Objective: To explore the prognostic impact of 2016 World Health Organization (WHO) classification of central nervous system (CNS) tumors on patients with low grade gliomas (LGG). Methods: A total of 482 patients diagnosed with LGG in Beijing Tiantan Hospital affiliated to Capital Medical University from January 2009 to May 2016 were pathologically reclassified and retrospectively reviewed. In the survival analysis, Kaplan-Meier Plot was used to univariate analysis and Cox proportional hazards model was used to multivariate analysis. Results: According to the 2016 WHO CNS criterion, a total of 232 LGG were reclassified as O 1p/19q-deleted and IDH-mutant, 134 as A IDH-mutant and 116 as A IDH-wildtype. Univariate analysis showed that 2016 WHO CNS divided LGG into three subgroups with distinct survival (P<0.001). Multivariate analysis showed that both 2007 WHO CNS and 2016 WHO CNS were independent prognostic factors, but the Hazard ratio (HR) of 2016 WHO CNS was significantly higher than that of 2007 WHO CNS (P<0.01). Conclusions: 2016 WHO CNS classification criteria can divide LGG into three subgroups with significantly distinct survival, which has further improved the clinical prognostic value of it and fully reflected its advantages in predicting prognosis.
目的： 探讨2016世界卫生组织(WHO)中枢神经系统(CNS)肿瘤分类标准在低级别胶质瘤(LGG)中的预后意义。 方法： 针对2009年1月至2016年5月首都医科大学附属北京天坛医院神经外科四病区收治的482例LGG重新进行病理学分类和回顾性分析。生存分析中单因素采用Kaplan－Meier法，多因素采用Cox比例风险模型。 结果： 参照2016 WHO CNS肿瘤分类标准，共有232例LGG重新诊断为O 1p/19q缺失及IDH突变型、134例诊断为A IDH突变型、116例诊断为A IDH野生型。单因素分析显示，2016 WHO CNS可以将LGG分为3个生存期显著不同的亚组(P<0.001)；多因素分析显示，2007 WHO CNS和2016 WHO CNS均为独立预后因子，但2016 WHO CNS的风险比(HR)显著高于2007 WHO CNS(P<0.01)。 结论： 2016 WHO CNS肿瘤分类标准可以将低级别胶质瘤分为3个预后差别显著的亚组，进一步提高了其临床预后判断价值，充分体现了其在预后判断方面的优势。.
Keywords: Classification; Glioma; Pathology; Prognosis.