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According to cIMPACT-NOW update 3,\n                    <jats:italic>IDH<\/jats:italic>\n                    -wild-type astrocytomas with any of the following factors show poor prognosis: combination of chromosome 7 gain and 10 loss (+\u20097\/\u2212\u200910), and\/or\n                    <jats:italic>EGFR<\/jats:italic>\n                    amplification, and\/or\n                    <jats:italic>TERT<\/jats:italic>\n                    promoter (\n                    <jats:italic>TERT<\/jats:italic>\n                    p) mutation. Multiplex ligation-dependent probe amplification (MLPA) can detect copy number alterations at reasonable cost. The purpose of this study was to identify a precise, cost-effective method for stratifying the prognosis of\n                    <jats:italic>IDH<\/jats:italic>\n                    -wild-type astrocytoma. Sanger sequencing, MLPA, and quantitative methylation-specific PCR were performed for 42\n                    <jats:italic>IDH<\/jats:italic>\n                    -wild-type lower-grade astrocytomas surgically treated at Kyoto University Hospital, and overall survival was analysed for 40 patients who underwent first surgery. Of the 42\n                    <jats:italic>IDH<\/jats:italic>\n                    -wild-type astrocytomas, 21 were classified as grade 4 using cIMPACT-NOW update 3 criteria and all had either\n                    <jats:italic>TERT<\/jats:italic>\n                    p mutation or\n                    <jats:italic>EGFR<\/jats:italic>\n                    amplification. Kaplan\u2013Meier analysis confirmed the prognostic significance of cIMPACT-NOW criteria, and World Health Organization grade was also prognostic. Cox regression hazard model identified independent significant prognostic indicators of\n                    <jats:italic>PTEN<\/jats:italic>\n                    loss (risk ratio, 9.75;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001) and\n                    <jats:italic>PDGFRA<\/jats:italic>\n                    amplification (risk ratio, 13.9;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.002). The classification recommended by cIMPACT-NOW update 3 could be completed using Sanger sequencing and MLPA. Survival analysis revealed\n                    <jats:italic>PTEN<\/jats:italic>\n                    and\n                    <jats:italic>PDGFRA<\/jats:italic>\n                    were significant prognostic factors for\n                    <jats:italic>IDH<\/jats:italic>\n                    -wild-type lower-grade astrocytoma.\n                  <\/jats:p>","DOI":"10.1038\/s41598-021-93937-8","type":"journal-article","created":{"date-parts":[[2021,7,13]],"date-time":"2021-07-13T06:24:02Z","timestamp":1626157442000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Prognostic stratification for IDH-wild-type lower-grade astrocytoma by Sanger sequencing and copy-number alteration analysis with MLPA"],"prefix":"10.1038","volume":"11","author":[{"given":"Yasuhide","family":"Makino","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshiki","family":"Arakawa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ema","family":"Yoshioka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomoko","family":"Shofuda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takeshi","family":"Kawauchi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yukinori","family":"Terada","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masahiro","family":"Tanji","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daisuke","family":"Kanematsu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yohei","family":"Mineharu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susumu","family":"Miyamoto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yonehiro","family":"Kanemura","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,7,13]]},"reference":[{"key":"93937_CR1","doi-asserted-by":"publisher","first-page":"iv1","DOI":"10.1093\/neuonc\/nou223","volume":"16","author":"QT Ostrom","year":"2014","unstructured":"Ostrom, Q. 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