ABSTRACT
Objective@#To investigate the prognostic impact of alterations of epidermal growth factor receptor(EGFR) and MGMT in glioblastoma.@*Methods@#The retrospective study included 161 supratentorial glioblastomas diagnosed in the Department of Pathology, Xuanwu Hospital, Capital Medical University from 2009 to 2015. EGFR and EGFRvⅢ protein expression was detected by immunohistochemistry; EGFR amplification was detected by fluorescence in situ hybridization; MGMT promoter methylation was detected by pyrosequencing. The change of molecular genetics EGFR and MGMT and outcome were assessed statistically.@*Results@#There were 161 patients, including 85 (52.8%) males and 76 (47.2%) females. The mean age was 53 years, and the median overall survival was 13 months. The integrated classification of glioblastoma included 16 IDH-mutant, 134 wild type, and 11 NOS. The rate of overexpression of EGFR protein was 32.9%(53/161), and that of EGFR amplification was 37.5%(18/48). There was high concordance between immunohistochemistry and FISH(85.4%, Kappa=0.475, P<0.01) and between the level of EGFR protein and EGFR amplification (P<0.01). Twelve cases showed EGFRvⅢ expression, and all also showed EGFR protein overexpression; 149 cases were EGFRv Ⅲ wild type, and EGFR protein overexpression was seen in 27.5%(41/149) of cases. There was no correlation between EGFR and EGFRv Ⅲ expression. Of all cases, 70.2%(106/151) showed MGMT promoter methylation by pyrosequencing. The changes of molecular genetics of EGFR and MGMT were not related. EGFR amplification and protein overexpression had no significant relationship with prognosis. Patients with EGFRv Ⅲ-mutant had shorter survival time than the EGFRv Ⅲ-wild type(P=0.014); patients with MGMT promoter methylation had better prognosis than without (PFS:P=0.002,OS:P=0.006),and MGMT promoter methylation was an independent predictor for overall survival (HR=0.269, 95%CI 0.124-0.583, P=0.001).@*Conclusions@#EGFR protein expression by immunohistochemistry correlates with the status of EGFR amplification. Patients with EGFRv Ⅲ-mutant tumors have poorer prognosis than that with EGFRv Ⅲ-wild type tumors. MGMT promoter methylation is closely associated with prognosis and an independent predictor for overall survival.
ABSTRACT
OBJECTIVE:To evaluate the economic effect of 3 therapeutic regimens in the treatment of skin allergy. METH-ODS:54 patients with skin allergy in our hospital were randomly divided into A,B,C groups. They were given calcium+Vc+Ma-lay bolt chlorpheniramine (Puermin),calcium+Vc+Loratadine tablets (Kairuitan),calcium+Vc+Cetirizine hydrochloride tablets (Xikewei),respectively. Short-term efficacy was observed,and analyzed with the minimum cost analysis. RESULTS:Effective rates of A,B,C groups were 94.44%,88.89% and 94.44%,respectively,there was no statistical significance (P>0.05);the cure rates of 3 groups were 55.56%,38.89% and 83.33%,there was statistical significance(P<0.05). The cost were 169.70 yu-an,195.70 yuan and 180.40 yuan,respectively. The cost of group A was the lowest. CONCLUSIONS:The regimens of A group is economical,but that of group C the best after comprehensive comparison.