The Relationship of Clinicopathological Features, Ki-67 Proliferation Index, IDH1, EGFR, and p53 Mutations with Prognosis in Glioblastomas

Yıl 2023, Cilt: 13 Sayı: 3, 237 - 244, 30.12.2023

Sevda Dalar , Şahsine Tolunay Ahmet Bekar

Öz

Aim: Glioblastoma is the most common malignant brain tumor. In the literature, few reports examine the relationship between morphologic findings of glioblastomas and patient prognosis. This study investigates the effects of morphological conclusions, IDH1, EGFR, p53 expressions, and Ki-67 proliferation index on patient prognosis in glioblastoma patients.
Material and Method: This study evaluated 166 patients diagnosed with glioblastoma between 2014 and 2017 in the Faculty of Medicine, Department of Pathology. Morphological findings (broad necrosis, focal necrosis, palisaded necrosis, microvascular proliferation, atypia, cellularity, lymphocyte infiltration, mitosis, cell type) were classified according to their presence/absence or intensity. IDH1, EGFR (Epidermal Growth Factor Receptor), p53 expressions, and Ki-67 proliferation indexes were grouped according to staining/non-staining conditions or staining percentages. The relationship between these findings and postoperative survival time was investigated.
Results: There was no statistically significant relationship with survival between morphologic findings, IDH1, EGFR, p53 expressions, and Ki-67 index.
Conclusion: Morphological and immunohistochemical features are insufficient to predict glioblastoma prognosis. Referring to molecular methods in estimating the prognosis may be more appropriate.

Anahtar Kelimeler

glioblastoma, IDH1, p53, ki-67; EGFR

Kaynakça

• 1. Ohgaki H, Kleihues P. Population-based studies on incidence, survival rates, and genetic alterations in astrocytic and oligodendroglial gliomas. J Neuropathol Exp Neurol 2005;64:479-89.
• 2. Ostrom QT, Gittleman H, Liao P, Rouse C, Chen Y, Dowling J, et al. CBTRUS Statistical Report: Primary Brain and Central Nervous System Tumors Diagnosed in the United States in 2007–2011. Neuro Oncol 2014;16 Suppl 4:iv1–63.
• 3. Louis DN, Ohgaki H, Wiestler OD, Cavenee WK, Ellison DW, Figarella-Branger D, et al. World Health Organization Histological Classification of Tumours of the Central Nervous System. International Agency for Research on Cancer, France.2016.
• 4. Louis DN, Brat DJ, Ellison DW, Figarella-Branger D, Hawkins CE, Perry A. Gliomas, glioneoral tumors, and neuronal tumors: Introduction. In: WHO Classification of Tumors Editorial Board. Central nervous system tumours. Lyon; International Agency for Research on Cancer, 2021:16-187.
• 5. Hartmann C, Hentschel B, Wick W. Patients with IDH1 wild type anaplastic astrocytomas exhibit worse prognosis than IDH1-mutated glioblastomas, and IDH1 mutation status accounts for the unfavorable prognostic effect of higher age: implications for classification of gliomas. Acta Neuropathol 2010;120:707–18.
• 6. Stupp R, Mason WP, van den Bent MJ, Weller M, Fisher B, Taphoorn MJ, et al. Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. N Engl J Med 2005;352:987-96.
• 7. Hegi ME, Diserens AC, Gorlia T, Hamou MF, de Tribolet N, Weller M, et al. MGMT gene silencing and benefit from temozolomide in glioblastoma. N Engl J Med 2005;352:997–1003.
• 8. Stupp R, Hegi ME, Mason WP, van den Bent MJ, Taphoorn MJ, Janzer RC, et al. Effects of radiotherapy with concomitant and adjuvant temozolomide versus radiotherapy alone on survival in glioblastoma in a randomised phase III study: 5-year analysis of the EORTC-NCIC trial. Lancet Oncol 2009;10:459–66.
• 9. Bouvier-Labit C, Chinot O, Ochi C, Gambarelli D, Dufour H, Figarella-Branger D. Prognostic significance of Ki 67, p53 and epidermal growth factor receptor immunostaining in human glioblastomas. Neuropathol Appl Neurobiol 1998;24:381-8.
• 10. Popova SN, Bergqvist M, Dimberg A, Edqvist PH, Ekman S, Hesselager G, et al. Subtyping of gliomas of various WHO grades by the application of immunohistochemistry. Histopathology 2014;64:365-79.
• 11. Parsons DW, Jones S, Zhang X, Lin JC, Leary RJ, Angenendt P, et al. An integrated genomic analysis of human glioblastoma multiforme. Science 2008;321:1807–12.
• 12. Miller CR, Dunham CP, Scheithauer BW, Perry A. Significance of necrosis in grading of oligodendroglial neoplasms: a clinicopathologic and genetic study of newly diagnosed high-grade gliomas. J Clin Oncol 2006;24:5419-26.
• 13. Van den Bent MJ, Carpentier AF, Brandes AA, Sanson M, Taphoorn MJ, Bernsen HJ, et al. Adjuvant procarbazine, lomustine, and vincristine improves progression-free survival but not overall survival in newly diagnosed anaplastic oligodendrogliomas and oligoastrocytomas: a randomized European Organisation for Research and Treatment of Cancer phase III trial. J Clin Oncol 2006;24:2715-22.
• 14. Bigner SH, Burger PC, Wong AJ, Werner MH, Hamilton SR, Muhlbaier LH, et al. Gene Amplification in Malignant Human Gliomas: Clinical and Histopathologic Aspects. Journal of Neuropathology and Experimental Neurology 1988;47:191–205.
• 15. Palma L, Celli P, Maleci A. Malignant monstrocellular brain tumors. A study of 42 surgically treated cases. Acta Neurochir 1989;97:17–25.
• 16. Ahmadipour Y, Jabbarli R, Oliver Gembruch O, Pierscianek D, Darkwah Oppong M, Dammann P, et al. Impact of Multifocality and Molecular Markers on Survival of Glioblastoma. World Neurosurg 2019;122:e461-6.
• 17. Perry JR, Laperriere N, O’Callaghan CJ, Brandes AA, Menten J Phillips C, Fay M, et al. Short-course radiation plus temozolomide in elderly patients with glioblastoma. N Engl J Med 2017;376:1027–37.