MYCN amplification defines an aggressive phenotype in IDH ‐mutant gliomas

作者：Xujun Xie, Yan Qin, Fang Wang, Jiabin Lu, Yuandong Zhang, Shaoyan Xi · 发表于：The Journal of Pathology Clinical Research · 年份：2025 · DOI：10.1002/2056-4538.70045 · 被引用次数：2 · 研究领域：Glioma Diagnosis and Treatment、Neuroblastoma Research and Treatments、Cancer, Hypoxia, and Metabolism

In alignment with the latest WHO classification system, which underscores the integration of molecular alterations in glioma diagnosis and grading, this study investigates the prognostic significance of MYCN amplification in IDH-mutant gliomas, a relationship that remains poorly characterized despite its established association with adverse outcomes in various malignancies. A cohort of 190 patients with IDH-mutant gliomas was analyzed for clinical and pathological characteristics. MYCN amplification status was determined using fluorescence in situ hybridization (FISH) with an MYCN-specific probe. Survival outcomes were assessed via Kaplan-Meier analysis, while independent prognostic factors were identified through multivariable Cox proportional hazards regression models. Tumor morphology was systematically evaluated in cases with MYCN amplification. MYCN amplification was identified in 28 of 190 cases (14.7%), demonstrating a significant correlation with advanced tumor grade and elevated Ki-67 proliferation indices (p < 0.05). Patients harboring MYCN amplification exhibited markedly reduced overall survival compared to non-amplified cases (112.13 ± 6.58 versus 91.14 ± 14.96 months, p = 0.001), with this association being particularly pronounced in lower-grade (WHO grades 2 and 3) IDH-mutant gliomas (122.12 ± 6.81 versus 47.76 ± 6.58 months, p < 0.001). To address limitations in current grading systems, we propose a refined classification approach that upgrades lower-grade IDH...