• Asian Pacific Journal of Cancer Prevention
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• v.14 no.7
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• pp.4243-4247
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• 2013

The relationship between the X-ray repair cross-complementing group 3 (XRCC3) Thr241Met polymorphism and gliomas remains inclusive or controversial. For better understanding of the effect of XRCC3 Thr241Met polymorphism on glioma risk, a meta-analysis was performed. All eligible studies were identified through a search of PubMed, Elsevier Science Direct, Excerpta Medica Database (Embase) and Chinese Biomedical Literature Database (CBM) before May 2013. The association between the XRCC3 Thr241Met polymorphism and gliomas risk was conducted by odds ratios (ORs) and 95% confidence intervals (95% CIs). A total of nine case-control studies including 3,533 cases and 4,696 controls were eventually collected. Overall, we found that XRCC3 Thr241Met polymorphism was significantly associated with the risk of gliomas (T vs. C: OR=1.10, 95%CI=1.01-1.20, P=0.034; TT vs. CC: OR=1.30, 95%CI=1.03-1.65, P=0.027; TT vs. TC/CC: OR=1.29, 95%CI=1.01-1.64, P=0.039). In the subgroup analysis based on ethnicity, the significant association was found in Asian under four models (T vs. C: OR=1.17, 95%CI=1.07-1.28, P=0.00; TT vs. CC: OR=1.79, 95%CI=1.36-2.36, P=0.00; TT vs. TC/CC: OR=1.75, 95%CI=1.32-2.32, P=0.00; TT/TC vs. CC: OR=1.11,95% CI=1.02-1.20). This meta-analysis suggested that the XRCC3 Thr241Met polymorphism is a risk factor for gliomas, especially for Asians. Considering the limited sample size and ethnicities included in the meta-analysis, further large scale and well-designed studies are needed to confirm our results.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.11
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• pp.5857-5863
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• 2012

Introduction: Mobile phones are in extensive use worldwide and concerns regarding their role in tumor formation were raised. Over the years multiple studies were published in order to investigate this issue using several approaches. The current study looks at secular trends of brain gliomas (low and high grade) incidence and changes in tumor's laterality over 30 years in a population extensively using this technology with a possible correlation to the spread of use of mobile phones. Materials and Methods: All brain gliomas that were diagnosed from 1980-2009 were included and subdivided into two groups - low and high grade. Secular and periodic time trend analyses of incidence rates and changes in laterality were performed. Preferred side of head using mobile phones was assessed with a questionnaire in a sample of adult individuals. Results: A decrease in incidence of low grade giomas (LGG) that correlated with introduction of mobile technology was found from 2.57, 2.34 and 2.79 for every 100,000 in the period 1980 to the end of 1994 to 1.72, 1.82 and 1.57, respectively, over the last three 5-years periods (1995-2009). High-grade glioma incidences increased significantly from 1980-2009 but in the period after mobile phones were introduced (1994-2009) a lower, non significant, rate of increase was observed in males and a lower one (significant) in females. A shift towards left sided tumor location for all adult gliomas combined and separately for LGG and HGG was noted from 1995 onward. The shift was more marked for those who were diagnosed in ages 20-49 (p=0.03). Conclusions: We found a statistically significant decrease in LGG's over 30-years period that correlates with introducing of mobile phones technology and a shift in laterality towards left-sided tumors, the latter occurred in both low and high-grade gliomas.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.24
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• pp.10621-10625
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• 2015

Background: Increasing evidence has indicated that high Forkhead box protein C2 (FOXC2) level is closely associated with the development, progression, and poor prognosis of a variety of tumors. However, the relationship between FOXC2 and the progression of human gliomas remains to be clarified. The aim of present study was to assess FOXC2 expression and to explore its contribution in human gliomas. Materials and Methods: Realtime quantitative PCR was performed to examine FOXC2 expression in 85 pairs of fresh frozen glioma tissues and corresponding non-neoplastic brain tissues. Associations of FOXC2 expression with clinicopathological factors and prognosis of glioma patients were statistically analyzed. Results: The relative mRNA expression of FOXC2 was significantly higher in glioma tissues than the corresponding non-neoplastic brain tissues (p<0.001). In addition, high FOXC2 expression was significantly associated with advanced pathological grade (P=0.005) and the low Karnofsky performance score (KPS) (p=0.003), correlating with poor survival (p<0.001). Furthermore, multivariate Cox regression analysis showed that high FOXC2 expression was an independent predictor of overall survival (p=0.006). Conclusions: FOXC2 may act as an oncogenic gene and represent a potential regulator of aggressive development and a candidate prognostic marker in human gliomas.

• Journal of Korean Neurosurgical Society
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• v.30 no.7
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• pp.855-860
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• 2001

Introduction : It has been reported that the survival of low-grade glioma patients depends upon the time of malignant transformation. The authors presents the clinical analysis of histologically proven trasformed gliomas. Materials and Method : A total 92 patients who were consecutively treated and histologically confirmed hemispheric low-grade gliomas between 1980 and 1998 were analyzed and followed. All cases meet the criteria of WHO glioma classification of grade II. Results : The mean follow-up period was 73 months. Twenty two among 92 cases(24%) were histologically proven to be transformed into malignant ones. The mean time to transformation was 56 months. The 5-year and 10-year survival rates of the transformed group were 66% and 30% respectively and significantly different from the survival rates of the non-transformed group(p=0.0018). Among clinical factors at presentation, the initial tumor volume had a tendency to be larger in the transformed group than that of the non-transformed group and became significant when it was divided into more than $30cm^3$ or not(p=0.02). Among therapeutic factors, the extent of removal had no influence on the rate of malignant transformation. But postoperative radiation therapy were more frequently given to the pre-transformed group than the non-transformed group and the frequency was significantly different(p=0.02). Conclusions : The authors had found that the initial tumor volume and radiation therapy could be clinical prognostic factors for the malignant transformation of low-grade gliomas.

• Journal of Korean Neurosurgical Society
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• v.66 no.4
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• pp.465-475
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• 2023

Objective : Our objective is to analyze the occurrence, clinical course and risk factors for glioma patients with leptomeningeal metastasis (LM) according to different metastasis patterns and clinical variables. Methods : We retrospectively reviewed data from 376 World Health Organization (WHO) grade II-IV adult glioma patients who were treated in the National Cancer Center from 2001 to 2020. Patients who underwent surgery at other institutions, those without initial images or those with pathologically unconfirmed cases were excluded. LM was diagnosed based on magnetic resonance imaging (MRI) findings or cerebrospinal fluid (CSF) cytology. The metastasis pattern was categorized as nodular or linear according to the enhancement pattern. Tumor proximity to the CSF space was classified as involved or separated, whereas location of the tumor was dichotomized as midline, for tumors residing in the thalamus, basal ganglia and brainstem, or lateral, for tumors residing in the cerebral and cerebellar hemispheres. Results : A total of 138 patients were enrolled in the study. A total of 44 patients (38%) were diagnosed with LM during a median follow-up of 9 months (range, 0-60). Among the clinical variables, tumor proximity to CSF space, the location of the tumor and the WHO grade were significant factors for LM development in univariate analysis. In multivariate analysis, the midline location of the tumor and WHO grade IV gliomas were the most significant factor for LM development. The hazard ratio was 2.624 for midline located gliomas (95% confidence interval [CI], 1.384-4.974; p=0.003) and 3.008 for WHO grade IV gliomas (95% CI, 1.379-6.561; p=0.006). Conclusion : Midline location and histological grading are an important factor for LM in glioma patients. The proximity to the CSF circulation pathway is also an important factor for WHO grade IV glioma LM. Patients carrying high risks should be followed up more thoroughly.

• Proceedings of the Korean Society of Medical Physics Conference
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• 2003.09a
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• pp.76-76
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• 2003

Purpose: To assess clinical proton MR spectroscopy (MRS) as a noninvasive method for evaluating tumor malignancy at 3T high field system. Methods: Using 3T MRI/MRS system, localized water-suppressed single-voxel technique in patients with brain tumors was employed to evaluate spectra with peaks of N-acetyl aspartate (NAA), choline-containing compounds (Cho), creatine/phosphocreatine (Cr) and lactate. On the basis of Cr, these peak areas were quantificated as a relative ratio. Results: The variation of metabolites measurements of the designated region in 10 normal volunteers was less than 10%. Normal ranges of NAA/Cr and Cho/Cr ratios were 1.67$\pm$018 and 1.16:1:0.15, respectively. NAA/Cr ratio of all tumor tissues was significantly lower than that of the normal tissues (P=0.005). Cho/Cr ratio of high-grade gliomas was significantly higher than that of low-grade gliomas (P= 0.001), Except 4 menigiomas, lactate signal was observed in all tumor cases. Conclusions: The present study demonstrated that the neuronal degradation or loss was observed in all tumor tissues. Higher grade of brain tumors was correlated with higher Cho/Cr ratio, indicating a significant dependence of Cho levels on malignancy of gliomas. This results suggest that clinical proton MR spectroscopy could be useful to predict tumor malignancy. Acknowledgement: This study was supported by a grant of the Mid and Long Term Nuclear R/D Plan Program, Ministry of Science and Technology, Republic of Korea.

• Journal of Korean Neurosurgical Society
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• v.66 no.3
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• pp.308-315
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• 2023

Recent updates in genomic-integrated glioma classification have caused confusion in current clinical practice, as management protocols and health insurance systems are based on evidence from previous diagnostic classifications. The Korean Brain Tumor Society conducted an electronic questionnaire for society members, asking for their ideas on risk group categorization and preferred treatment for each individual diagnosis listed in the new World Health Organization (WHO) classification of gliomas. Additionally, the current off-label drug use (OLDU) protocols for glioma management approved by the Health Insurance Review and Assessment Service (HIRA) in Korea were investigated. A total of 24 responses were collected from 20 major institutes in Korea. A consensus was reached on the dichotomic definition of risk groups for glioma prognosis, using age, performance status, and extent of resection. In selecting management protocols, there was general consistency in decisions according to the WHO grade and the risk group, regardless of the individual diagnosis. As of December 2022, there were 22 OLDU protocols available for the management of gliomas in Korea. The consensus and available options described in this report will be temporarily helpful until there is an accumulation of evidence for effective management under the new classification system for gliomas.

• Investigative Magnetic Resonance Imaging
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• v.1 no.1
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• pp.86-93
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• 1997

Purpose: To assess the ability of in vivo H-1 MRS to determine the degree of malignancy and to characterize the histopathologic type of intracranial solid tumors. Materials and Methods: In vivo H-1 MR spectra of the pathologically-proven 81 intracranial soild tumors (low-grade glioma 17 cases, high-grade glioma 31 cases, lymphoma 9 cases, meningioma 8 cases, central neurocytoma 4 cases, medulloblastoma 3 cases, PNET 3 cases, metastasis 2 cases, others 4 cases) were analyzed. H-1 MR spectroscopy was performed on a 1.5T MR unit using PRESS sequence with a TR of 2000ms, a TE of 270 or 135ms and a voxel size of $2{\times}2{\times}2cm^3$ for all spectra. N-acetyl aspartate (NAA)/Creatine complex(Cr), Choline complex (Cho)/Cr, and lactate (Lac)/Cr ratios were measured on the peak heights of each resonance and compared among the different tumors. Results: All intracranial solid tumors demonstrated decreased NAA, elevated Cho and lactate, and variable Cr levels. All tumors showed increased Cho/Cr and Lac/Cr, whereas NAA/Cr level was decreased. Mean Cho/Cr and Lac/Cr ratios were significantly higher in high-grade gliomas than in low-grade gliomas. However, NAA/Cr ratio showed no significant difference between low-grade and high-grade gliomas. Very high Cho peaks were seen in lymphomas, meningiomas, medulloblastomas, and neurocytomas in addition to high-grade gliomas. Conclusion: H-1 MRS may be useful in differentiating between low-grade and high-grade gliomas, however cannot characterize the histologic types or subtypes of tumors.

• Journal of radiological science and technology
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• v.32 no.4
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• pp.461-469
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• 2009

To predict the tumor grading, various imaging modalities have been applied clinically. This study determines clinical usefulness of perfusion MRI, using relative cerebral blood volume in grading of the gliomas. We did a retrospective review of 17 patients (mean age, 57.5 years; 11 male, 6 female) who underwent perfusion MR and conventional MRI, and then correlated pathologically after operation. Statistical analysis of regional cerebral blood volume and relative cerebral blood volume(rCBV) was performed by using softwares such as PAT by SIEMENS and Xmap ver 2.0 developed by ourselves. Six patients out of 13 were low-grade gliomas while eleven patients were the high-grade gliomas. Mean relative CBV (m_rCBV/white matter) in the low-grade gliomas was 1.62, and mean relative CBV(m_rCBV/cortex) was 0.12. In the high-grade gliomas, mean relative CBV(m_rCBV/white matter) and mean relative CBV(m_rCBV/cortex) were 33.53 and 0.96. Mean relative CBV of gliomas were elevated with a statistical difference(P<.05), compared with contralateral white matter(P=.019) or cortex(P=.025). Furthermore mean relative CBV(m_rCBV/white matter) was much higher than mean relative CBV(m_rCBV/cortex). Perfusion MRI using regional cerebral blood volume and rCBV is very useful imaging modality for grading the glioma.

• Journal of Korean Neurosurgical Society
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• v.61 no.3
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• pp.319-332
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• 2018

Germline mutations in cancer causing genes result in high risk of developing cancer throughout life. These cancer predisposition syndromes (CPS) are especially prevalent in childhood brain tumors and impact both the patient's and other family members' survival. Knowledge of specific CPS may alter the management of the cancer, offer novel targeted therapies which may improve survival for these patients, and enables early detection of other malignancies. This review focuses on the role of CPS in pediatric high grade gliomas (PHGG), the deadliest group of childhood brain tumors. Genetic aspects and clinical features are depicted, allowing clinicians to identify and diagnose these syndromes. Challenges in the management of PHGG in the context of each CPS and the promise of innovative options of treatment and surveillance guidelines are discussed with the hope of improving outcome for individuals with these devastating syndromes.