Details

Autor(en) / Beteiligte

• Mizoguchi, Masahiro
• Hata, Nobuhiro
• Kuga, Daisuke
• Hatae, Ryusuke
• Akagi, Yojiro
• Sangatsuda, Yuhei
• Fujioka, Yutaka
• Takigawa, Kosuke
• Funakoshi, Yusuke
• Suzuki, Satoshi O.
• Iwaki, Toru

Titel

Clinical implications of molecular analysis in diffuse glioma stratification

Ist Teil von

• Brain tumor pathology, 2021-07, Vol.38 (3), p.210-217

Ort / Verlag

Singapore: Springer Singapore

Erscheinungsjahr

2021

Quelle

Alma/SFX Local Collection

Beschreibungen/Notizen

• The revised 4th edition of the 2016 World Health Organization Classification of Tumors of the Central Nervous System (2016 CNS WHO) has introduced the integrated diagnostic classification that combines molecular and histological diagnoses for diffuse gliomas. In this study, we evaluated the molecular alterations for consecutive 300 diffuse glioma cases (grade 2, 56; grade 3, 62; grade 4, 182) based on this classification. Mutations in the isocitrate dehydrogenase (IDH) genes were common in lower grade glioma (LGG: grade2–3), and when combined with 1p/19q status, LGGs could be stratified into three groups except for four cases (Astrocytoma, IDH-mutant: 44; Oligodendroglioma, IDH-mutant and 1p/19q codeleted: 37; Astrocytoma, IDH -wildtype: 33). 1p/19q-codeleted oligodendrogliomas were clinically the most favorable subgroup even with upfront chemotherapy. In contrast, IDH -wildtype astrocytomas had a relatively worse prognosis; however, this subgroup was more heterogeneous. Of this subgroup, 11 cases had TERT promoter (p TERT ) mutation with shorter overall survival than 12 p TERT -wildtype cases. Additionally, a longitudinal analysis indicated p TERT mutation as early molecular event for gliomagenesis. Therefore, p TERT mutation is critical for the diagnosis of molecular glioblastoma (WHO grade 4), regardless of histological findings, and future treatment strategy should be considered based on the precise molecular analysis.