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Published on: September 18, 2020
Prognostic value of H3K27me3 in children with ependymoma
Zhe Han1, Peng Kang1, Heng Zhang1
1Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Insights
Low H3K27me3 expression predicts poor prognosis in pediatric infratentorial ependymoma. High expression may indicate a better prognosis for spinal ependymoma in children.
Area of Science:
- Pediatric neuro-oncology
- Epigenetics in brain tumors
Background:
- Ependymoma is a common pediatric brain tumor.
- Histone modifications, such as H3K27me3, play a role in tumor development.
- Understanding the prognostic value of H3K27me3 is crucial for treatment stratification.
Purpose of the Study:
- To investigate the expression of H3K27me3 in pediatric ependymoma across different anatomical locations.
- To analyze the prognostic significance of H3K27me3 expression for patient outcomes.
Main Methods:
- Retrospective analysis of 188 pediatric ependymoma cases.
- Immunohistochemistry to assess H3K27me3 expression.
- Kaplan-Meier and Cox regression analyses for survival correlation.
Main Results:
- H3K27me3 expression significantly impacted progression-free survival and overall survival in infratentorial ependymoma.
- Low H3K27me3 expression was associated with poor prognosis in infratentorial ependymoma.
- High H3K27me3 expression in spinal ependymoma suggested a better prognosis.
Conclusions:
- H3K27me3 expression is a valuable prognostic marker in pediatric ependymoma, particularly for infratentorial and spinal subtypes.
- Low H3K27me3 expression indicates a poorer prognosis for infratentorial ependymoma.
- High H3K27me3 expression may predict a better prognosis for spinal ependymoma.
Objective:
To investigate the expression of H3K27me3 in different anatomical sites and analyze its prognostic value in children with ependymoma.
Methods:
A total of 188 children diagnosed with ependymoma were admitted to the Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, between 2012 and 2017, and regular follow-up was conducted. Expression of H3K27me3 was analyzed by immunohistochemistry and scored semiquantitatively. The prognostic correlation was analyzed by Kaplan-Meier and Cox regression survival analyses.
Results:
Of the 188 children with ependymoma, 61.7% were male, and the median and average age was five years (0-17 years) and 6.26 years, respectively. There were 65 cases of supratentorial ependymoma, 115 cases of infratentorial ependymoma, and 8 cases of spinal cord ependymoma. The median follow-up time was 39.95 months (0.3-90.19 months). Five-year progression-free survival (PFS) and overall survival (OS) were 48.5% and 61.4%, respectively. Kaplan-Meier univariate survival analysis showed that H3K27me3 expression had significant effects on PFS (P = 0.0003) and OS (P < 0.0001) in infratentorial ependymoma, but only affected OS (P = 0.03) in supratentorial ependymoma.
Conclusion:
In Chinese children, infratentorial ependymoma with incomplete resection and no adjuvant radiotherapy is associated with poor OS. On the other hand, low expression of H3K27me3 indicates poor prognosis of infratentorial ependymoma, but it has no significant prognostic value for supratentorial ependymoma. In addition, high expression of H3K27me3 in spinal ependymoma may indicate a better prognosis.
