Significance of Notch1 Gene Expression in Patients with Astrocytic Glioma Tumors

Introduction: Glioma, a prevalent primary brain malignancy, involves multiple signaling pathways crucial for its progression. This study aimed to investigate the clinical significance of Notch1 in patients with glioma, particularly the most common, Astrocytoma tumors.

Methods and Materials: In this study, 48 histopathologically confirmed astrocytoma tumors were comprehensively incorporated for the assessment of Notch1 gene expression through Real-time PCR. Following ΔΔCT computation, Notch1 expression was systematically assessed in correlation with clinicopathological parameters, progression-free survival, and overall survival in glioma patients using SPSS software. Significance was determined at P values ≤ 0.05.

Results: The study found abnormal Notch1 expression in 90% of patients, among 70% patients showed up-regulated Notch1. The up-regulated Notch1 demonstrated significant positive correlation with higher KPS (Karnofsky Performance Status) score (P = .006) and trends towards significance with grade of tumors (P = .07). Kaplan-Meier univariate survival analysis for 24 months progression-free survival and overall survival demonstrated that a part from high KPS score (progression-free survival: P = <.001, overall survival: P = <.001) and patients with up-regulated Notch1 had a significantly increase progression-free survival (P = .009) and better overall survival (P = <.001) compared with patients with down-regulated Notch1, indicating favorable prognosticator. Also, grade 4 IDH wild-type showed inversed correlation with worse overall survival (P = .005), however, patients who had tumors in frontal lobes, showed significantly better overall survival than their respective counterparts. In multivariate survival analysis, only low KPS score emerged as significant independent parameter for predicting reduced progression-free survival and poorer overall survival. However, other conventional parameters including Notch1, lost their significance in multivariate survival analysis.

Conclusion: Our study revealed that up-regulated Notch1 in low-grade gliomas, correlating with extended progression-free survival and overall survival. Consequently, we conclude that high Notch1 expression serves as a positive prognostic indicator for patients with astrocytoma tumors, however, further studies are needed for validation in larger sample size.