The Chinese Glioma Cooperative Group (CGCG) Guideline Panel for adult diffuse gliomas provided recommendations for diagnostic and therapeutic procedures. The Panel covered all fields of expertise in neuro-oncology, i.e. neurosurgeons, neurologists, neuropathologists, neuroradiologists, radiation and medical oncologists and clinical trial experts. The task made clearer and more transparent choices about outcomes considered most relevant through searching the references considered most relevant and evaluating their value. The scientific evidence of papers collected from the literature was evaluated and graded based on the Oxford Centre for Evidence-based Medicine Levels of Evidence and recommendations were given accordingly. The recommendations will provide a framework and assurance for the strategy of diagnostic and therapeutic measures to reduce complications from unnecessary treatment and cost. The guideline should serve as an application for all professionals involved in the management of patients with adult diffuse glioma and also as a source of knowledge for insurance companies and other institutions involved in the cost regulation of cancer care in China.

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Gliomas are the most common type of malignant brain tumors, and the related prognosis is poor. Though many genes have been identified as factors in the development and progression of gliomas, underlying mechanisms remained unclear. It was clear that abnormal lipid metabolism was one of the major hallmarks of cancers. However, few factors associated with lipid metabolism have been reported to be involved in cancer pathogenesis. Hydroxysteroid dehydrogenase-like 2 (HSDL2) is a protein containing sterol carrier protein 2 (SCP2) domain localized in peroxisomes, which indicated that HSDL2 might be a fatty acid regulatory factor. Here, we revealed that HSDL2 was significantly upregulated in gliomas and its expression was positively correlated with glioma grades. Furthermore, lentiviral-mediated HSDL2 knockdown showed that HSDL2 downregulation inhibited the proliferation in two human glioblastoma cell lines U-251 cells and U87 MG cells, induced cell cycle arrest, and promoted cell apoptosis. Our study provided multiple lines of evidence for the causal relationship between HSDL2 overexpression and glioma progression and provided possible mechanisms underlying HSDL2-mediated glioma growth. Taken together, these results indicated that HSDL2 might serve as a potential target for glioma treatment in the future.

Long non-coding RNAs (lncRNAs) have been recently shown to be dysregulated and closely related to several cancers. Here, we aimed to elucidate the function and the possible molecular mechanisms of lncRNA Metastasis-associated lung Adenocarcinoma transcript-1 (MALAT1) in human glioma. Quantitative real-time PCR (qRT-PCR) was used to detect the expressions of MALAT1, miR-101 and Rap1B mRNA in U251 and U87 cells. The protein level of Rap1B was examined by western blot assays. Moreover, the proliferation and apoptosis of U251 and U87 cells were determined by CCK-8 assay and flow cytometry analysis, respectively. Additionally, the targets of miR-101 were identified by target prediction and luciferase reporter assays. The results demonstrated that MALAT1 and Rap1B were upregulated, while miR-101 expression was downregulated in glioma cell lines U251 and U87. MALAT1 and Rap1B knockdown could inhibit proliferation and induce apoptosis of glioma cells. Moreover, MALAT1 promoted the Rap1B expression by sponging miR-101 in U251 and U87 cells. Furthermore, miR-101 downregulation or Rap1B overexpression reversed the proliferation inhibitory and apoptosis induction of glioma cell lines caused by MALAT1 knockdown. Taken together, MALAT1 promotes proliferation and suppresses apoptosis of glioma cells through derepressing Rap1B by sponging miR-101. The present study elucidates a novel MALAT1-miR-101-Rap1B regulatory axis in glioma, contributing to a better understanding of the glioma pathogenesis and providing a promising therapeutic target for glioma patients.

A multifunctional drug delivery system with polypyrrole confined in dendrimer-like silica nanoparticles and DOX loading for chemo-photothermal synergistic therapy of cancer.

The prediction of clinical outcome for patients with infiltrative gliomas is challenging. Although preoperative hematological markers have been proposed as predictors of survival in glioma and other cancers, systematic investigations that combine these data with other relevant clinical variables are needed to improve prognostic accuracy and patient outcomes. We investigated the prognostic value of preoperative hematological markers, alone and in combination with molecular pathology, for the survival of 592 patients with Grade II-IV diffuse gliomas. On univariate analysis, increased neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR), and decreased albumin-to-globulin ratio (AGR), all predicted poor prognosis in Grade II/III gliomas. Multivariate analysis incorporating tumor status based on the presence of IDH mutations, TERT promoter mutations, and 1p/19q codeletion showed that in lower-grade gliomas, high NLR predicted poorer survival for the triple-negative, IDH mutation only, TERT mutation only, and IDH and TERT mutation groups. NLR was an independent prognostic factor in Grade IV glioma. We therefore propose a prognostic model for diffuse gliomas based on the presence of IDH and TERT promoter mutations, 1p/19q codeletion, and NLR. This model classifies lower-grade gliomas into nine subgroups that can be combined into four main risk groups based on survival projections.

OBJECTIVEChordoma shows poor patient prognosis because of its high recurrence rate. Even though many clinical factors and biomarkers are reported to be associated with prognosis, no prediction model has been applied clinically. Thus, the authors aim to derive and validate a prognostic nomogram to predict progression-free survival (PFS) of chordoma.METHODSA total of 201 patients were randomly divided into a derivation group (151 cases) and a validation group (50 cases). The expression levels of biomarkers were quantified using tissue microarray analysis. A nomogram was established via univariate and multivariate Cox regression analysis in the derivation group. The predictive performance of the nomogram was then tested in the validation group.RESULTSThe mean follow-up interval was 57 months (range 26–107 months). One clinical factor and 3 biomarkers were confirmed to be associated with PFS, including degree of resection, E-cadherin, Ki-67, and VEGFA. The nomogram with these prognostic factors had areas under the receiver operating characteristic curve of 0.87 and 0.95 in the derivation group at 3 years and 5 years, respectively, compared with 0.87 and 0.84 in the validation group. Calibration and score-stratified survival curve were good in the derivation group and validation group, respectively.CONCLUSIONSThe established nomogram performs well for predicting the PFS of chordoma and for risk stratification, which could facilitate prognostic evaluation and follow-up.

Complete spontaneous thrombosis followed by recanalization of non-giant aneurysms is a rare event that can be discovered incidentally on advanced neural images. In this case report, the authors described a woman who presented with subarachnoid hemorrhage (SAH) and left posterior cerebral artery (PCA) territory ischemic stroke. Cerebral angiography revealed a left PCA aneurysm at the P1-P2 junction. The patient received conservative treatment and repeated cerebral angiography 4 weeks later demonstrated the disappeared aneurysm. Subsequent magnetic resonance imaging (MRI) and contrast-enhanced computed tomography (CT) demonstrated the totally thrombosed aneurysm with hydrocephalus. Ventriculo-peritoneal shunt surgery for hydrocephalus was performed and the patient noted a great improvement of the neurological deficit. Follow-up contrast-enhanced CT after 10 weeks revealed recurrence of the aneurysm. This case provides insight into the natural dynamic process of intracranial aneurysm, and a complete thrombosed aneurysm has the potential for recanalization. KEywoRds: Intracranial aneurysm, Subarachnoid hemorrhage, Spontaneous thrombosis, Recanalization ÖZDev olmayan anevrizmalarda rekanalizasyonla birlikte tam spontan tromboz nadirdir ve gelişmiş nöral görüntülerde tesadüfen bulunabilir. Bu olgu raporunda yazarlar subaraknoid kanama (SAK) ve sol posterior serebral arter (PSA) bölgesinde iskemik inmeyle gelen bir hastayı sunmaktadır. Serebral anjiyografi P1-P2 bileşkesinde bir sol PSA anevrizması göstermiştir. Hastaya konservatif tedavi verilmiş ve 4 hafta sonra tekrarlanan serebral anjiyografi anevrizmanın kaybolduğunu ortaya koymuştur. Daha sonraki manyetik rezonans görüntüleme (MRG) ve kontrastlı bilgisayarlı tomografi (BT) total tromboze olmuş anevrizma ve hidrosefali göstermiştir. Hidrosefali için ventriküloperitoneal şant cerrahisi yapılmış ve hastanın nörolojik defisinde büyük bir düzelme görmüştür. 10 hafta sonra takip kontrastlı BT anevrizmanın tekrarladığını göstermiştir. Bu olgu bir intrakraniyal anevrizmanın doğal dinamik süreci konusunda bilgi sağlamaktadır ve tam trombozlu bir anevrizmada rekanalizasyon potansiyeli mevcuttur.