From glioblastoma to gangliocytoma: an unforeseen but welcome shift in biological behavior

2009 ◽  
Vol 4 (5) ◽  
pp. 475-478 ◽  
Author(s):  
Astrid Jeibmann ◽  
Martin Hasselblatt ◽  
Stefan Pfister ◽  
Ronald Sträter ◽  
Angela Brentrup ◽  
...  
Keyword(s):  
Prognostic Significance ◽  
Genetic Alterations ◽  
Biological Behavior ◽  
Proliferation Index ◽  
Comparative Genomic ◽  
Biological Mechanisms ◽  
Ki 67 ◽  
Who Grade ◽  
Chemotherapy Sensitivity ◽  
Neuronal Markers

The prognosis in children harboring a glioblastoma multiforme (GBM) is usually poor. Few GBMs in children, however, seem to respond quite well to adjuvant chemotherapy. The biological basis for such chemotherapy sensitivity remains uncertain. In this paper the authors report the case of a 2-month-old girl with a histologically confirmed GBM (WHO Grade IV) in whom chemotherapy was accompanied by differentiation of the malignant primary tumor into a typical gangliocytoma (WHO Grade I) showing ganglioid differentiation and expression of neuronal markers synaptophysin, neurofilament, and NeuN as well as a low Ki 67/MIB-1 proliferation index. Array-comparative genomic hybridization did not reveal genetic alterations in either specimen. Even though the underlying biological mechanisms remain to be elucidated, closer examination of frequency and prognostic significance of neuronal differentiation in pediatric GBMs within ongoing and future clinical trials may be warranted.

scholarly journals Diagnostic value of microvessel structure in brain glial tumors

2017 ◽  
Vol 25 (3) ◽  
pp. 350-361 ◽  
Author(s):  
I. S. Shpon’ka ◽  
T. V. Shynkarenko
Keyword(s):  
Prognostic Significance ◽  
Diagnostic Value ◽  
Proliferation Index ◽  
Ki 67 ◽  
Who Grade ◽  
Vascular Area ◽  
Diffuse Gliomas ◽  
The Mean ◽  
Brain Gliomas ◽  
Diffuse Brain

Diffuse gliomas are the most common primary brain tumors with a disproportionately high mortality rate. Characteristics of microvessels are of high diagnostic and prognostic significance, however, the results of previous studies are controversial. The aim of the work is to evaluate the features of angiogenesis in diffuse gliomas on the basis of determining the qualitative and quantitative microvascular characteristics. Also important is their relationship with the histological type of tumor. Microvascular density (μm-1), total vascular area (%), total lumen area (%) and the mean diameter of microvessels (μm) were measured and calculated in diffuse brain gliomas (n=76) using GFAP-negative status of endothelium in the presence of exclusively GFAP-positive tumor cells. Proliferation of microvessels was evaluated using proliferation index of vascular epithelium (Ki-67). The possibility of routine evaluation of the angiogenesis in diffuse gliomas using GFAP and Ki-67 markers was defined. We revealed significant correlation between features of the neoplastic microvasculature and WHO Grade.

scholarly journals Prognostic Significance of Preoperative Neutrophil-to-Lymphocyte Ratio in Patients With Meningiomas

2020 ◽  
Vol 10 ◽  
Author(s):  
Yuki Kuranari ◽  
Ryota Tamura ◽  
Noboru Tsuda ◽  
Kenzo Kosugi ◽  
Yukina Morimoto ◽  
...  
Keyword(s):  
Prognostic Significance ◽  
Laboratory Data ◽  
Progression Free Survival ◽  
Cost Effective ◽  
Tumor Location ◽  
Neutrophil To Lymphocyte Ratio ◽  
Ki 67 ◽  
Who Grade ◽  
Lymphocyte Ratio ◽  
Subtotal Removal

BackgroundMeningiomas are the most common benign intracranial tumors. However, even WHO grade I meningiomas occasionally show local tumor recurrence. Prognostic factors for meningiomas have not been fully established. Neutrophil-to-lymphocyte ratio (NLR) has been reported as a prognostic factor for several solid tumors. The prognostic value of NLR in meningiomas has been analyzed in few studies.Materials and MethodsThis retrospective study included 160 patients who underwent surgery for meningiomas between October 2010 and September 2017. We analyzed the associations between patients’ clinical data (sex, age, primary/recurrent, WHO grade, extent of removal, tumor location, peritumoral brain edema, and preoperative laboratory data) and clinical outcomes, including recurrence and progression-free survival (PFS).ResultsForty-four meningiomas recurred within the follow-up period of 3.8 years. WHO grade II, III, subtotal removal, history of recurrence, Ki-67 labeling index ≥3.0, and preoperative NLR value ≥2.6 were significantly associated with shorter PFS (P < 0.001, < 0.001, 0.002, < 0.001, and 0.015, respectively). Furthermore, NLR ≥ 2.6 was also significantly associated with shorter PFS in a subgroup analysis of WHO grade I meningiomas (P = 0.003). In univariate and multivariate analyses, NLR ≥2.6 remained as a significant predictive factor for shorter PFS in patients with meningioma (P = 0.014).ConclusionsNLR may be a cost-effective and novel preoperatively usable biomarker in patients with meningiomas.

scholarly journals P14.95 Is the pathological-grade relevant in “IDH-wild type, TERT-mutant” diffuse-gliomas? An analysis in 147 patients

2019 ◽  
Vol 21 (Supplement_3) ◽  
pp. iii90-iii90
Author(s):  
A E Danyeli ◽  
C B Akyerli ◽  
A Dinçer ◽  
E Coşgun ◽  
U Abacıoğlu ◽  
...  
Keyword(s):  
Overall Survival ◽  
Progression Free Survival ◽  
Genetic Alterations ◽  
Lower Grade ◽  
Wild Type ◽  
Ki 67 ◽  
Who Grade ◽  
Free Survival ◽  
Tert Promoter ◽  
Diffuse Gliomas

Abstract BACKGROUND Although the word “glioblastoma” still denotes a grade-IV pathology, basic molecular studies have clearly indicated that a significant proportion of lower-grade gliomas harbor genetic alterations typical of glioblastomas. Based on these findings cIMPACT-NOW update 3 has defined an entity called the “diffuse astrocytic glioma, IDH-wildtype, with molecular features of glioblastoma, WHO grade IV”. A TERT-promoter mutation is one of these typical molecular markers of glioblastomas. In this study we analyzed IDH-wild type, TERT-mutant diffuse gliomas of different pathological grades to look for differences in demographic, clinical and survival characteristics. MATERIAL AND METHODS 147 adult hemispheric diffuse-gliomas with wild-type IDH1/2 and mutant TERT-promoter (C228T or C250T) were retrospectively analyzed. Primary thalamic, cerebellar brainstem or spinal cases were excluded. 126 (86%), 16(11%) and 5(3%) patients were WHO grade IV, III and II respectively. After surgical treatment or stereotactic biopsy all patients underwent chemoradiation. Median follow-up was 16mo (1–110). Tumors of different grades were compared for age, gender, multifocality, gliomatosis pattern, Ki-67 index, progression-free survival and overall-survival. RESULTS Mean age at presentation for grade II, III and IV were comparable (58.1, 58 and 58.1; ANOVA, p=0.72). There was a slight male predominance in both lower-grades and WHO-grade IV (M:F ratios 1.625 and 1.74). Mean Ki-67 index was significantly higher in higher grades (0.06, 0.14 and 0.25 for grades II, III and IV; ANOVA, p=0.001). Multifocality was comparable (chi-sq, p=1) in lower-grades (3/21; 14.3%) vs. WHO-grade IV (18/126; 14.3%). Gliomatosis pattern was comparable (chi-sq, p=0.095) in lower-grades (2/21; 9.5%) vs. (3/126; 2.3%). Median recurrence free survival (RFS) was 16 months (0–63) in lower-grades and 8months (1–50) in WHO-grade IV. PFS was significantly different between 3 WHO-grades (Log rank, p=0.007) and also between lower-grades and WHO-grade IV (Log rank, p=0.002). Median overall survival was 26 months(2–110) in lower-grades and 15mo(1–91) in WHO-grade IV. OS was significantly different between 3 WHO-grades (Log rank, p=0.014) and also between lower-grades and WHO-grade IV (Log rank, p=0.007). CONCLUSION Increasing pathological grades of hemispheric “IDH-wild type, TERT-mutant diffuse gliomas” have similar demographic and clinical characteristics but incrasing proliferation indices, decrasing progression free survival and shorter overall survival. The findings may be suggesitve of different grades of one common tumor entity.

Overall Genomic Pattern Is a Predictor of Outcome in Neuroblastoma

2009 ◽  
Vol 27 (7) ◽  
pp. 1026-1033 ◽  
Author(s):  
Isabelle Janoueix-Lerosey ◽  
Gudrun Schleiermacher ◽  
Evi Michels ◽  
Véronique Mosseri ◽  
Agnès Ribeiro ◽  
...  
Keyword(s):  
Copy Number ◽  
Prognostic Significance ◽  
Genetic Alterations ◽  
Copy Number Variations ◽  
Comparative Genomic ◽  
Mycn Amplification ◽  
Clinical Markers ◽  
Prognostic Information ◽  
Stage 4 ◽  
Risk Of Relapse

Purpose For a comprehensive overview of the genetic alterations of neuroblastoma, their association and clinical significance, we conducted a whole-genome DNA copy number analysis. Patients and Methods A series of 493 neuroblastoma (NB) samples was investigated by array-based comparative genomic hybridization in two consecutive steps (224, then 269 patients). Results Genomic analysis identified several types of profiles. Tumors presenting exclusively whole-chromosome copy number variations were associated with excellent survival. No disease-related death was observed in this group. In contrast, tumors with any type of segmental chromosome alterations characterized patients with a high risk of relapse. Patients with both numerical and segmental abnormalities clearly shared the higher risk of relapse of segmental-only patients. In a multivariate analysis, taking into account the genomic profile, but also previously described individual genetic and clinical markers with prognostic significance, the presence of segmental alterations with (HR, 7.3; 95% CI, 3.7 to 14.5; P < .001) or without MYCN amplification (HR, 4.5; 95% CI, 2.4 to 8.4; P < .001) was the strongest predictor of relapse; the other significant variables were age older than 18 months (HR, 1.8; 95% CI, 1.2 to 2.8; P = .004) and stage 4 (HR, 1.8; 95% CI, 1.2 to 2.7; P = .005). Finally, within tumors showing segmental alterations, stage 4, age, MYCN amplification, 1p and 11q deletions, and 1q gain were independent predictors of decreased overall survival. Conclusion The analysis of the overall genomic pattern, which probably unravels particular genomic instability mechanisms rather than the analysis of individual markers, is essential to predict relapse in NB patients. It adds critical prognostic information to conventional markers and should be included in future treatment stratification.

Canine Neuroendocrine Tumors of the Pancreas: A Study Using Image Analysis Techniques for the Discrimination of Metastatic Versus Nonmetastatic Tumors

1997 ◽  
Vol 34 (2) ◽  
pp. 138-145 ◽  
Author(s):  
G. Minkus ◽  
U. Jütting ◽  
M. Aubele ◽  
K. Rodenacker ◽  
P. Gais ◽  
...  
Keyword(s):  
Image Analysis ◽  
Neuroendocrine Tumors ◽  
Nucleolar Organizer ◽  
Biological Behavior ◽  
Proliferation Index ◽  
Nucleolar Organizer Regions ◽  
Ki 67 ◽  
Analysis Techniques ◽  
Significant Difference ◽  
Image Analysis Techniques

Canine pancreatic neuroendocrine tumors were studied using different image analysis techniques (nuclear image histometry, analysis of argyrophilic proteins of nucleolar organizer regions, determination of the mouse anti-Ki 67 antigen proliferation index, and DNA densitometry) to correlate their biological behavior with objective phenotypic markers. The methods were compared to determine the best method for distinguishing between metastatic and nonmetastatic tumors. Discrimination between the two types of tumor was possible using nuclear image histometry in combination with morphometric analysis of argyrophilic proteins of nucleolar organizer regions. In contrast, the mouse anti-Ki 67 antigen proliferation index, DNA measurement, and immunohistochemical parameters revealed no significant difference between the two types of tumors.

scholarly journals Correlation of Brain Tumor-related Epilepsy With Clinicopathological Factors in Gliomas

2021 ◽  
Author(s):  
Bo Li ◽  
Shunli Jiang ◽  
Guangning Zhang ◽  
Junchen Zhang
Keyword(s):  
Brain Tumor ◽  
Treatment Strategies ◽  
Rank Correlation ◽  
Idh1 Mutation ◽  
Expression Level ◽  
Proliferation Index ◽  
Clinicopathological Factors ◽  
Ki 67 ◽  
Who Grade ◽  
Wide Range

Abstract Objectives: Glioma patients with brain tumor-related epilepsy (BTRE) have a complex profile due to the simultaneous presence of two pathologies: glioma and epilepsy. However, the underlying pathophysiology of BTRE remains poorly understood. The purpose of this study is to investigate the correlation between molecular neuropathology and glioma with BTRE.Methods: A retrospective cohort study of 186 glioma patients was evaluated at our hospital, with 64 presenting with BTRE. Chi-square test, spearman rank correlation and multivariate logistic analyses were used to identify clinicopathological factors associated with BTRE. Results: Of the 186 patients examined in this study, 64 (34.4 %) had BTRE. By analyzing the characteristics of these patients, the results showed that patient age (over 40 years; p=0.007), low WHO grade (grade I, II; p = 0.001), IDH-1 positive mutation (p=0.027), ATR-X low expression level (OR=0.44; 95% CI: 0.21, 0.92) and low Ki-67 proliferation index (OR=0.25; 95% CI: 0.10, 0.68) were associated with the occurrence of BTRE. BTRE did not differ by sex, tumor location, expression of olig-2 or CD34. The results of the matching study showed that low Ki-67 proliferation index and negative ATR-X expression level were independent factors for a higher incidence of preoperative seizures in glioma patients. Conclusion: The current study updates existing information on genetic markers in gliomas with BTRE and explores the correlation of a wide range of clinicopathological factors and glioma patients with BTRE. Our study suggests that three putative biomarkers for BTRE: positive IDH1 mutation, low Ki-67 proliferation index and negative ATR-X expression. These factors may provide insights for developing a more thorough understanding of the pathogenesis of epilepsy and effective treatment strategies aimed at seizure control.

scholarly journals Case Report: Genetic Alterations Associated with the Progression of Carotid Paraganglioma

2021 ◽  
Vol 43 (3) ◽  
pp. 2266-2275
Author(s):  
Vladislav Pavlov ◽  
Anastasiya Snezhkina ◽  
Dmitry Kalinin ◽  
Alexander Golovyuk ◽  
Anastasiya Kobelyatskaya ◽  
...  
Keyword(s):  
Molecular Mechanisms ◽  
Neck Region ◽  
Genetic Alterations ◽  
The Body ◽  
Proliferation Index ◽  
Recurrent Tumor ◽  
Sdhb Mutation ◽  
Ki 67 ◽  
Whole Exome ◽  
Tert Gene

Paragangliomas (PGLs) are rare neuroendocrine tumors that can develop from any paraganglion across the body. The carotid body is the most often location of PGLs in the head and neck region. Carotid PGLs (CPGLs) are characterized by predominantly non-aggressive behavior; however, all tumors have the potential to metastasize. To date, molecular mechanisms of paraganglioma progression remain elusive. We report a case of a 38-year-old woman with metastatic CPGL manifesting as a recurrent tumor with lymph node metastasis. The tumor was fast-growing and had a high Ki-67 proliferation index. Immunohistochemical (IHC) examination and whole-exome sequencing were performed for both recurrent tumor and metastasis. A germline pathogenic splice acceptor variant in the SDHB gene was found in the patient. Immunoreactivity of the SDHB subunit was weak diffuse in both samples, indicating deficiency of the succinate dehydrogenase. Moreover, the recurrent tumor exhibited loss of heterozygosity (LOH) at the SDHB locus, that is according to Knudson’s "two-hit" hypothesis of cancer causation. We also identified a rare somatic promotor mutation in the TERT gene associated with the tumor progression. Obtained results confirmed the indicative role of the germline SDHB mutation for metastatic CPGLs, as well as the potential prognostic value of the TERT promoter mutation.

scholarly journals Adjuvant Therapy in Adrenocortical Carcinoma: Reflections and Future Directions

Cancers ◽  
2020 ◽  
Vol 12 (2) ◽  
pp. 508 ◽  
Author(s):  
Sara Bedrose ◽  
Marilyne Daher ◽  
Lina Altameemi ◽  
Mouhammed Amir Habra
Keyword(s):  
Adjuvant Therapy ◽  
Surgical Resection ◽  
Adrenocortical Carcinoma ◽  
Genetic Alterations ◽  
Disease Stage ◽  
Proliferation Index ◽  
Resection Margins ◽  
Ki 67 ◽  
Platinum Based Chemotherapy

Adrenocortical carcinoma (ACC) is a rare and aggressive malignancy with high risk of recurrence despite macroscopically complete surgical resection. The main predictors of ACC recurrence include advanced disease stage, incomplete surgical resection, cortisol production, certain genetic alterations, and high proliferation rate (Ki-67 proliferation index). Mitotane has been the mainstay adjuvant therapy of ACC. However, the use of mitotane is based on retrospective and occasionally conflicting evidence. As mitotane levels can take a few months before reaching therapeutic levels, there is an emerging practice of combining platinum-based chemotherapy with mitotane in the adjuvant setting. Retrospective data indicate that radiotherapy is an option for select patients, particularly those with positive resection margins. There are multiple knowledge gaps in selecting patients for adjuvant therapy. It is of great importance to establish risk calculators to predict recurrence and to implement molecular profiling of ACC to guide adjuvant therapy. The role of immunotherapy in metastatic ACC is emerging and if deemed efficacious, then future studies will be needed to ascertain the role of adjuvant immunotherapy in ACC.

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