Establishment of age group classification for risk stratification in glioma patients

Abstract

Background: Age is associated with the prognosis of glioma patients, but there is no uniform standard of agegroup classification to evaluate the prognosis of glioma patients. In this study, we aimed to establish an age group classification for risk stratification in glioma patients. Methods: 1502 patients diagnosed with gliomas at Nanfang Hospital between 2000 and 2018 were enrolled. The WHO grade of glioma was used as a dependent variable to evaluate the effect of age on risk stratification. The evaluation model was established by logistic regression, and the Akaike information criterion (AIC) value of the model was used to determine the optimal cutoff points for age-classification. The differences in gender, WHO grade, pathological subtype, tumor cell differentiation, tumor size, tumor location, and molecular markers between different age groups were analyzed. The molecular markers included GFAP, EMA, MGMT, P53, NeuN, Oligo2, EGFR, VEGF, IDH1, Ki-67, PR, CD3, H3K27M, TS, and 1p/19q status. Results: The proportion of men with glioma was higher than that of women with glioma (58.3% vs 41.7%). Analysis of age showed that appropriate classifications of age group were 0-14 years old (pediatric group), 15-47 years old (youth group), 48-63 years old (middle-aged group), and ≥ 64 years old (elderly group).The proportions of glioblastoma and large tumor size (4-6 cm) increased with age (p = 0.000, p = 0.018, respectively). Analysis of the pathological molecular markers across the four age groups showed that the proportion of patients with larger than 10% area of Ki-67 expression or positive PR expression increased with age (p = 0.000, p = 0.017, respectively). Conclusions: Appropriate classifications of the age group for risk stratification are 0-14 years old (pediatric group), 15-47 years old (young group), 48-63 years old (middle age group) and ≥ 64 years old (elderly group). This age group classification is effective in evaluating the risk of glioblastoma in glioma patients.

Current Status and Quality of Machine Learning-Based Radiomics Studies for Glioma Grading: A Systematic Review

“…WHO grade 1 and 2 gliomas are considered low- grade gliomas (LGG), while grades 3 and 4 are classified as high-grade gliomas (HGG). Glioblastoma multiforme (GBM, WHO grade 4) is the most aggressive type of glioma with poor prognosis and median survival of about 15 months, even after multimodal therapy [2]. However, this classification has been modified in the most recent WHO classification.…”

Genomic profiling of cancerous patients identifies FPR2 as an alternative immunotherapeutic target in glioblastoma multiforme

“…Formyl peptide receptor 2 (FPR2) is classified as the formyl peptide receptor (FPR) family subordinated to the GPCR superfamily. FPR2 as well as FPR1 participate in multiple intracellular signaling pathways ranging from activation of various protein kinases and phosphatase to tyrosine kinase receptors transactivation [16, 17, 21, 23]. The significance of these crucial cellular pathways within cells also suggested that any dysfunction of the activated pathways could lead to disorder within the body [47].…”

Advances in Research of Adult Gliomas

“…Of all adult primary brain tumours, glioblastoma (median age of 46.3 years at diagnosis [ 3 ]) is the most common (56.6%) and most aggressive for which there is no curative treatment [ 4 ]. Recent evidence suggests that there has been a significant increase in the incidence of glioblastoma from 1995 to 2015 more than doubling from 2.4 to 5.0 per 100,000 in the UK, whereas the rest of gliomas remained stable [ 5 ].…”

“…Glioblastoma may develop rapidly without evidence of a less malignant precursor lesion (primary glioblastoma or ‘de novo’ glioblastoma), or through progression from a lower grade tumour (secondary glioblastoma). Low grade gliomas (astrocytoma, and oligodendrogliomas grade II) normally affect young adults (median age at diagnosis is 35 years for grade II astrocytoma and 34.8 years for grade II oligodendrogliomas [ 3 ]) with a survival average of approximately 7 years for patients affected by astrocytomas and more than 15 years for those who have developed oligodendrogliomas [ 9 ]. Although low grade glioma patients have better survival rates compared to patients with high grade glioma, all low grade gliomas are invasive and eventually progress to high grade glioma (grade III/IV) leading to death [ 9 ].…”