MGMT甲基化对脑胶质瘤术后替莫唑胺敏感性影响

打开文本图片集

[中图分类号]R730.264;R345.51[文献标志码]A[文章编号]2096-5532（2025）04-0583-05

doi：10.11712/jms.2096-5532.2025.61.125

[Abstract]ObjectiveTo investigate the efectof O6-methylguanine-DNA methyltransferase（MGMT）methylationon the sensitivitytotemozolomide（TMZ）chemotherapyin patients with glioma aftersurgery.MethodsAtotalof 60patients with glioma who wereadmitedtoCangzhouCentralHospitalfromJanuarytoDecember2O22wereenrolldassubjects，andallpatients received microsurgery，followed byTMZchemotherapyaftersurgery.According tothe methylationstatusof MGMT，thepatients weredividedintopositivemethylationgroupwith3lpatientsandnegativemethylationgroupwith29patients，andaccordingtothe responsetochemotherapy，thepatients were divided intoresponse group with 38 patientsandno-response group with22patients. Thepositiveandnegativemethylationgroupswerecomparedintermsoftheresponsetochemotherapy，andunivariateand multivariatelogistic regresion analyses were used to investigate the influencing factors for sensitivityto TMZ chemotherapy. Results The positive methylation group had a significantly higher response rate than the negative methylation group （ 80.6% us 44.8% . （20 χ2=8.277，P<0.01） . There were no significant differences between the response group and the no-response group in sex，age， average course of disease， body massindex， tumor histological type，tumor location， and tumor diameter （ P>0.05 ），while there weresignificant diferencesbetweenthesetwogroupsinthepatternofsurgicalresection，clinicalstageof tumor，andthestatusof MGMT gene promoter methylation （ ⟨χ2=7.542-8.735，P<0.05） . The multivariate logistic regression analysis showed that subtotal resection and tumor stage II-N were independent influencing factors for the sensitivity to TMZ chemotherapy in glioma patients，while positive MGMT methylation was a protective factor （OR=0.651-4.602，95% （204号 CI=0.522-2.456 to 0.723-10.371 ， all P<0.05 ）.ConclusionGlioma patients with positive MGMT promoter methylation tend to havea higher response rate，and positivemethylationisaprotectivefactorforsensitivitytochemotherapy.ThestatusofMGMTmethylationmaybeanimportant indicator for assessing the prognosis of glioma patients.

[Key words]glioma;O（6）-methylguanine-DNA methyltrans-ferase； methylation； neurosurgical procedures； temozolomide;treatment outcome

脑胶质瘤在所有原发性中枢神经系统肿瘤中约占 30%[1] ，作为最常见的原发性中枢神经系统肿瘤，其具有高度的侵袭性和复发性，这对治疗造成巨大的挑战[2-4]。（剩余8657字）