Differential molecular genetic analysis in glioblastoma multiforme of long- and short-term survivors: a clinical study in Chinese patients.

This study was designed to find whether long-term survivors (LTSs) exhibit molecular genetic differences compared with short-term survivors (STSs) in patients with GBM. Tumors from 12 patients initially diagnosed with GBM and survived longer than 36 months (LTSs) were compared with 30 patients with GBM and STSs (survival <18 months) for detecting of MGMT promoter methylation, 1p/19q LOH and IDH1 mutation. IDH1 mutation and MGMT promoter methylation were significantly more frequent in the LTSs group (P = 0.039 and 0.017, respectively). The incidence of 1p/19q co-deletion was not significantly different (P = 1.0). IDH1 mutation and MGMT promoter methylation might be independent, significant, and favorable factors for LTSs with GBM.

[Iconographic analysis for pituitary adenoma, craniopharyngioma and Rathke cleft cyst involving both intrasellar and suprasellar regions].

OBJECTIVE: To explore the iconographic differences for pituitary adenoma, craniopharyngioma and Rathke cleft cyst involving both intrasellar and suprasellar regions. METHODS: A total of 99 eligible pathologically confirmed patients (pituitary adenoma, n = 49; craniopharyngioma, n = 35; Rathke cleft cyst, n = 24) were selected during January 2008 and January 2012. The following characteristics were evaluated: (1) calcification or not and density of tumor on computed tomography (CT); (2) shape, size, extent and component characteristics, signal intensities of solid portions on T2-weighted images, signal intensities of cystic portions on T1-weighted images and enhancement patterns of solid portions and cyst walls and complicated hydrocephaly or not. A flowchart for differential diagnosis for three tumors was constructed based on statistical analysis of the results. RESULTS: A snowman shape, solid characteristics and homogeneous enhancement of solid portion were more common in pituitary adenomas; a lobulated shape, third ventricle compression by superior tumor extension, mixed solid and cystic characteristics, reticular enhancement of solid portion, calcification on CT scan and complicated hydrocephalus were more common in craniopharyngioma; an ovoid shape, small tumor size, cystic characteristics and none or thin cyst wall enhancement were more common in Rathke cleft cysts. CONCLUSION: The above iconography characteristics are helpful in the differential diagnosis of three tumors involving both intrasellar and suprasellar regions.

[Characteristics of combining loss of heterozygosity of 1p/19q in glioma].

OBJECTIVES: To find possible factors correlated with combined loss of heterozygosity (LOH) of 1p and 19q. METHODS: The status of 1p and 19q of 138 glioma specimen from January 2009 to December 2009 was evaluated by Fluorescence in situ hybridization (FISH) method, and the frequencies of combining LOH of 1p/19q were compared between different pathologies, brain sub-regions, genders and ages. RESULTS: The frequencies of combined LOH of 1p and 19q of oligodendroglial (81.3%) and oligo astrocytic tumors (55.8%) were significantly higher than that of astrocytic tumor (22.2%) (P < 0.01), and the frequency of oligodendroglial tumor was significantly higher than that of oligo astrocytic tumor (P < 0.05). The frequency of combining LOH of 1p and 19q in frontal lobe (61.8%) was higher than that in temporal (31.8%) and insular lobes (34.6%) (P < 0.05). CONCLUSION: Combining LOH of 1p and 19q has significant correlation with the pathologies and brain sub-regions.

[Microsurgery for intracranial aneurysm, clinical analysis of 1,041 cases].

OBJECTIVE: To study the effect of microsurgery on incranial aneurysm and factors influential in prognosis. METHODS: A retrospective analysis was made on the clinical data of 1,041 patients, 505 males and 536 females, aged 44.2 +/- 12.6, with incranial aneurysm treated by microsurgery 1988 approximately 2001, including clipping of aneurysm (982 cases, 94.3%), isolating of the aneurysm (32 cases, 3.1%), and coating of the aneurysm (27 cases, 2.6%). RESULTS: 93 patients (8.9%) had multiple aneurysms. 357 aneurysms (31.2%) were in the posterior communicating artery, 261 (22.8%) in the anterior communicating artery, 210 (18.4%) in the internal carotid artery, 158 (13.8%) in the middle cerebral artery, 63 (5.5%) in the anterior cerebral artery, 59 (5.2%) in the vertebral-basilar artery, and 35 (3.1%) in the posterior cerebral artery. The overall operative mortality was 1.8%. Angiography performed post-operationally showed that the aneurysm was occluded in 978 patients (99.6%). The prognosis was related to the age of patient (P = 0.001), Hunt and Hess grading before operation (P = 0.001), diameter of aneurysm (P = 0.000), and whether the aneurysm ruptures during operation (P = 0.006), and was not related to the gender of patient (P = 0.059). CONCLUSION: Clipping of the aneurysm is considered the best treatment. Microinvasive neurosurgery has improved significantly the effect of treatment of intracranial aneurysm. Factors influencing prognosis after operation include the age of patient, Hunt and Hess grading before operation, diameter of aneurysm, and whether the aneurysm ruptures during operation.