Immunohistochemical and molecular features of diffuse astrocytic tumors grade III–IV
Summary. According to WHO recommendation, a histological and molecular investigation is necessary for providing an accurate diagnosis and prognosis for patients with tumors of central nervous system. The aim of this research was to figure out the phenotypic features of diffuse astrocytic tumors grade III–IV and to value their prognostic impact. We studied case histories of patients with anaplastic astrocytoma and glioblastoma and analyzed their postoperative tumor specimens (55 cases). These specimens were divided into 2 groups: primary tumors and recurrences. Phenotypic features were investigated with immunohistochemical markers: GFAP, NSE, anti-IDH1R132H. The additional mutation in isocitrate dehydrogenase-1 (IDH1) was detected with use of molecular analysis. The primary diffuse astrocytic tumors included only 1% of glioblastoma, IDH1mt, but in recurrent cases, their part was 20% (predominantly, it was remote relapses). Moreover, the primary tumors included 5 gliosarcomas, 2 giant cell glioblastomas and 1 glioblastoma with a primitive neuronal component. All these tumors relapsed within a year after surgery. We could not show the significant influence of mutation IDH1R132H on prognosis (Fisher’s exact test =0.175; р>0.05). However, we studied the mutation IDH1SNP and found out that it was strongly associated with anaplastic astrocytomas (Fisher’s exact test =0.00755; p<0.05) and, most likely, related to remote relapses (Mann — Whitney U test =36.5; p=0.043; p<0.05).
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