Abstract
Various genetic variants, such as telomerase reverse transcriptase (TERT) promoter mutations (TERTmut) and 1p/19q co-deletion, are linked to gliomas; however, their prognostic significance remains uncertain. Here, we investigated the prevalence of TERTmut in gliomas, their correlation with clinicopathological features and molecular abnormalities, and prognostic implications of molecular abnormalities. Clinicopathological data were retrospectively collected from 161 patients diagnosed with glioma. An increased incidence of TERTmut was found in patients older than 50 years. Oligodendrogliomas and glioblastomas exhibited a higher susceptibility to TERT promoter mutations than astrocytomas. TERT promoter mutation rates were higher in WHO grade 3 and 4 tumors than in grade 1 and 2 tumors. The TERTmut group demonstrated a higher incidence of 1p19q co-deletion than the TERT wild-type group. Prognosis within the TERTmut group was closely correlated with histological type and glioma grade, along with IDH1/2 mutation, 1p19q co-deletion, and MGMT methylation, all indicative of a favorable prognosis. 1p19q co-deletion, and not IDH1/2 mutation, was identified as an independent prognostic factor for TERTmut glioma. The ensemble prognostic signature, incorporating 1p19q co-deletion, could aid in risk stratification and survival prediction in gliomas with TERTmut. Our findings establish a reliable and practical protocol for developing individualized surgical and treatment strategies.