTIVE: Subsequent microvascular decompression (MVD) might be affected by the previous two-isocentre gamma knife radiosurgery (GKS) due to the tissue changes caused by its higher dose radiation and larger treatment volume. This study aimed to evaluate the safety and efficacy of MVD as a second step treatment after two-isocentre GKS. METHODS: Between December 2016 and May 2019, data from 19 consecutive trigeminal neuralgia (TN) patients who experienced MVD after failed two-isocentre GKS were collected. The clinical characteristics, intraoperative findings, surgical outcomes and complications were reviewed and compared with 158 patients who underwent MVD as an initial treatment. RESULTS: Fifteen patients (78.9%) achieved complete pain relief (Barrow Neurological Institute, BNI class I) immediately after surgery and nine patients (47.4%) maintained complete pain relief at the last follow-up, which was similar to patients who underwent initial MVD. The median follow-up period was 36 months. The incidence of new or worsened facial numbness showed no statistical significance between the groups. During surgery, trigeminal nerve atrophy was noted in 9 patients (47.4%), thickened arachnoid in 3 patients (15.8%), atherosclerotic plaque in 3 patients (15.8%) and neurovascular adhesion in 1 patient (5.3%). CONCLUSIONS: MVD remains an effective and safe rescue therapy for patients who elect the minimally invasive treatment with two-isocentre GKS for the first time, without an increased risk of facial numbness.

CNN3 in glioma: The prognostic factor and a potential immunotherapeutic target.

BACKGROUND: Gliomas are the most intrinsic type of primary intracranial tumors. The protein encoded by The calponin 3 (CNN3) has been proven to be a member of the calponin family. Its relationships with cervical cancer, colorectal cancer, gastric cancer, and colon cancer have been emphasized by several studies. Our research aims to explore the prognosis value and immunotherapeutic targetability of CNN3 in glioma patients using bioinformatics approach. METHODS: CNN3 expression in glioma was analyzed based on GEO and TCGA datasets. Gene expression profiling with clinical information was employed to investigate the correlation between clinicopathological features of glioma patients and relative CNN3 expression levels. Survival analysis was conducted using Kaplan-Meier analysis and the Cox proportional-hazards regression model. Gene set enrichment analysis was conducted to select the pathways significantly enriched for CNN3 associations. Correlations between inflammatory activities, immune checkpoint molecules and CNN3 were probed by gene set variation analysis, correlograms, and correlation analysis. RESULTS: CNN3 was enriched in gliomas, and high expression of CNN3 correlated with worse clinicopathological features and prognosis. Associations between CNN3 and several immune-related pathways were confirmed using a bioinformatics approach. Correlation analysis revealed that CNN3 was associated with inflammatory and immune activities, tumor microenvironment, and immune checkpoint molecules. CONCLUSION: Our results indicate that high CNN3 expression levels predict poor prognosis, and CNN3 may be a promising immunotherapy target.

Microscopic versus endoscopic microvascular decompression for the treatment of hemifacial spasm in China: A meta-analysis and systematic review.

OBJECTIVE: To date, microvascular decompression has become the standard surgical treatment for hemifacial spasm. Microscopic microvascular decompression (MI-MVD) and endoscopic microvascular decompression (E-MVD) are both popular with surgeons. The present study aims to investigate whether MI-MVD and E-MVD show better results as surgical treatments for hemifacial spasm in the Chinese population. METHODS: Electronic retrieval of articles on PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure and Wanfang Database was performed to identify comparative studies on Chinese patients who underwent MI-MVD and E-MVD from January 2000 to December 2020. After data extraction and quality assessment of the included studies, a meta-analysis was performed using the Review Manager 5.4 software. The pooled incidence of patient effective rate, detection rate of offensive blood vessels, total complication rate, and recurrence rate were calculated. RESULTS: A total of 12 studies with 1122 patients (MI-MVD: 562, E-MVD: 560) were identified. The patient effective rate (MI-MVD: 89% vs E-MVD:97%, OR = 0.22, P < 0.00001) and detection rate of offensive blood vessels (MI-MVD:91% vs E-MVD:98%, OR = 0.17, P = 0.0002) showed patients with E-MVD were significantly higher than patients who underwent MI-MVD. However, the total complication rate (MI-MVD: 27% vs E-MVD:12%, OR = 2.92, P = 0.0002) and recurrence rates (MI-MVD:5.7% vs E-MVD:0.3%, OR = 8.8, P = 0.0005) showed patients with E-MVD were significantly lower than patients who underwent MI-MVD. In addition, the incidence of facial paralysis or weakness and hearing loss in E-MVD group was lower than that of in MI-MVD group, whereas no statistical difference was found between the two groups in terms of the incidence of cerebrospinal fluid leakage and intracranial infection. CONCLUSIONS: While the operation of MI-MVD is relatively simple and the learning curve is short, E-MVD is better than MI-MVD in terms of treatment effect, overall complications, and recurrence rate. Therefore, E-MVD can be used as an alternative to MI-MVD in the treatment of hemifacial spasm in the Chinese population.

Remodelling and Treatment of the Blood-Brain Barrier in Glioma.

The blood-brain barrier (BBB) is an essential structure of the central nervous system (CNS), and its existence makes the local internal environment of the CNS a relatively independent structure distinct from other internal environments of the human body to ensure normal physiological and high stability of activities of the CNS. Changes in BBB structure and function are fundamental to the pathophysiology of many diseases. The occurrence and development of glioma are often accompanied by a series of changes in the structure and function of the internal environment, the most significant of which is remodelling of the BBB. The remodelling of the BBB usually leads to changes in the permeability of local microvessels, which provide certain favourable conditions for the occurrence and development of glioma. Meanwhile, the newly generated abnormal blood vessels and the remaining intact regions of the BBB also hinder the effects of drug treatments. Changes in permeability and structural function often lead to the creation of abnormally functioning vascular regions, which pose further treatment challenges. At present, therapeutic methods for glioma have not achieved satisfactory effects in clinical practice, and emerging therapeutic methods have not yet been widely used in clinical practice. In this review, we summarize the knowledge of remodelling of the BBB in the glioma environment, the type of changes that occur, and current BBB treatment methods and prospects for the treatment of glioma.

Preoperative risk grade predicts the long-term prognosis of intrahepatic cholangiocarcinoma: a retrospective cohort analysis.

BACKGROUND: Cumulating evidence indicates that the systemic inflammatory response (SIR) plays a crucial role in the prognosis of various cancers. We aimed to generate a preoperative risk grade (PRG) by integrating SIR markers to preoperatively predict the long-term prognosis of intrahepatic cholangiocarcinoma (ICC). METHODS: 468 consecutive ICC patients who underwent hepatectomy between 2010 and 2017 were enrolled. The PRG and a nomogram were generated and their predictive accuracy was evaluated. RESULTS: The PRG consisted of two non-tumor-specific SIR markers platelet-to-lymphocyte ratio (PLR) and albumin (ALB), which were both the independent predictors of overall survival (OS). Multivariate analysis showed that the PRG was significantly associated with OS (PRG = 1: hazard ratio (HR) = 3.800, p < 0.001; PRG = 2: HR = 7.585, p < 0.001). The C-index of the PRG for predicting survival was 0.685 (95% CI 0.655 to 0.716), which was statistically higher than that of the following systems: American Joint Committee on Cancer (AJCC) 8th edition (C-index 0.645), Liver Cancer Study Group of Japan (LCSGJ) (C-index 0.644) and Okabayashi (C-index 0.633) (p < 0.05). Besides, the C-index of the nomogram only consisting of the tumor-specific factors (serum carcinoembryonic antigen, carbohydrate antigen 19-9, tumor number) could be improved to 0.737 (95% CI 0.062-0.768) from 0.625 (95% CI 0.585-0.665) when the PRG was incorporated (p < 0.001). CONCLUSIONS: The PRG integrating two non-tumor-specific SIR markers PLR and ALB was a novel method to preoperative predicting the prognosis of ICC.

Salvage gamma knife surgery for recurrent glossopharyngeal neuralgia following microvascular decompression: a retrospective case series.

BACKGROUND: Although microvascular decompression (MVD) is recognized as the preferred therapy for drug-resistant idiopathic glossopharyngeal neuralgia (GPN), the management of recurrent GPN following MVD is seldom mentioned in the current literature. This study aims to demonstrate the efficacy and safety of salvage Gamma Knife surgery (GKS) in the treatment of recurrent GPN after MVD. METHODS: From October 2012 to January 2018, seven patients (three males and four females) underwent salvage GKS for recurrent GPN following MVD, including two patients who received repeat GKS due to pain recurrence after their initial GKS salvage. The median age was 69 years (range 49-81 years) at first GKS and 72 years (67 years; 77 years) at second GKS. The delivered dose was 80 or 90 Gy at first GKS and 90 Gy at second GKS. Pain outcome was assessed according to the Barrow Neurological Institute (BNI) score. RESULTS: The median duration of follow-up after first GKS was 68 months (range 29-89 months) and 45 months (56 months; 33 months) after second GKS. The median time to pain response was 24 days (range, 6-80 days). One patient experienced palatoglossal hyperesthesia after first GKS, and no complications were noted after second GKS. At the last follow-up, 4 patients were BNI I, 1 was BNI II, and 2 was BNI IIIa. CONCLUSIONS: Salvage GKS is safe and effective for treating recurrent GPN after MVD, even for patients who experienced pain recurrence following their initial GKS salvage.

Hypoxic Glioma Stem Cell-Derived Exosomes Containing Linc01060 Promote Progression of Glioma by Regulating the MZF1/c-Myc/HIF1α Axis.

Glioma stem cells (GSC) are a subpopulation of tumor cells with special abilities to proliferate and differentiate in gliomas. They are one of the main causes of tumor recurrence, especially under hypoxic conditions. Although long noncoding RNAs (lncRNA) are known to be involved in numerous biological processes and are implied in the occurrence of certain diseases, their role in tumor development and progression remains poorly understood. Here we explored the mechanisms by which lncRNA derived from hypoxic GSCs (H-GSC) cause glioma progression. Isolation and identification of the Linc01060 gene, the exosomes containing them, and the proteins from tumor cells regulating the gene allowed for studying the effects of Linc01060 on proliferation and glycometabolism. H-GSC exerted their effects by transferring exosomes to glioma cells, resulting in a significant increase in Linc01060 levels. Mechanistically, Linc01060 directly interacted with the transcription factor myeloid zinc finger 1 (MZF1) and enhanced its stability. Linc01060 facilitated nuclear translocation of MZF1 and promoted MZF1-mediated c-Myc transcriptional activities. In addition, c-Myc enhanced the accumulation of the hypoxia-inducible factor-1 alpha (HIF1α) at the posttranscriptional level. HIF1α bound the hormone response elements of the Linc01060 promoter, upregulating the transcription of Linc01060 gene. Clinically, Linc01060 was upregulated in glioma and was significantly correlated with tumor grade and poor clinical prognosis. Overall, these data show that secretion of Linc01060-containing exosomes from H-GSCs activates prooncogenic signaling pathways in glioma cells to promote disease progression. SIGNIFICANCE: These findings suggest that inhibition of Linc01060-containing exosomes or targeting the Linc01060/MZF1/c-Myc/HIF1α axis may be an effective therapeutic strategy in glioma.