Clinicopathological Correlation of Glioma Patients with Respect to Immunohistochemistry Markers: A Prospective Study of 115 Patients in a Tertiary Care Hospital in North India

Overview

Journal Asian J Neurosurg

Specialty Neurology

Date 2022 Jan 24

PMID 35071070

Authors

Gitanshu Dahuja

Ashok Gupta

Arpita Jindal

Gaurav Jain

Santosh Sharma

Arvind Kumar

Affiliations

Soon will be listed here.

Abstract

Background: With the incorporation of molecular subtyping in glioma patients in 2016 WHO classification, there is a need to understand the immunohistochemistry (IHC) marker expression in various glioma patients and to clinically correlate with various subgroups.

Objective: Aim of the study was to assess IHC marker expression profile in glioma patients and to clinically correlate them in various subgroups.

Materials And Methods: The prospective study included 115 glioma patients. IHC markers (isocitrate dehydrogenase [IDH] 1, ATRX, P53, Ki-67 antibody) were done in all patients. Patients received treatment as per the grade of tumor. The patients were followed in 3 monthly intervals, for a period of 12 months. SPSS software version 20.0 was used for statistical analysis. Tables were prepared in Microsoft Excel sheet. Kaplan-Meier method was used for survival analysis.

Results: There were 11 Grade 1, 33 Grade 2, 26 Grade 3, and 45 glioblastoma multiforme (GBM) patients out of which 10 patients were secondary GBM cases. IDH1 mutation is frequent in Grade 2 and Grade 3 tumors of both astrocytic and oligodendroglia tumors. Its mutation is also common in secondary GBM patients. ATRX mutation is specific to astrocytic lineage, Grade 2, Grade 3, and secondary GBM patients.

Conclusion: Molecular nature of DA and AA cases can be accurately confirmed by combined IDH1 and ATRX IHC thereby avoiding costly investigations such as fluorescence hybridization. In astrocytic tumors, p53 can act as a surrogate marker. IDH-mutant glioma patients have better prognoses than IDH wild gliomas.

Citing Articles

Histopathological Spectrum of Gliomas and Its Immunohistochemical Correlation in a Tertiary Care Setup.

Malla S, Bavikar R, Gore C, Chugh A, Gurwale S Cureus. 2024; 16(7):e65036.

PMID: 39165459 PMC: 11335173. DOI: 10.7759/cureus.65036.

Prognostic Value of ATRX and p53 Status in High-Grade Glioma Patients in Morocco.

Squalli Houssaini A, Lamrabet S, Senhaji N, Sekal M, Nshizirungu J, Mahfoudi H Cureus. 2024; 16(3):e56361.

PMID: 38633919 PMC: 11022269. DOI: 10.7759/cureus.56361.

Using radiomics based on multicenter magnetic resonance images to predict isocitrate dehydrogenase mutation status of gliomas.

Liu Y, Zheng Z, Wang Z, Qian X, Yao Z, Cheng C Quant Imaging Med Surg. 2023; 13(4):2143-2155.

PMID: 37064376 PMC: 10102787. DOI: 10.21037/qims-22-836.

References

Yang P, Cai J, Yan W, Zhang W, Wang Y, Chen B . Classification based on mutations of TERT promoter and IDH characterizes subtypes in grade II/III gliomas. Neuro Oncol. 2016; 18(8):1099-108. PMC: 4933482. DOI: 10.1093/neuonc/now021. View

Fan Z, Liu Y, Li S, Liu X, Jiang T, Wang Y . Association of tumor growth rates with molecular biomarker status: a longitudinal study of high-grade glioma. Aging (Albany NY). 2020; 12(9):7908-7926. PMC: 7244074. DOI: 10.18632/aging.103110. View

Zeng A, Hu Q, Liu Y, Wang Z, Cui X, Li R . IDH1/2 mutation status combined with Ki-67 labeling index defines distinct prognostic groups in glioma. Oncotarget. 2015; 6(30):30232-8. PMC: 4745793. DOI: 10.18632/oncotarget.4920. View

Thon N, Eigenbrod S, Grasbon-Frodl E, Ruiter M, Mehrkens J, Kreth S . Novel molecular stereotactic biopsy procedures reveal intratumoral homogeneity of loss of heterozygosity of 1p/19q and TP53 mutations in World Health Organization grade II gliomas. J Neuropathol Exp Neurol. 2009; 68(11):1219-28. DOI: 10.1097/NEN.0b013e3181bee1f1. View

Rodriguez F, Vizcaino M, Lin M . Recent Advances on the Molecular Pathology of Glial Neoplasms in Children and Adults. J Mol Diagn. 2016; 18(5):620-634. PMC: 5397677. DOI: 10.1016/j.jmoldx.2016.05.005. View

Reuss D, Mamatjan Y, Schrimpf D, Capper D, Hovestadt V, Kratz A . IDH mutant diffuse and anaplastic astrocytomas have similar age at presentation and little difference in survival: a grading problem for WHO. Acta Neuropathol. 2015; 129(6):867-73. PMC: 4500039. DOI: 10.1007/s00401-015-1438-8. View

Khan I, Waqas M, Shamim M . Prognostic significance of IDH 1 mutation in patients with glioblastoma multiforme. J Pak Med Assoc. 2017; 67(5):816-817. View

Zou P, Xu H, Chen P, Yan Q, Zhao L, Zhao P . IDH1/IDH2 mutations define the prognosis and molecular profiles of patients with gliomas: a meta-analysis. PLoS One. 2013; 8(7):e68782. PMC: 3718803. DOI: 10.1371/journal.pone.0068782. View

Sanson M, Marie Y, Paris S, Idbaih A, Laffaire J, Ducray F . Isocitrate dehydrogenase 1 codon 132 mutation is an important prognostic biomarker in gliomas. J Clin Oncol. 2009; 27(25):4150-4. DOI: 10.1200/JCO.2009.21.9832. View

10.

Louis D, Perry A, Reifenberger G, von Deimling A, Figarella-Branger D, Cavenee W . The 2016 World Health Organization Classification of Tumors of the Central Nervous System: a summary. Acta Neuropathol. 2016; 131(6):803-20. DOI: 10.1007/s00401-016-1545-1. View

11.

Agarwal S, Sharma M, Jha P, Pathak P, Suri V, Sarkar C . Comparative study of IDH1 mutations in gliomas by immunohistochemistry and DNA sequencing. Neuro Oncol. 2013; 15(6):718-26. PMC: 3661098. DOI: 10.1093/neuonc/not015. View

12.

Jaiswal S . Role of immunohistochemistry in the diagnosis of central nervous system tumors. Neurol India. 2016; 64(3):502-12. DOI: 10.4103/0028-3886.181547. View

13.

Park S, Won J, Kim S, Lee Y, Park C, Kim S . Molecular Testing of Brain Tumor. J Pathol Transl Med. 2017; 51(3):205-223. PMC: 5445205. DOI: 10.4132/jptm.2017.03.08. View

14.

Pai T, Epari S, Desai S, Wadile A, Gupta T, Goda J . Histological spectrum of oligodendroglial tumors: Only a subset shows 1p/19q codeletion. Neurol India. 2017; 65(1):113-120. DOI: 10.4103/0028-3886.198195. View

15.

Weller M, Felsberg J, Hartmann C, Berger H, Steinbach J, Schramm J . Molecular predictors of progression-free and overall survival in patients with newly diagnosed glioblastoma: a prospective translational study of the German Glioma Network. J Clin Oncol. 2009; 27(34):5743-50. DOI: 10.1200/JCO.2009.23.0805. View

16.

Goyal R, Mathur S, Gupta S, Goyal R, Kumar S, Batra A . Immunohistochemical expression of glial fibrillary acidic protein and CAM5.2 in glial tumors and their role in differentiating glial tumors from metastatic tumors of central nervous system. J Neurosci Rural Pract. 2016; 6(4):499-503. PMC: 4692005. DOI: 10.4103/0976-3147.168426. View

17.

Skjulsvik A, Mork J, Torp M, Torp S . Ki-67/MIB-1 immunostaining in a cohort of human gliomas. Int J Clin Exp Pathol. 2015; 7(12):8905-10. PMC: 4313958. View

18.

Kannan K, Inagaki A, Silber J, Gorovets D, Zhang J, Kastenhuber E . Whole-exome sequencing identifies ATRX mutation as a key molecular determinant in lower-grade glioma. Oncotarget. 2012; 3(10):1194-203. PMC: 3717947. DOI: 10.18632/oncotarget.689. View

19.

Shao L, Pan Y, Qi X, Li Y, Ma X, Yi W . ATRX loss in adult supratentorial diffuse astrocytomas correlates with p53 over expression and IDH1 mutation and predicts better outcome in p53 accumulated patients. Histol Histopathol. 2015; 31(1):103-14. DOI: 10.14670/HH-11-664. View

20.

Chatterjee D, Radotra B, Kumar N, Vasishta R, Gupta S . , , and V600E mutation in astrocytic tumors and their significance in patient outcome in north Indian population. Surg Neurol Int. 2018; 9:29. PMC: 5838837. DOI: 10.4103/sni.sni_284_17. View