Correlation Between IDH1 Mutation and Prognosis in Supratentorial High-grade Astrocytomas

Objective To study the correlation between isoeitratedehydrogenasel 1 (IDH1) mutation and prognosis in supratentorial high-grade astrocytomas. Methods There were 217 samples of supratentorial high-grade astrocytomas specimens collected for DNA extraction, IDH1 mutation of each patient was determined by PCR and direct sequencing. The differences of clinical features were compared between mutant group and wild type group. The relationship between IDH1 mutation and overall survival of the patients was studied with Kaplan-Meier survival curve, while multiple factors analysis was carried out by COX regression model. Results There were 43 (19.3%) IDH1 mutations in 217 specimens, of which 9 (24.3%) in WHO grade Ⅲ, 34 (18.9%) in WHO grade Ⅳ. The mean age of primary glioblastoma multiforme (GBM) in mutant type group and wild type group were 39.17 and 47.66 years old respectively (P<0.05). The median survival time was 64 weeks for the patients in IDH1 mutation group and 50 weeks for those in wild type group, and the difference was statistically significant (P<0.001). The median survival time was 51 weeks for the wild type group of WHO grade Ⅲ cases and 58 weeks for the mutant group of WHO grade Ⅳ cases (P<0.001). COX multiple variable analysis showed that IDH1 mutation, surgical resection, preoperative Karnofsky performance, radiotherapy and chemotherapy were statistically significant in prognosis (P<0.05). Conclusion IDH1 mutation can be found in supratentorial high-grade astrocytomas, the patients with IDH1 mutation may have a better prognosis.