10-Year Journey Through Brain Gliomas: Case Report

AbstractWe present the case of a 28-year-old doctor who was diagnosed in 2009 with grade II oligodendroglioma. In the next 10 years he underwent 4 surgeries, passing in turn through 3 different types of cerebral gliomas: grade II oligodendroglioma, grade III oligoastrocytoma and IDH Wild-Type glioblastoma. In the spirit of the surgical resection limited by the preservation of the function, he was able to practice his medical profession until the last months of his life. Life expectancy at the time of diagnosis complied with all the statistical data. Although the etiology, pathophysiology and treatment of cerebral gliomas is still full of unknowns, knowing our limits we can provide a good quality of life for our patients.

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RNA-Seq analysis of glioma tumors to reveal targetable gene fusions.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.15_suppl.2019 ◽

2017 ◽

Vol 35 (15_suppl) ◽

pp. 2019-2019 ◽

Cited By ~ 4

Author(s):

Deepa Suresh Subramaniam ◽

Joanne Xiu ◽

Shwetal Mehta ◽

Zoran Gatalica ◽

Jeffrey Swensen ◽

...

Keyword(s):

Life Sciences ◽

Gene Fusions ◽

Astrocytic Tumors ◽

Fusion Genes ◽

Rna Seq ◽

Wild Type ◽

Oligodendroglial Tumors ◽

Grade Ii ◽

Glioma Tumors ◽

Grade Iii

2019 Background: Fusions involving oncogenes have been reported in gliomas and may serve as novel therapeutic targets. We aim to use RNA-sequencing to interrogate a large cohort of gliomas for targetable genetic fusions. Methods: Gliomas were profiled using the ArcherDx FusionPlex Assay at a CLIA-certified lab (Caris Life Sciences) and 52 gene targets were analyzed. Fusions with preserved kinase domains were investigated. Results: Among 404 gliomas tested, 39 (9.7%) presented potentially targetable fusions, of which 24/226 (11%) of glioblastoma (GBM), 5/42 (12%) of anaplastic astrocytoma (AA), 2/25 (8%) of grade II astrocytoma and 3 of 7 (43%) of pilocytic astrocytoma (PA) harbored targetable fusions. In GBMs, 1 of 15 (6.7%) IDH-mutated tumors had a fusion while 22 of 175 (12.6%) IDH-wild type tumors had fusions. 46 oligodendroglial tumors were profiled and no fusions were seen, which was lower than frequency of fusions in astrocytic tumors (34/300, p = 0.0236). The most frequent fusions seen involved FGFR3 (N = 12), including 10 FGFR3-TACC3 (1 AA, 6 GBM and 3 glioma NOS); 1 FGFR3-NBR1 (AA) and 1 FGFR3-BRAP (GBM). 11 fusions involving MET were seen, 10 in GBM and 1 in AA. The most common MET fusion was PTPRZ1-MET (1 in AA and 4 in GBM), followed by ST7-MET (N = 3, GBM), CAPZA2-Met (N = 2, GBM) and TPR-MET (N = 1, GBM). 8 NTRK fusions were seen; 1 involving NTRK1 (BCAN-NTRK1, PA), 6 NTRK2 (1 NOS1AP-NTRK2 in AA; GKAP1-NTRK2, KCTD8-NTRK2, TBC1D2-NTRK2 and SOSTM1-NTRK2, 1 each in GBM and 1 VCAN-NTRK2 in grade II astrocytoma) and 1 NTRK3 (EML4-NTRK3 in GBM). EGFR fusions (2 EGFR-SEPT14 and 1 EGFR-VWC2) were seen in 3 GBMs, BRAF in 3 (1 KIAA1549-BRAF, 1 LOC100093631-BRAF in PA and 1 ZSCAN23-BRAF in glioma NOS) and PDGFRA (RAB3IP-PDGFRA, in GBM) in 1. C11orf95-RELA fusions were seen in 2 of 3 grade III ependymomas but not in the 2 grade II ependymomas. Conclusions: We report targetable fusion genes involving NTRK, MET, EGFR, FGFR3, BRAF and PDGFRA including novel fusions that haven’t been previously described in gliomas (e.g., EGFR-VWC2; FGFR3-NBR1). Fusions were seen in over 10% of astrocytic tumors, while none was seen oligodendrogliomas. Identification of such kinase-associated fusion transcripts may allow us to exploit therapeutic opportunities with targeted therapies in gliomas.

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A Combined Study with 18F-FDG and 11C-Methionine Dynamic PET for the Grading of Brain Gliomas.

10.21203/rs.3.rs-134833/v1 ◽

2020 ◽

Author(s):

Andrey Postnov ◽

Nina Vikhrova ◽

Samuel Valable ◽

Diana Kalaeva ◽

Tatiana Konakova ◽

...

Keyword(s):

Prospective Study ◽

Metabolic Imaging ◽

Dynamic Pet ◽

Informative Parameter ◽

Conventional Mri ◽

Diffuse Gliomas ◽

Grade Ii ◽

18F Fdg ◽

Brain Gliomas ◽

Grade Iii

Abstract Purpose: Conventional MRI based on contrast enhancement and T2/FLAIR is often not sufficient in differentiating grade II from grade III and grade III from grade IV diffuse gliomas. Here we assessed advanced metabolic imaging using two well characterized PET tracers, namely 18F-FDG and 11C-Methionine.Methods: In this prospective study, 39 patients were enrolled with diffuse gliomas of grades II, III or IV underwent dynamic [18F]-FDF-PET and [11C]-Methionine. The first minutes were taken into accountResults: The use of 11C- Methionine provided significant differences between the different histologic subgroups with a higher number of parameters than did the use of 18 F-FDG. The most informative parameter is T/Np (T/N at the peak of the first maximum) with 11C- Methionine.Conclusion: The study of the first minute passage of 18F-FDG and/or 11C- Methionine through the tumor and healthy tissues in brain gliomas could not only allow improving the identification of the different glioma grades, but also to shorten the time spent by the patients under the camera. In case of using one tracer, methionine still would be the best choice. Otherwise, the use of 18F-FDG and SUVр (SUV at the peak of the first maximum) would provide results likely comparable to methionine T/N index.

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Symptomatic Epileptic Seizures in Patients with Brain Gliomas

Russian Sklifosovsky Journal Emergency Medical Care ◽

10.23934/2223-9022-2021-10-3-549-557 ◽

2021 ◽

Vol 10 (3) ◽

pp. 549-557

Author(s):

D. I. Abzalova ◽

A. V. Prirodov ◽

M. V. Sinkin

Keyword(s):

Antiepileptic Drugs ◽

Tumor Resection ◽

Epileptic Seizures ◽

Low Grade ◽

Drug Resistant ◽

Newly Diagnosed ◽

New Antiepileptic Drugs ◽

Cerebral Gliomas ◽

Brain Gliomas

Introduction. Epileptic seizures are an important problem that significantly worsens the quality of patients’ life with both newly diagnosed and recurrent brain gliomas.Review. The analysis of domestic and foreign literature showed that low-grade gliomas, this symptom occurs on average in 76%, with high-grade gliomas – in 21% of patients. Despite the maximum allowable tumor resection, it is likely that epileptic seizures persist in 18-64% of patients, and in 5% of patients they first appear in the postoperative period. From 15 to 50% of epileptic seizures in cerebral gliomas are drug-resistant. In patients undergoing chemotherapy, it is better to use new antiepileptic drugs because their cross-effects are minimal.Conclusion. There is no generally accepted algorithm for prescribing and discontinuing antiepileptic drugs in patients with symptomatic epileptic seizures with cerebral gliomas. Further research is needed to determine the optimal combination and dosage regimen of antiepileptic drugs, especially during chemotherapy.

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Grading Fish for Quality. 2. Statistical Analysis of the Results of Experiments Regarding Grades and Trimethylamine values

Journal of the Fisheries Research Board of Canada ◽

10.1139/f58-037 ◽

1958 ◽

Vol 15 (4) ◽

pp. 717-728 ◽

Cited By ~ 11

Author(s):

P. L. Hoogland

Keyword(s):

Statistical Analysis ◽

Linear Regression ◽

Recent Work ◽

Statistical Treatment ◽

Regression Equation ◽

Linear Regression Equation ◽

Grade Ii ◽

Set Up ◽

Grade Iii

The results of recent work at this station regarding the organoleptic grade of cod and haddock and the trimethylamine content of these fish were subjected to statistical treatment. It was established that there is a relation between grade and trimethylamine content which may be represented by a linear regression equation, if the trimethylamine content is expressed as log (1 + TMA value). The confidence with which this TMA index may be used to estimate grade was also determined. Based on these findings, a scale of TMA values for use in practical grading was set up; the suggested values are grade I: TMA value 0.00 to 1.00; grade II: TMA value 1.01 to 7.00 and grade III: TMA value 7.01 and higher. Finally, a method is suggested by means of which the ability of a grader to judge the quality of fish may be assessed.

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A Systematic Study on the Analysis of the Emission of CO, CO2 and HC for Four-Wheelers and Its Impact on the Sustainable Ecosystem

Sustainability ◽

10.3390/su12176707 ◽

2020 ◽

Vol 12 (17) ◽

pp. 6707

Author(s):

Rohit Sharma ◽

Raghvendra Kumar ◽

Pradeep Kumar Singh ◽

Maria Simona Raboaca ◽

Raluca-Andreea Felseghi

Keyword(s):

Statistical Data ◽

Survival Rates ◽

Gaseous Pollutants ◽

High Survival ◽

Different Types ◽

Pollutants Emission ◽

Standard Values ◽

The Government ◽

Carbon Dioxide Co2

The urbanization in Delhi NCR has led to a rapid increase in the vehicle count concerning the rise in population and mobilization. The emissions from the vehicles are currently counted amongst the main sources of air pollution in Delhi. This affects the quality of air. The emission criterion of various pollutants that are emitted from vehicles is evaluated through various International models, which include various vehicles, their modes of pollutants emitted while driving and other factors that are affecting the weather. The approximate emission of pollutants such as Carbon Monoxide (CO) and/or Particulate Matter (PM), from a variety of vehicles and different fuel types, has undergone diurnal variation over the years, depending on the time of the day. This study presents the emission factor of gaseous pollutants Hydrocarbons (HC), Carbon Monoxides (CO) and Carbon Dioxide (CO2) of 181 four-wheeler cars from different companies containing different types of fuels. The measurement of gaseous pollutants is performed for Delhi, the most polluted city in India. The various facts and data were calculated and analyzed with reference to the standard values set by the national schemes of the Pollution and Environment. Based on this statistical data obtained and analyzed, the scenarios regarding future vehicle growth rate and its impact on air quality are mentioned to overcome emission problems. Therefore, it is important to develop and deploy methods for obtaining real-world measurements of vehicle emissions, to estimate the pollutants. The analysis shows that few parameters need to be a concern for reducing the pollutants emission by vehicles. These major parameters are the high survival rates, decrease in annual mileage and major enforcement for three-to-five-year-old vehicles. This study shows that many old vehicles are used in different regions of the country, regardless of many notifications of banning old vehicles by the Government of India. These old vehicles are the major source of vehicle pollutants. The analysis stated that the diesel engine would emit less CO2/km than a petrol engine if having an almost similar engine capacity.

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Comprehensive assessment of ATRX mutation, protein expression, and alternative lengthening of telomeres (ALT) phenotype in grade II and III gliomas.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.15_suppl.2064 ◽

2017 ◽

Vol 35 (15_suppl) ◽

pp. 2064-2064 ◽

Cited By ~ 1

Author(s):

Aline P. Becker ◽

Erica Hlavin Bell ◽

Jessica Fleming ◽

Joseph P McElroy ◽

Denise Fabian ◽

...

Keyword(s):

Protein Expression ◽

Point Mutations ◽

Small Sample ◽

Wild Type ◽

Idh1 R132h ◽

Long Term Follow Up ◽

Grade Ii ◽

The Ohio State University ◽

Small Sample Sizes ◽

Grade Iii

2064 Background: ATRX mutations are key molecular markers for classification of gliomas. We aimed to evaluate ATRXmutations and protein expression and the ALT phenotype as potential biomarkers for grade II and III gliomas. Methods: Retrospective analysis of 156 adult gliomas, with long-term follow up. Gene sequencing ( IDH1/2 and ATRX), Oncoscan array (1p19q co-deletion), FISH assays (1p19q co-deletion and ALT phenotype) and immunohistochemistry (IDH1 R132H and ATRX) were performed and the results were correlated with OS and PFS. Results: Twenty-six out of 94 samples (27.7%) had ATRX mutations, commonly related to IDH1/2 mutant-1p/19q intact tumors (22/26 cases – p < 0.0001), however, 3 (11.5%) mutant tumors had concurrent 1p/19q co-deletions. ATRX loss of expression occurred in 66/150 cases (44%), consistently related to ATRX mutations (p < 0.0001). Intriguingly, 4/25 ATRX mutant tumors (2 frameshift and 2 point mutations with low/medium functional impact) showed weak/heterogeneous expression, while 18/65 (27.7%) ATRX wild type tumors had loss of protein expression. ALT phenotype was detected in 50/150 cases (33.3%), strongly related to ATRX mutations (23/32 cases), loss of protein expression (45/50 cases), and to IDH1/2 mutant-1p/19q intact tumors (35/41 cases). Two ATRX mutant tumors were ALT negative, while nine ATRX wild type tumors with loss of expression had ALT phenotype. ATRXmutations, loss of protein expression, and ALT phenotype were strongly related to longer OS in grade III gliomas (p = 0.006, 0.023 and 0.003, respectively). Further subset analyses were not completed due to small sample sizes. Conclusions: ATRX mutations and loss of protein expression as well as ALT phenotype are potential prognostic factors for grade III gliomas. Importantly, this study highlights possible discrepancies (although infrequent) between ATRX sequencing, immunohistochemistry, and FISH (ALT). In addition, other mechanisms of ATRX gene silencing should be further investigated in grade II and III gliomas. FUNDING: R01CA108633, R01CA169368, RC2CA148190, U10CA180850-01 (NCI), Brain Tumor Funders Collaborative Grant, and The Ohio State University CCC (all to AC).

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PATH-61. IMMUNOHISTOCHEMICAL PHENOTYPING AND SURVIVAL ANALYSIS OF WHO GRADE II-IV GLIOMAS

Neuro-Oncology ◽

10.1093/neuonc/noz175.656 ◽

2019 ◽

Vol 21 (Supplement_6) ◽

pp. vi157-vi157

Author(s):

Nora Poulos ◽

Srikar Sattiraju ◽

Charles Opalak ◽

Mikhail Dozmorov ◽

Jason Harrison ◽

...

Keyword(s):

Overall Survival ◽

Wilms Tumor ◽

Positive Staining ◽

High Grade ◽

Wild Type ◽

Isocitrate Dehydrogenase 1 ◽

Who Grade ◽

Clinical Prognosis ◽

Grade Ii ◽

Grade Iii

Abstract INTRODUCTION Specific genetic mutations are linked to clinical prognosis in gliomas. There has been increasing demand to understand the association between tissue biomarker expression and survival. Using patient-derived samples, WHO grade II-IV gliomas were evaluated by the protein-staining pattern of molecular markers of interest across tumor grade, and the association between their expression and survival was investigated. METHODS Tissue microarrays (TMA) containing duplicate 1 mm cores were generated from 78 gliomas (WHO grade II-IV) using an automated TMA system. Immunohistochemistry was performed per the manufactures recommendation to evaluate expression of: Wilms tumor 1 (WT1), platelet endothelial cell adhesion molecule (CD31), adhesion G protein-coupled receptor E5 (CD97), complement decay-accelerating factor (CD55), hypoxia inducible factor 1 subunit alpha (HIF1α), EGF-like module-containing mucin-like hormone receptor-like 3 (EMR3), integrin, and isocitrate dehydrogenase 1 (IDH1). Samples with moderate (+1) or intense (+2) staining to WT1, CD31, CD97, CD55, or HIF1α, or any staining to EMR3 or IDH1 mutation, were considered positive. RESULTS Of the 78 tumor samples, there were 11 (14%) WHO grade II, 22 (28%) grade III, and 45 (59%) grade IV gliomas. Across grade III gliomas, anaplastic astrocytomas had significantly higher positive WT1 (p=0.04), CD31 (p=0.002) and IDH1 wild-type (p< 0.0001) staining. High-grade (III & IV) gliomas had significantly higher positive staining for WT1 (p=0.013), CD31 (0.024), integrin (p=0.021), and IDH1 wild type (p=0.044). In all gliomas, positive staining for WT1 (p< 0.0001), CD31 (p=0.009), CD97 (p=0.024), EMR3 (p=0.036), and IDH1 wild type (p=0.0006) were associated with worse overall survival. After adjusting for patient age, positive staining for WT1 (p=0.003) was associated with worse overall survival. CONCLUSION Using immunohistochemistry, unique biomarker staining patterns were identified for WHO grade III anaplastic astrocytomas and for high-grade gliomas. Irrespective of grade, staining for WT1, CD97, CD31, EMR3, and IDH1 wild-type were associated with worse overall survival.

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Image-guided stereotactic biopsy of infiltrative, multicentric and deep-seated supratentorial cerebral gliomas

Romanian Neurosurgery ◽

10.2478/v10282-012-0005-2 ◽

2012 ◽

Vol 19 (2) ◽

pp. 87-95

Author(s):

F.M. Brehar ◽

R.M. Gorgan ◽

M. Lisievici

Keyword(s):

Stereotactic Biopsy ◽

Postoperative Mortality ◽

Planning System ◽

World Health ◽

Neurological Deficits ◽

Temporary Increase ◽

Image Guided ◽

Cerebral Gliomas ◽

Grade Ii ◽

Grade Iii

Abstract Infiltrative cerebral gliomas remain a neurosurgical challenge despite the latest achievements in neuroimaging techniques and microsurgical approaches. In this paper the authors present their experience in 85 cases of stereotactic biopsies performed for infiltrative, multicentric and deep-seated cerebral gliomas. The stereotactic and neuroimagistic tools used for these procedures included the Leksell stereotactic system and the software: Stereotactic Planning System (SPS), NTPS 8.2. The histopatological results (according to World Health Organization (WHO) classification) were: 51 cases of glioblastomas (grade IV) (60%), 7 cases of anaplastic astrocytomas (grade III) (8,2%), 13 cases of grade II diffuse astrocytomas (15,3%), 6 cases of grade I astrocytomas (7,1%), one case of grade II oligodendroglioma (1,2%), 3 cases of anaplastic oligodendrogliomas (grade III) (3,5%), one case of grade I ganglioglioma (1,2%), one case of anaplastic ganglioglioma (grade III) (1,2%), and 2 cases of anaplastic ependymomas (grade III) (2,3%). In 21 cases (24,7%) the immunohistochemistry has been performed in order to obtain an accurate histopathological result. In this series, the early postoperative mortality was 0%, with no cases of clinically significant hemorrhages after biopsy procedures. Temporary increase of neurological deficits has been noticed in 7 patients (8,2%). In conclusion, image-guided stereotactic biopsy represents now a safe and accurate diagnostic method for cerebral gliomas, which can favorably influence the therapeutic management of the patients

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Recovery of equine oocytes by scraping of the follicular wall with different specifications of needles and morphological analysis of cumulus oophorus

Semina Ciências Agrárias ◽

10.5433/1679-0359.2015v36n6sup2p4333 ◽

2015 ◽

Vol 36 (6Supl2) ◽

pp. 4333

Author(s):

Suellen Miguez González ◽

Camila Bizarro da Silva ◽

Andressa Guidugli Lindquist ◽

Isabela Búfalo ◽

Fernanda Zandonadi Machado ◽

...

Keyword(s):

Tunica Albuginea ◽

Cumulus Cells ◽

Recovery Rates ◽

Follicular Aspiration ◽

Cumulus Oophorus ◽

Grade Ii ◽

Student’S T ◽

Group B ◽

Grade Iii

In follicular aspiration, physical aspects are of high significance for the technique to succeed, such as vacuum pressure, caliber of the needle and the way the follicular wall curettage is performed. The aim of this study was to investigate the recovery rate of equine oocytes aspirated by scraping of the follicular wall, testing different calibers of disposable needles, as well as the morphological evaluation of the cumulus oophorus complexes (COCs). Mares ovaries (n=447) obtained at a local slaughterhouse were transported to the laboratory in a thermal container (20 °C) and had the tunica albuginea and connective tissues dissected. The aspirated follicles had 10 to 25 mm in diameter, and 30x8 (21G 1 ¼) or 40x12 (18G 1 ½) needles were used for the aspiration, forming group A (G-A) and group B (G-B), respectively. In G-A and G-B, 480 and 548 follicles were aspirated, respectively. Under the stereomicroscope, the oocytes were evaluated according to the quality of the ooplasm and characteristics of the cumulus cells (grade I, II, III and denuded). The statistical analysis was performed using the Student’s t-test, logistic regression and test of proportions, and differences were considered significant when P<0.05. There was no difference between recovery rates of groups G-A (66.5%; 330/496) and G-B (65.5%; 359/548). In the G-A group, grade II oocytes were related to higher recovery rates (46.9%; 145/330) than grade I (23.6%; 72/330), grade III (20.6%; 59/330) and denuded oocytes (8.5%; 24/330; P<0.05). However, in G-B, there was no statistical difference regarding the quality of the recovered oocytes: grade I (23.4%; 77/359), grade II (43.2%; 145/359), grade III (22.5%; 73/359) and denuded (11.1%; 32/359). The 30x8 (21G 1 ¼) needle provided a higher proportion of grades I and II oocytes than the 40x12 (18G 1 ½) needle, with 72.4% (239/330) and 65% (233/359; P<0.05), respectively. Both calibers of needles tested in this study provide efficient oocyte recovery rates. Aspiration with 30x8 (21G 1 ¼) needles resulted in a higher proportion of morphologically good equine oocytes for use in reproductive biotechnologies.

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PATH-05. A RETROSPECTIVE STUDY OF TREATMENT STRATEGIES AND OUTCOMES IN WHO GRADE II AND III ISOCITRATE DEHYDROGENASE (IDH) WILD-TYPE ASTROCYTOMA

Neuro-Oncology ◽

10.1093/neuonc/noaa215.687 ◽

2020 ◽

Vol 22 (Supplement_2) ◽

pp. ii164-ii165

Author(s):

Ashley Aaroe ◽

Antonio Dono ◽

Michael Youssef ◽

Kristin Alfaro-Munoz ◽

Shiao-Pei Weathers ◽

...

Keyword(s):

Health Science ◽

Concurrent Chemoradiation ◽

Diffuse Glioma ◽

Wild Type ◽

Science Center ◽

Who Grade ◽

Molecular Features ◽

Adjuvant Temozolomide ◽

Grade Ii ◽

Grade Iii

Abstract BACKGROUND WHO grade II and III IDH wild-type astrocytomas behave more aggressively than their IDH mutated counterparts. A subpopulation shares molecular features with the novel entity proposed in cIMPACT-NOW Update 3 “Diffuse astrocytic glioma, IDH wild-type, with molecular features of glioblastoma (GBM), WHO IV”. METHODS We performed a retrospective analysis of clinical and molecular features, management and survival of 134 adult patients treated for grade II and III IDH wild-type astrocytoma between 06/2012 and 12/2018 at MD Anderson Cancer Center (MDACC - 112) and UT Health Science Center at Houston (UTHSC - 22). All patients had IDH1 sequenced, all but 2 had IDH2 sequenced, and 73 had further next generation sequencing. RESULTS Median age at diagnosis was 53 (interquartile range 18-83). 82 patients (61%) were male. 31 patients were histologically diagnosed with grade II astrocytoma, 102 with grade III astrocytoma, and one with diffuse glioma (insufficient tissue to render histologic grade or perform sequencing). EGFR alterations were found in 31 patients and TERT promoter mutations in 22. 84 (63%) received concurrent chemoradiation and adjuvant temozolomide (grade II, n=9; grade III, n=74; NOS, n=1). PFS overall was 12.0 months (grade II = 17.9; grade III = 10.7). OS in patients treated with concurrent chemoradiation and adjuvant temozolomide was 17.1 months versus 17.7 in patients treated with sequential radiation and temozolomide (p = NS), and 10.6 in patients treated with RT alone or surveillance (p< 0.016). The highest 2-year OS was seen in grade II patients treated with concurrent chemoradiation and adjuvant temozolomide (60%). CONCLUSIONS WHO grade II and III IDHwt astrocytoma survival is similar to historical GBM cohorts. The proportion meeting molecular criteria for GBM is yet undefined. Groups who received chemotherapy may perform better than those who do not. Further analysis of MGMT methylation and other molecular factors is ongoing.

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