1
|
Barnes EA, Knutsen C, Kindt A, Che X, Ying L, Adams E, Gonzalez E, Oak P, Hilgendorff A, Alvira CM, Cornfield DN. Hypoxia-Inducible Factor-1α in SM22α-Expressing Cells Modulates Alveolarization. Am J Respir Cell Mol Biol 2023; 69:470-483. [PMID: 37290124 PMCID: PMC10557922 DOI: 10.1165/rcmb.2023-0045oc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 06/08/2023] [Indexed: 06/10/2023] Open
Abstract
Worldwide, the incidence of both preterm births and chronic lung disease of infancy, or bronchopulmonary dysplasia, remains high. Infants with bronchopulmonary dysplasia have larger and fewer alveoli, a lung pathology that can persist into adulthood. Although recent data point to a role for hypoxia-inducible factor-1α (HIF-1α) in mediating pulmonary angiogenesis and alveolarization, the cell-specific role of HIF-1α remains incompletely understood. Thus, we hypothesized that HIF-1α, in a distinct subset of mesenchymal cells, mediates postnatal alveolarization. To test the hypothesis, we generated mice with a cell-specific deletion of HIF-1α by crossing SM22α promoter-driven Cre mice with HIF-1αflox/flox mice (SM22α-HIF-1α-/-), determined SM-22α-expressing cell identity using single-cell RNA sequencing, and interrogated samples from preterm infants. Deletion of HIF-1α in SM22α-expressing cells had no effect on lung structure at day 3 of life. However, at 8 days, there were fewer and larger alveoli, a difference that persisted into adulthood. Microvascular density, elastin organization, and peripheral branching of the lung vasculature were decreased in SM22α-HIF-1α-/- mice, compared with control mice. Single-cell RNA sequencing demonstrated that three mesenchymal cell subtypes express SM22α: myofibroblasts, airway smooth muscle cells, and vascular smooth muscle cells. Pulmonary vascular smooth muscle cells from SM22α-HIF-1α-/- mice had decreased angiopoietin-2 expression and, in coculture experiments, a diminished capacity to promote angiogenesis that was rescued by angiopoietin-2. Angiopoietin-2 expression in tracheal aspirates of preterm infants was inversely correlated with overall mechanical ventilation time, a marker of disease severity. We conclude that SM22α-specific HIF-1α expression drives peripheral angiogenesis and alveolarization in the lung, perhaps by promoting angiopoietin-2 expression.
Collapse
Affiliation(s)
- Elizabeth A. Barnes
- Division of Pulmonary, Asthma, and Sleep Medicine, Center for Excellence in Pulmonary Biology, and
| | - Carsten Knutsen
- Division of Pulmonary, Asthma, and Sleep Medicine, Center for Excellence in Pulmonary Biology, and
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, California
| | - Alida Kindt
- Metabolomics and Analytics Centre, Leiden Academic Centre for Drug Research, Leiden University, Leiden, the Netherlands; and
| | - Xibing Che
- Division of Pulmonary, Asthma, and Sleep Medicine, Center for Excellence in Pulmonary Biology, and
| | - Lihua Ying
- Division of Pulmonary, Asthma, and Sleep Medicine, Center for Excellence in Pulmonary Biology, and
| | - Eloa Adams
- Division of Pulmonary, Asthma, and Sleep Medicine, Center for Excellence in Pulmonary Biology, and
| | - Erika Gonzalez
- Comprehensive Pneumology Center, Ludwig Maximilian University of Munich, Munich, Germany
| | - Prajakta Oak
- Comprehensive Pneumology Center, Ludwig Maximilian University of Munich, Munich, Germany
| | - Anne Hilgendorff
- Comprehensive Pneumology Center, Ludwig Maximilian University of Munich, Munich, Germany
| | - Cristina M. Alvira
- Division of Pulmonary, Asthma, and Sleep Medicine, Center for Excellence in Pulmonary Biology, and
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, California
| | - David N. Cornfield
- Division of Pulmonary, Asthma, and Sleep Medicine, Center for Excellence in Pulmonary Biology, and
| |
Collapse
|
2
|
Hirschler L, Sollmann N, Schmitz‐Abecassis B, Pinto J, Arzanforoosh F, Barkhof F, Booth T, Calvo‐Imirizaldu M, Cassia G, Chmelik M, Clement P, Ercan E, Fernández‐Seara MA, Furtner J, Fuster‐Garcia E, Grech‐Sollars M, Guven NT, Hatay GH, Karami G, Keil VC, Kim M, Koekkoek JAF, Kukran S, Mancini L, Nechifor RE, Özcan A, Ozturk‐Isik E, Piskin S, Schmainda K, Svensson SF, Tseng C, Unnikrishnan S, Vos F, Warnert E, Zhao MY, Jancalek R, Nunes T, Emblem KE, Smits M, Petr J, Hangel G. Advanced MR Techniques for Preoperative Glioma Characterization: Part 1. J Magn Reson Imaging 2023; 57:1655-1675. [PMID: 36866773 PMCID: PMC10946498 DOI: 10.1002/jmri.28662] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 02/08/2023] [Accepted: 02/09/2023] [Indexed: 03/04/2023] Open
Abstract
Preoperative clinical magnetic resonance imaging (MRI) protocols for gliomas, brain tumors with dismal outcomes due to their infiltrative properties, still rely on conventional structural MRI, which does not deliver information on tumor genotype and is limited in the delineation of diffuse gliomas. The GliMR COST action wants to raise awareness about the state of the art of advanced MRI techniques in gliomas and their possible clinical translation or lack thereof. This review describes current methods, limits, and applications of advanced MRI for the preoperative assessment of glioma, summarizing the level of clinical validation of different techniques. In this first part, we discuss dynamic susceptibility contrast and dynamic contrast-enhanced MRI, arterial spin labeling, diffusion-weighted MRI, vessel imaging, and magnetic resonance fingerprinting. The second part of this review addresses magnetic resonance spectroscopy, chemical exchange saturation transfer, susceptibility-weighted imaging, MRI-PET, MR elastography, and MR-based radiomics applications. Evidence Level: 3 Technical Efficacy: Stage 2.
Collapse
Affiliation(s)
- Lydiane Hirschler
- C.J. Gorter MRI Center, Department of RadiologyLeiden University Medical CenterLeidenThe Netherlands
| | - Nico Sollmann
- Department of Diagnostic and Interventional RadiologyUniversity Hospital UlmUlmGermany
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der IsarTechnical University of MunichMunichGermany
- TUM‐Neuroimaging Center, Klinikum rechts der IsarTechnical University of MunichMunichGermany
| | - Bárbara Schmitz‐Abecassis
- Department of RadiologyLeiden University Medical CenterLeidenThe Netherlands
- Medical Delta FoundationDelftThe Netherlands
| | - Joana Pinto
- Institute of Biomedical Engineering, Department of Engineering ScienceUniversity of OxfordOxfordUK
| | | | - Frederik Barkhof
- Department of Radiology & Nuclear MedicineAmsterdam UMC, Vrije UniversiteitAmsterdamThe Netherlands
- Queen Square Institute of Neurology and Centre for Medical Image ComputingUniversity College LondonLondonUK
| | - Thomas Booth
- School of Biomedical Engineering and Imaging SciencesKing's College LondonLondonUK
- Department of NeuroradiologyKing's College Hospital NHS Foundation TrustLondonUK
| | | | | | - Marek Chmelik
- Department of Technical Disciplines in Medicine, Faculty of Health CareUniversity of PrešovPrešovSlovakia
| | - Patricia Clement
- Department of Diagnostic SciencesGhent UniversityGhentBelgium
- Department of Medical ImagingGhent University HospitalGhentBelgium
| | - Ece Ercan
- Department of RadiologyLeiden University Medical CenterLeidenThe Netherlands
| | - Maria A. Fernández‐Seara
- Department of RadiologyClínica Universidad de NavarraPamplonaSpain
- IdiSNA, Instituto de Investigación Sanitaria de NavarraPamplonaSpain
| | - Julia Furtner
- Department of Biomedical Imaging and Image‐guided TherapyMedical University of ViennaViennaAustria
- Research Center of Medical Image Analysis and Artificial IntelligenceDanube Private UniversityKrems an der DonauAustria
| | - Elies Fuster‐Garcia
- Biomedical Data Science Laboratory, Instituto Universitario de Tecnologías de la Información y ComunicacionesUniversitat Politècnica de ValènciaValenciaSpain
| | - Matthew Grech‐Sollars
- Centre for Medical Image Computing, Department of Computer ScienceUniversity College LondonLondonUK
- Lysholm Department of Neuroradiology, National Hospital for Neurology and NeurosurgeryUniversity College London Hospitals NHS Foundation TrustLondonUK
| | - Nazmiye Tugay Guven
- Institute of Biomedical EngineeringBogazici University IstanbulIstanbulTurkey
| | - Gokce Hale Hatay
- Institute of Biomedical EngineeringBogazici University IstanbulIstanbulTurkey
| | - Golestan Karami
- School of Biomedical Engineering and Imaging SciencesKing's College LondonLondonUK
| | - Vera C. Keil
- Department of Radiology & Nuclear MedicineAmsterdam UMC, Vrije UniversiteitAmsterdamThe Netherlands
- Cancer Center AmsterdamAmsterdamThe Netherlands
| | - Mina Kim
- Centre for Medical Image Computing, Department of Medical Physics & Biomedical Engineering and Department of NeuroinflammationUniversity College LondonLondonUK
| | - Johan A. F. Koekkoek
- Department of NeurologyLeiden University Medical CenterLeidenThe Netherlands
- Department of NeurologyHaaglanden Medical CenterThe HagueThe Netherlands
| | - Simran Kukran
- Department of BioengineeringImperial College LondonLondonUK
- Department of Radiotherapy and ImagingInstitute of Cancer ResearchLondonUK
| | - Laura Mancini
- Lysholm Department of Neuroradiology, National Hospital for Neurology and NeurosurgeryUniversity College London Hospitals NHS Foundation TrustLondonUK
- Department of Brain Repair and Rehabilitation, Institute of NeurologyUniversity College LondonLondonUK
| | - Ruben Emanuel Nechifor
- Department of Clinical Psychology and PsychotherapyInternational Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babes‐Bolyai UniversityCluj‐NapocaRomania
| | - Alpay Özcan
- Electrical and Electronics Engineering DepartmentBogazici University IstanbulIstanbulTurkey
| | - Esin Ozturk‐Isik
- Institute of Biomedical EngineeringBogazici University IstanbulIstanbulTurkey
| | - Senol Piskin
- Department of Mechanical Engineering, Faculty of Natural Sciences and EngineeringIstinye University IstanbulIstanbulTurkey
| | - Kathleen Schmainda
- Department of BiophysicsMedical College of WisconsinMilwaukeeWisconsinUSA
| | - Siri F. Svensson
- Department of Physics and Computational RadiologyOslo University HospitalOsloNorway
- Department of PhysicsUniversity of OsloOsloNorway
| | - Chih‐Hsien Tseng
- Medical Delta FoundationDelftThe Netherlands
- Department of Imaging PhysicsDelft University of TechnologyDelftThe Netherlands
| | - Saritha Unnikrishnan
- Faculty of Engineering and DesignAtlantic Technological University (ATU) SligoSligoIreland
- Mathematical Modelling and Intelligent Systems for Health and Environment (MISHE), ATU SligoSligoIreland
| | - Frans Vos
- Medical Delta FoundationDelftThe Netherlands
- Department of Radiology & Nuclear MedicineErasmus MCRotterdamThe Netherlands
- Department of Imaging PhysicsDelft University of TechnologyDelftThe Netherlands
| | - Esther Warnert
- Department of Radiology & Nuclear MedicineErasmus MCRotterdamThe Netherlands
| | - Moss Y. Zhao
- Department of RadiologyStanford UniversityStanfordCaliforniaUSA
- Stanford Cardiovascular InstituteStanford UniversityStanfordCaliforniaUSA
| | - Radim Jancalek
- Department of NeurosurgerySt. Anne's University Hospital, BrnoBrnoCzech Republic
- Faculty of Medicine, Masaryk UniversityBrnoCzech Republic
| | - Teresa Nunes
- Department of NeuroradiologyHospital Garcia de OrtaAlmadaPortugal
| | - Kyrre E. Emblem
- Department of Physics and Computational RadiologyOslo University HospitalOsloNorway
| | - Marion Smits
- Institute of Biomedical Engineering, Department of Engineering ScienceUniversity of OxfordOxfordUK
- Department of Radiology & Nuclear MedicineErasmus MCRotterdamThe Netherlands
- Brain Tumour CentreErasmus MC Cancer InstituteRotterdamThe Netherlands
| | - Jan Petr
- Helmholtz‐Zentrum Dresden‐RossendorfInstitute of Radiopharmaceutical Cancer ResearchDresdenGermany
| | - Gilbert Hangel
- Department of NeurosurgeryMedical University of ViennaViennaAustria
- High Field MR Centre, Department of Biomedical Imaging and Image‐guided TherapyMedical University of ViennaViennaAustria
- Christian Doppler Laboratory for MR Imaging BiomarkersViennaAustria
- Medical Imaging ClusterMedical University of ViennaViennaAustria
| |
Collapse
|
3
|
Duffau H. A Personalized Longitudinal Strategy in Low-Grade Glioma Patients: Predicting Oncological and Neural Interindividual Variability and Its Changes over Years to Think One Step Ahead. J Pers Med 2022; 12:jpm12101621. [PMID: 36294760 PMCID: PMC9604939 DOI: 10.3390/jpm12101621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 09/15/2022] [Accepted: 09/22/2022] [Indexed: 11/09/2022] Open
Abstract
Diffuse low-grade glioma (LGG) is a rare cerebral cancer, mostly involving young adults with an active life at diagnosis. If left untreated, LGG widely invades the brain and becomes malignant, generating neurological worsening and ultimately death. Early and repeat treatments for this incurable tumor, including maximal connectome-based surgical resection(s) in awake patients, enable postponement of malignant transformation while preserving quality of life owing to constant neural network reconfiguration. Due to considerable interindividual variability in terms of LGG course and consecutive cerebral reorganization, a multistage longitudinal strategy should be tailored accordingly in each patient. It is crucial to predict how the glioma will progress (changes in growth rate and pattern of migration, genetic mutation, etc.) and how the brain will adapt (changes in patterns of spatiotemporal redistribution, possible functional consequences such as epilepsy or cognitive decline, etc.). The goal is to anticipate therapeutic management, remaining one step ahead in order to select the optimal (re-)treatment(s) (some of them possibly kept in reserve), at the appropriate time(s) in the evolution of this chronic disease, before malignization and clinical worsening. Here, predictive tumoral and non-tumoral factors, and their ever-changing interactions, are reviewed to guide individual decisions in advance based on patient-specific markers, for the treatment of LGG.
Collapse
Affiliation(s)
- Hugues Duffau
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, 80 Av. Augustin Fliche, 34295 Montpellier, France; ; Tel.: +33-4-67-33-66-12; Fax: +33-4-67-33-69-12
- Team “Plasticity of Central Nervous System, Stem Cells and Glial Tumors”, National Institute for Health and Medical Research (INSERM), U1191 Laboratory, Institute of Functional Genomics, University of Montpellier, 34091 Montpellier, France
| |
Collapse
|
4
|
Relier S, Amalric A, Attina A, Koumare IB, Rigau V, Burel Vandenbos F, Fontaine D, Baroncini M, Hugnot JP, Duffau H, Bauchet L, Hirtz C, Rivals E, David A. Multivariate Analysis of RNA Chemistry Marks Uncovers Epitranscriptomics-Based Biomarker Signature for Adult Diffuse Glioma Diagnostics. Anal Chem 2022; 94:11967-11972. [PMID: 35998076 PMCID: PMC9453740 DOI: 10.1021/acs.analchem.2c01526] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
![]()
One of the main challenges in cancer management relates
to the
discovery of reliable biomarkers, which could guide decision-making
and predict treatment outcome. In particular, the rise and democratization
of high-throughput molecular profiling technologies bolstered the
discovery of “biomarker signatures” that could maximize
the prediction performance. Such an approach was largely employed
from diverse OMICs data (i.e., genomics, transcriptomics, proteomics,
metabolomics) but not from epitranscriptomics, which encompasses more
than 100 biochemical modifications driving the post-transcriptional
fate of RNA: stability, splicing, storage, and translation. We and
others have studied chemical marks in isolation and associated them
with cancer evolution, adaptation, as well as the response to conventional
therapy. In this study, we have designed a unique pipeline combining
multiplex analysis of the epitranscriptomic landscape by high-performance
liquid chromatography coupled to tandem mass spectrometry with statistical
multivariate analysis and machine learning approaches in order to
identify biomarker signatures that could guide precision medicine
and improve disease diagnosis. We applied this approach to analyze
a cohort of adult diffuse glioma patients and demonstrate the existence
of an “epitranscriptomics-based signature” that permits
glioma grades to be discriminated and predicted with unmet accuracy.
This study demonstrates that epitranscriptomics (co)evolves along
cancer progression and opens new prospects in the field of omics molecular
profiling and personalized medicine.
Collapse
Affiliation(s)
- S Relier
- IGF, Univ. Montpellier, CNRS, INSERM, Montpellier, Hérault 34094, France
| | - A Amalric
- IGF, Univ. Montpellier, CNRS, INSERM, Montpellier, Hérault 34094, France.,IRMB-PPC, INM, Univ Montpellier, CHU Montpellier, INSERM CNRS, Montpellier 34295, France
| | - A Attina
- IRMB-PPC, INM, Univ Montpellier, CHU Montpellier, INSERM CNRS, Montpellier 34295, France
| | - I B Koumare
- Neurosurgery Department, Montpellier University Medical Center, Montpellier, Hérault 34295, France.,Neurosurgery Department, CHU Gabriel Toure, Bamako, Mali
| | - V Rigau
- Department of Pathology and Oncobiology, Montpellier University Medical Center, Montpellier, Hérault 34295, France
| | - F Burel Vandenbos
- Central Laboratory of Pathology, Univ. Côte d'Azur, CHU Nice, CNRS, INSERM, Nice, Alpes-Maritimes 06000, France
| | - D Fontaine
- Neurosurgery Department, Univ. Côte d'Azur, CHU Nice, Nice, Alpes-Maritimes 06000, France
| | - M Baroncini
- Neurosurgery Department, CHU Lille, Univ. of Lille, Lille, Nord 59037, France
| | - J P Hugnot
- IGF, Univ. Montpellier, CNRS, INSERM, Montpellier, Hérault 34094, France
| | - H Duffau
- IGF, Univ. Montpellier, CNRS, INSERM, Montpellier, Hérault 34094, France.,Neurosurgery Department, Montpellier University Medical Center, Montpellier, Hérault 34295, France
| | - L Bauchet
- IGF, Univ. Montpellier, CNRS, INSERM, Montpellier, Hérault 34094, France.,Neurosurgery Department, Montpellier University Medical Center, Montpellier, Hérault 34295, France
| | - C Hirtz
- IRMB-PPC, INM, Univ Montpellier, CHU Montpellier, INSERM CNRS, Montpellier 34295, France
| | - E Rivals
- LIRMM, Univ. Montpellier, CNRS, Montpellier, Hérault 34095, France
| | - A David
- IGF, Univ. Montpellier, CNRS, INSERM, Montpellier, Hérault 34094, France.,IRMB-PPC, INM, Univ Montpellier, CHU Montpellier, INSERM CNRS, Montpellier 34295, France
| |
Collapse
|
5
|
Silva M, Vivancos C, Duffau H. The Concept of «Peritumoral Zone» in Diffuse Low-Grade Gliomas: Oncological and Functional Implications for a Connectome-Guided Therapeutic Attitude. Brain Sci 2022; 12:brainsci12040504. [PMID: 35448035 PMCID: PMC9032126 DOI: 10.3390/brainsci12040504] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 04/10/2022] [Accepted: 04/12/2022] [Indexed: 12/22/2022] Open
Abstract
Diffuse low-grade gliomas (DLGGs) are heterogeneous and poorly circumscribed neoplasms with isolated tumor cells that extend beyond the margins of the lesion depicted on MRI. Efforts to demarcate the glioma core from the surrounding healthy brain led us to define an intermediate region, the so-called peritumoral zone (PTZ). Although most studies about PTZ have been conducted on high-grade gliomas, the purpose here is to review the cellular, metabolic, and radiological characteristics of PTZ in the specific context of DLGG. A better delineation of PTZ, in which glioma cells and neural tissue strongly interact, may open new therapeutic avenues to optimize both functional and oncological results. First, a connectome-based “supratotal” surgical resection (i.e., with the removal of PTZ in addition to the tumor core) resulted in prolonged survival by limiting the risk of malignant transformation, while improving the quality of life, thanks to a better control of seizures. Second, the timing and order of (neo)adjuvant medical treatments can be modulated according to the pattern of peritumoral infiltration. Third, the development of new drugs specifically targeting the PTZ could be considered from an oncological (such as immunotherapy) and epileptological perspective. Further multimodal investigations of PTZ are needed to maximize long-term outcomes in DLGG patients.
Collapse
Affiliation(s)
- Melissa Silva
- Department of Neurosurgery, Hospital Garcia de Orta, 2805-267 Almada, Portugal;
| | - Catalina Vivancos
- Department of Neurosurgery, Hospital Universitario La Paz, 28046 Madrid, Spain;
| | - Hugues Duffau
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, 34295 Montpellier, France
- Team “Plasticity of Central Nervous System, Stem Cells and Glial Tumors”, Institute of Functional Genomics, National Institute for Health and Medical Research (INSERM) U1191, University of Montpellier, 34295 Montpellier, France
- Correspondence:
| |
Collapse
|
6
|
Sarubbo S, Duffau H. Connectomic evidences driving a functional approach in neuro-oncological surgery. J Neurosurg Sci 2022; 65:545-547. [PMID: 35128917 DOI: 10.23736/s0390-5616.21.05517-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Silvio Sarubbo
- Department of Neurosurgery, "Santa Chiara" Hospital, Azienda Provinciale per i Servizi Sanitari (APSS), Trento, Italy -
| | - Hugues Duffau
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France.,Institut of Functional Genomics, University of Montpellier, Montpellier, France
| |
Collapse
|
7
|
Valente Aguiar P, Sousa O, Silva R, Vaz R, Linhares P. Early atypical malignant transformation of diffuse low-grade astrocytoma: The importance of genotyping. NEUROCIRUGIA (ENGLISH EDITION) 2022; 33:31-34. [PMID: 34998489 DOI: 10.1016/j.neucie.2020.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 09/19/2020] [Indexed: 06/14/2023]
Abstract
Diffuse astrocytoma (WHO grade II) has classically been considered a slow growing tumour, typically affecting young adults, with tendency for late malignant conversion. We describe a case of early atypical malignant transformation of diffuse astrocytoma seventeen months after complete surgical removal, as an intraventricular high-grade glioma (HGG). Retrospective laboratory findings for the presence of IDH 1/2 (isocitrate dehydrogenase) mutations were negative. There is growing evidence that IDH-wildtype (wt) astrocytomas behave more aggressively, therefore identifying IDH-mutation status should be mandatory in order to determine disease prognosis and guide treatment course.
Collapse
Affiliation(s)
- Pedro Valente Aguiar
- Department of Neurosurgery, Centro Hospitalar Universitário São João, Oporto, Portugal; Faculty of Medicine, Oporto University, Portugal.
| | - Osvaldo Sousa
- Department of Neurosurgery, Centro Hospitalar Universitário São João, Oporto, Portugal; Faculty of Medicine, Oporto University, Portugal
| | - Roberto Silva
- Department of Anatomical Pathology, Centro Hospitalar Universitário São João, Oporto, Portugal
| | - Rui Vaz
- Department of Neurosurgery, Centro Hospitalar Universitário São João, Oporto, Portugal; Faculty of Medicine, Oporto University, Portugal; Neurosciences Centre, Hospital CUF, Oporto, Portugal
| | - Paulo Linhares
- Department of Neurosurgery, Centro Hospitalar Universitário São João, Oporto, Portugal; Faculty of Medicine, Oporto University, Portugal; Neurosciences Centre, Hospital CUF, Oporto, Portugal
| |
Collapse
|
8
|
Taillandier L, Obara T, Duffau H. What Does Quality of Care Mean in Lower-Grade Glioma Patients: A Precision Molecular-Based Management of the Tumor or an Individualized Medicine Centered on Patient's Choices? Front Oncol 2021; 11:719014. [PMID: 34354956 PMCID: PMC8329449 DOI: 10.3389/fonc.2021.719014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 07/02/2021] [Indexed: 12/02/2022] Open
Affiliation(s)
- Luc Taillandier
- Centre de Recherche en Automatique Nancy France - UMR 7039 - BioSiS Department, Faculty of Medicine, Université de Lorraine, Vandoeuvre-lès-Nancy, France
- Neurology Departement, Neurooncology Unit, CHRU, Nancy, France
| | - Tiphaine Obara
- Centre de Recherche en Automatique Nancy France - UMR 7039 - BioSiS Department, Faculty of Medicine, Université de Lorraine, Vandoeuvre-lès-Nancy, France
- Neurology Departement, Neurooncology Unit, CHRU, Nancy, France
| | - Hugues Duffau
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France
- Team “Plasticity of Central Nervous System, Stem Cells and Glial Tumors”, National Institute for Health and Medical Research (INSERM), U1191 Laboratory, Institute of Functional Genomics, University of Montpellier, Montpellier, France
| |
Collapse
|
9
|
Eliferov VA, Zhvansky ES, Sorokin AA, Shurkhay VA, Bormotov DS, Pekov SI, Nikitin PV, Ryzhova MV, Kulikov EE, Potapov AA, Nikolaev EN, Popov IA. The Role of Lipids in the Classification of Astrocytoma and Glioblastoma Using Mass Spectrometry Tumor Profiling. BIOCHEMISTRY (MOSCOW), SUPPLEMENT SERIES B: BIOMEDICAL CHEMISTRY 2021. [DOI: 10.1134/s1990750821020025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
|
10
|
Identification of CRYAB + KCNN3 + SOX9 + Astrocyte-Like and EGFR + PDGFRA + OLIG1 + Oligodendrocyte-Like Tumoral Cells in Diffuse IDH1-Mutant Gliomas and Implication of NOTCH1 Signalling in Their Genesis. Cancers (Basel) 2021; 13:cancers13092107. [PMID: 33925547 PMCID: PMC8123787 DOI: 10.3390/cancers13092107] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 04/18/2021] [Accepted: 04/21/2021] [Indexed: 12/12/2022] Open
Abstract
Simple Summary Diffuse grade II IDH-mutant gliomas are rare brain tumors mainly affecting young patients. These tumors are composed of different populations of tumoral cells. Little is known of these cells and how they are generated. These different cells may show different sensitivity to treatments, so our aim was to study them in detail by directly using patient resections. We identified two clearly distinct tumoral populations and defined reliable markers for them. We also uncovered part of the molecular mechanisms that generate them. Finally, we found that the two cell types have different electrical activity. This article provides unique data and new issues on these rare tumors, which need to be further investigated to develop innovative treatments. Abstract Diffuse grade II IDH-mutant gliomas are slow-growing brain tumors that progress into high-grade gliomas. They present intratumoral cell heterogeneity, and no reliable markers are available to distinguish the different cell subtypes. The molecular mechanisms underlying the formation of this cell diversity is also ill-defined. Here, we report that SOX9 and OLIG1 transcription factors, which specifically label astrocytes and oligodendrocytes in the normal brain, revealed the presence of two largely nonoverlapping tumoral populations in IDH1-mutant oligodendrogliomas and astrocytomas. Astrocyte-like SOX9+ cells additionally stained for APOE, CRYAB, ID4, KCNN3, while oligodendrocyte-like OLIG1+ cells stained for ASCL1, EGFR, IDH1, PDGFRA, PTPRZ1, SOX4, and SOX8. GPR17, an oligodendrocytic marker, was expressed by both cells. These two subpopulations appear to have distinct BMP, NOTCH1, and MAPK active pathways as stainings for BMP4, HEY1, HEY2, p-SMAD1/5 and p-ERK were higher in SOX9+ cells. We used primary cultures and a new cell line to explore the influence of NOTCH1 activation and BMP treatment on the IDH1-mutant glioma cell phenotype. This revealed that NOTCH1 globally reduced oligodendrocytic markers and IDH1 expression while upregulating APOE, CRYAB, HEY1/2, and an electrophysiologically-active Ca2+-activated apamin-sensitive K+ channel (KCNN3/SK3). This was accompanied by a reduction in proliferation. Similar effects of NOTCH1 activation were observed in nontumoral human oligodendrocytic cells, which additionally induced strong SOX9 expression. BMP treatment reduced OLIG1/2 expression and strongly upregulated CRYAB and NOGGIN, a negative regulator of BMP. The presence of astrocyte-like SOX9+ and oligodendrocyte-like OLIG1+ cells in grade II IDH1-mutant gliomas raises new questions about their role in the pathology.
Collapse
|
11
|
Zhvansky ES, Eliferov VA, Sorokin AA, Shurkhay VA, Pekov SI, Bormotov DS, Ivanov DG, Zavorotnyuk DS, Bocharov KV, Khaliullin IG, Belenikin MS, Potapov AA, Nikolaev EN, Popov IA. Assessment of variation of inline cartridge extraction mass spectra. JOURNAL OF MASS SPECTROMETRY : JMS 2021; 56:e4640. [PMID: 32798239 DOI: 10.1002/jms.4640] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 07/20/2020] [Accepted: 07/31/2020] [Indexed: 06/11/2023]
Abstract
Recently, mass-spectrometry methods show its utility in tumor boundary location. The effect of differences between research and clinical protocols such as low- and high-resolution measurements and sample storage have to be understood and taken into account to transfer methods from bench to bedside. In this study, we demonstrate a simple way to compare mass spectra obtained by different experimental protocols, assess its quality, and check for the presence of outliers and batch effect in the dataset. We compare the mass spectra of both fresh and frozen-thawed astrocytic brain tumor samples obtained with the inline cartridge extraction prior to electrospray ionization. Our results reveal the importance of both positive and negative ion mode mass spectrometry for getting reliable information about sample diversity. We show that positive mode highlights the difference between protocols of mass spectra measurement, such as fresh and frozen-thawed samples, whereas negative mode better characterizes the histological difference between samples. We also show how the use of similarity spectrum matrix helps to identify the proper choice of the measurement parameters, so data collection would be kept reliable, and analysis would be correct and meaningful.
Collapse
Affiliation(s)
- Evgeny S Zhvansky
- Phystech School of Biological and Medical Physics, Moscow Institute of Physics and Technology, Dolgoprudny, Moscow Region, Russian Federation
| | - Vasiliy A Eliferov
- Phystech School of Biological and Medical Physics, Moscow Institute of Physics and Technology, Dolgoprudny, Moscow Region, Russian Federation
| | - Anatoly A Sorokin
- Phystech School of Biological and Medical Physics, Moscow Institute of Physics and Technology, Dolgoprudny, Moscow Region, Russian Federation
| | - Vsevolod A Shurkhay
- Phystech School of Biological and Medical Physics, Moscow Institute of Physics and Technology, Dolgoprudny, Moscow Region, Russian Federation
- Outpatient department, Federal State Autonomous Institution «N.N. Burdenko National Scientific and Practical Center for Neurosurgery» of the Ministry of Healthcare of the Russian Federation, Moscow, Russian Federation
| | - Stanislav I Pekov
- Phystech School of Biological and Medical Physics, Moscow Institute of Physics and Technology, Dolgoprudny, Moscow Region, Russian Federation
- Center for Computational and Data-Intensive Science and Engineering, Skolkovo Institute of Science and Technology, Moscow, Russian Federation
| | - Denis S Bormotov
- Phystech School of Biological and Medical Physics, Moscow Institute of Physics and Technology, Dolgoprudny, Moscow Region, Russian Federation
| | - Daniil G Ivanov
- Phystech School of Biological and Medical Physics, Moscow Institute of Physics and Technology, Dolgoprudny, Moscow Region, Russian Federation
- Emanuel Institute for Biochemical Physics, Russian Academy of Sciences, Moscow, Russian Federation
| | - Denis S Zavorotnyuk
- Phystech School of Biological and Medical Physics, Moscow Institute of Physics and Technology, Dolgoprudny, Moscow Region, Russian Federation
| | - Konstantin V Bocharov
- Phystech School of Biological and Medical Physics, Moscow Institute of Physics and Technology, Dolgoprudny, Moscow Region, Russian Federation
- V. L. Talrose Institute for Energy Problems of Chemical Physics, N. N. Semenov Federal Center of Chemical Physics, Russian Academy of Sciences, Moscow, Russia
| | - Iliyas G Khaliullin
- Phystech School of Biological and Medical Physics, Moscow Institute of Physics and Technology, Dolgoprudny, Moscow Region, Russian Federation
| | - Maksim S Belenikin
- Phystech School of Biological and Medical Physics, Moscow Institute of Physics and Technology, Dolgoprudny, Moscow Region, Russian Federation
| | - Aleksandr A Potapov
- Outpatient department, Federal State Autonomous Institution «N.N. Burdenko National Scientific and Practical Center for Neurosurgery» of the Ministry of Healthcare of the Russian Federation, Moscow, Russian Federation
| | - Evgeny N Nikolaev
- Center for Computational and Data-Intensive Science and Engineering, Skolkovo Institute of Science and Technology, Moscow, Russian Federation
| | - Igor A Popov
- Phystech School of Biological and Medical Physics, Moscow Institute of Physics and Technology, Dolgoprudny, Moscow Region, Russian Federation
| |
Collapse
|
12
|
Zhvansky E, Sorokin A, Shurkhay V, Zavorotnyuk D, Bormotov D, Pekov S, Potapov A, Nikolaev E, Popov I. Comparison of Dimensionality Reduction Methods in Mass Spectra of Astrocytoma and Glioblastoma Tissues. Mass Spectrom (Tokyo) 2021; 10:A0094. [PMID: 33747696 PMCID: PMC7953827 DOI: 10.5702/massspectrometry.a0094] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 01/21/2021] [Indexed: 11/24/2022] Open
Abstract
Recently developed methods of ambient ionization allow the collection of mass spectrometric datasets for biological and medical applications at an unprecedented pace. One of the areas that could employ such analysis is neurosurgery. The fast in situ identification of dissected tissues could assist the neurosurgery procedure. In this paper tumor tissues of astrocytoma and glioblastoma are compared. The vast majority of the data representation methods are hard to use, as the number of features is high and the amount of samples is limited. Furthermore, the ratio of features and samples number restricts the use of many machine learning methods. The number of features could be reduced through feature selection algorithms or dimensionality reduction methods. Different algorithms of dimensionality reduction are considered along with the traditional noise thresholding for the mass spectra. From our analysis, the Isomap algorithm appears to be the most effective dimensionality reduction algorithm for negative mode, whereas the positive mode could be processed with a simple noise reduction by a threshold. Also, negative and positive mode correspond to different sample properties: negative mode is responsible for the inner variability and the details of the sample, whereas positive mode describes measurement in general.
Collapse
Affiliation(s)
- Evgeny Zhvansky
- Moscow Institute of Physics and Technology, Dolgoprudny,
Moscow Region, Russian Federation
| | - Anatoly Sorokin
- Moscow Institute of Physics and Technology, Dolgoprudny,
Moscow Region, Russian Federation
- Institute of Cell Biophysics RAS, Pushchino, Russian
Federation
- Institute of Systems, Molecular and Integrative Biology,
University of Liverpool, Liverpool, UK
| | - Vsevolod Shurkhay
- Moscow Institute of Physics and Technology, Dolgoprudny,
Moscow Region, Russian Federation
- Federal State Autonomous Institution «N.N. Burdenko
National Scientific and Practical Center for Neurosurgery» of the Ministry of
Healthcare of the Russian Federation, Moscow, Russian Federation
| | - Denis Zavorotnyuk
- Moscow Institute of Physics and Technology, Dolgoprudny,
Moscow Region, Russian Federation
| | - Denis Bormotov
- Moscow Institute of Physics and Technology, Dolgoprudny,
Moscow Region, Russian Federation
| | - Stanislav Pekov
- N.N. Semenov Federal Research Center of Chemical Physics
Russian Academy of Sciences, Moscow, Russian Federation
| | - Alexander Potapov
- Federal State Autonomous Institution «N.N. Burdenko
National Scientific and Practical Center for Neurosurgery» of the Ministry of
Healthcare of the Russian Federation, Moscow, Russian Federation
| | - Evgeny Nikolaev
- Skolkovo Institute of Science and Technology, Moscow,
Russian Federation
| | - Igor Popov
- Moscow Institute of Physics and Technology, Dolgoprudny,
Moscow Region, Russian Federation
| |
Collapse
|
13
|
Zhu L, Wu J, Zhang H, Niu H, Wang L. The value of intravoxel incoherent motion imaging in predicting the survival of patients with astrocytoma. Acta Radiol 2021; 62:423-429. [PMID: 32551800 DOI: 10.1177/0284185120926907] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
BACKGROUND The evaluation of the prognosis of gliomas may have great value in individualized treatment. PURPOSE To evaluate the value of intravoxel incoherent motion (IVIM) in predicting the survival of patients with astrocytoma and comparing it to apparent diffusion coefficients (ADC). MATERIAL AND METHODS Sixty patients with pathologically confirmed cerebral astrocytomas underwent IVIM scans before any treatment was performed. Patients were divided into death group and survival group according to a two-year follow-up. ADC and quantitative parameters of IVIM including D, D*, and f were measured. Independent sample t test was used to compare the two groups of parameters. The accuracy of each parameter for two-year survival rate was analyzed by receiver operating characteristic (ROC) curve and Kaplan-Meier survival curves. The correlation between quantitative parameters and survival days was analyzed by Pearson correlation analysis. RESULTS The ADC, D*, and f values were statistically significant different between the death and the survival groups (P < 0.05). The AUC of the ADC, D*, and f were 0.811, 0.858, and 0.892, respectively. The ADC cut-off value of 0.668 × 10-3 mm2/s corresponded to 82.6% sensitivity and 73% specificity. The D* cut-off value of 3.913 × 10-3 mm2/s corresponded to 78.4% sensitivity and 87% specificity. The f cut-off value of 0.487 corresponded to 83.8% sensitivity and 87% specificity. Significant log rank test was performed for each parameter to predict overall survival (P < 0.05). There was a correlation between ADC (r = 0.625, P = 0.023), D* (r = -0.655, P = 0.012), f (r = -0.725, P = 0.000) and survival days. CONCLUSION The D* and f values demonstrated great potential in predicting the two-year survival rate for patients with astrocytoma.
Collapse
Affiliation(s)
- Lina Zhu
- Department of Magnetic Resonance, Shanxi Cardiovascular Hospital, Taiyuan, Shanxi, PR China
| | - Jiang Wu
- Department of Magnetic Resonance, Shanxi Cardiovascular Hospital, Taiyuan, Shanxi, PR China
| | - Hui Zhang
- Department of Magnetic Resonance, the First Hospital of Shanxi Medical University, Taiyuan, Shanxi, PR China
| | - Heng Niu
- Department of Magnetic Resonance, Shanxi Cardiovascular Hospital, Taiyuan, Shanxi, PR China
| | - Le Wang
- Department of Magnetic Resonance, the First Hospital of Shanxi Medical University, Taiyuan, Shanxi, PR China
| |
Collapse
|
14
|
Valente Aguiar P, Sousa O, Silva R, Vaz R, Linhares P. Early atypical malignant transformation of diffuse low-grade astrocytoma: The importance of genotyping. Neurocirugia (Astur) 2020; 33:S1130-1473(20)30126-3. [PMID: 33162332 DOI: 10.1016/j.neucir.2020.09.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 08/25/2020] [Accepted: 09/19/2020] [Indexed: 10/23/2022]
Abstract
Diffuse astrocytoma (WHO grade II) has classically been considered a slow growing tumour, typically affecting young adults, with tendency for late malignant conversion. We describe a case of early atypical malignant transformation of diffuse astrocytoma seventeen months after complete surgical removal, as an intraventricular high-grade glioma (HGG). Retrospective laboratory findings for the presence of IDH 1/2 (isocitrate dehydrogenase) mutations were negative. There is growing evidence that IDH-wildtype (wt) astrocytomas behave more aggressively, therefore identifying IDH-mutation status should be mandatory in order to determine disease prognosis and guide treatment course.
Collapse
Affiliation(s)
- Pedro Valente Aguiar
- Department of Neurosurgery, Centro Hospitalar Universitário São João, Oporto, Portugal; Faculty of Medicine, Oporto University, Portugal.
| | - Osvaldo Sousa
- Department of Neurosurgery, Centro Hospitalar Universitário São João, Oporto, Portugal; Faculty of Medicine, Oporto University, Portugal
| | - Roberto Silva
- Department of Anatomical Pathology, Centro Hospitalar Universitário São João, Oporto, Portugal
| | - Rui Vaz
- Department of Neurosurgery, Centro Hospitalar Universitário São João, Oporto, Portugal; Faculty of Medicine, Oporto University, Portugal; Neurosciences Centre, Hospital CUF, Oporto, Portugal
| | - Paulo Linhares
- Department of Neurosurgery, Centro Hospitalar Universitário São João, Oporto, Portugal; Faculty of Medicine, Oporto University, Portugal; Neurosciences Centre, Hospital CUF, Oporto, Portugal
| |
Collapse
|
15
|
Eliferov VA, Zhvansky ES, Sorokin AA, Shurkhay VA, Bormotov DS, Pekov SI, Nikitin PV, Ryzhova MV, Kulikov EE, Potapov AA, Nikolaev EN, Popov IA. [The role of lipids in the classification of astrocytoma and glioblastoma using MS tumor profiling]. BIOMEDIT︠S︡INSKAI︠A︡ KHIMII︠A︡ 2020; 66:317-325. [PMID: 32893821 DOI: 10.18097/pbmc20206604317] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Express MS identification of biological tissues has become a much more accessible research method due to the application of direct specimen ionization at atmospheric pressure. In contrast to traditional methods of analysis employing GC-MS methods for determining the molecular composition of the analyzed objects it eliminates the influence of mutual ion suppression. Despite significant progress in the field of direct MS of biological tissues, the question of mass spectrometric profile attribution to a certain type of tissue still remains open. The use of modern machine learning methods and protocols (e.g., "random forests") enables us to trace possible relationships between the components of the sample MS profile and the result of brain tumor tissue classification (astrocytoma or glioblastoma). It has been shown that the most pronounced differences in the mass spectrometric profiles of these tumors are due to their lipid composition. Detection of statistically significant differences in lipid profiles of astrocytoma and glioblastoma may be used to perform an express test during surgery and inform the neurosurgeon what type of malignant tissue he is working with. The ability to accurately determine the boundaries of the neoplastic growth significantly improves the quality of both surgical intervention and postoperative rehabilitation, as well as the duration and quality of life of patients.
Collapse
Affiliation(s)
- V A Eliferov
- Moscow Institute of Physics and Technology (National Research University), Dolgoprudny, Russia
| | - E S Zhvansky
- Moscow Institute of Physics and Technology (National Research University), Dolgoprudny, Russia
| | - A A Sorokin
- Moscow Institute of Physics and Technology (National Research University), Dolgoprudny, Russia
| | - V A Shurkhay
- N.N. Burdenko National Medical Research Center of Neurosurgery, Moscow, Russia
| | - D S Bormotov
- Moscow Institute of Physics and Technology (National Research University), Dolgoprudny, Russia
| | - S I Pekov
- Moscow Institute of Physics and Technology (National Research University), Dolgoprudny, Russia
| | - P V Nikitin
- N.N. Burdenko National Medical Research Center of Neurosurgery, Moscow, Russia
| | - M V Ryzhova
- N.N. Burdenko National Medical Research Center of Neurosurgery, Moscow, Russia
| | - E E Kulikov
- Moscow Institute of Physics and Technology (National Research University), Dolgoprudny, Russia; Federal Research Center "Fundamentals of Biotechnology", RAS, Moscow, Russia
| | - A A Potapov
- N.N. Burdenko National Medical Research Center of Neurosurgery, Moscow, Russia
| | - E N Nikolaev
- Skolkovo Institute of Science and Technology, Moscow, Russia
| | - I A Popov
- Moscow Institute of Physics and Technology (National Research University), Dolgoprudny, Russia
| |
Collapse
|
16
|
Darlix A, Rigau V, Duffau H. Neoformazioni intracraniche: gliomi di grado II. Neurologia 2020. [DOI: 10.1016/s1634-7072(20)44227-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
|
17
|
Rudà R, Angileri FF, Ius T, Silvani A, Sarubbo S, Solari A, Castellano A, Falini A, Pollo B, Del Basso De Caro M, Papagno C, Minniti G, De Paula U, Navarria P, Nicolato A, Salmaggi A, Pace A, Fabi A, Caffo M, Lombardi G, Carapella CM, Spena G, Iacoangeli M, Fontanella M, Germanò AF, Olivi A, Bello L, Esposito V, Skrap M, Soffietti R. Italian consensus and recommendations on diagnosis and treatment of low-grade gliomas. An intersociety (SINch/AINO/SIN) document. J Neurosurg Sci 2020; 64:313-334. [PMID: 32347684 DOI: 10.23736/s0390-5616.20.04982-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
In 2018, the SINch (Italian Society of Neurosurgery) Neuro-Oncology Section, AINO (Italian Association of Neuro-Oncology) and SIN (Italian Association of Neurology) Neuro-Oncology Section formed a collaborative Task Force to look at the diagnosis and treatment of low-grade gliomas (LGGs). The Task Force included neurologists, neurosurgeons, neuro-oncologists, pathologists, radiologists, radiation oncologists, medical oncologists, a neuropsychologist and a methodologist. For operational purposes, the Task Force was divided into five Working Groups: diagnosis, surgical treatment, adjuvant treatments, supportive therapies, and follow-up. The resulting guidance document is based on the available evidence and provides recommendations on diagnosis and treatment of LGG patients, considering all aspects of patient care along their disease trajectory.
Collapse
Affiliation(s)
- Roberta Rudà
- Department of Neuro-Oncology, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Filippo F Angileri
- Section of Neurosurgery, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy -
| | - Tamara Ius
- Neurosurgery Unit, Department of Neurosciences, Santa Maria della Misericordia University Hospital, Udine, Italy
| | - Antonio Silvani
- Department of Neuro-Oncology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Silvio Sarubbo
- Department of Neurosurgery, Structural and Functional Connectivity Lab Project, "S. Chiara" Hospital, Trento, Italy
| | - Alessandra Solari
- Unit of Neuroepidemiology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Antonella Castellano
- Neuroradiology Unit, IRCCS San Raffaele Scientific Institute and Vita-Salute San Raffaele University, Milan, Italy
| | - Andrea Falini
- Neuroradiology Unit, IRCCS San Raffaele Scientific Institute and Vita-Salute San Raffaele University, Milan, Italy
| | - Bianca Pollo
- Section of Oncologic Neuropathology, Division of Neurology V - Neuropathology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | | | - Costanza Papagno
- Center of Neurocognitive Rehabilitation (CeRiN), Interdepartmental Center of Mind/Brain, University of Trento, Trento, Italy.,Department of Psychology, University of Milan-Bicocca, Milan, Italy
| | - Giuseppe Minniti
- Radiation Oncology Unit, Department of Medicine, Surgery and Neurosciences, Policlinico Le Scotte, University of Siena, Siena, Italy
| | - Ugo De Paula
- Unit of Radiotherapy, San Giovanni-Addolorata Hospital, Rome, Italy
| | - Pierina Navarria
- Department of Radiotherapy and Radiosurgery, Humanitas Cancer Center and Research Hospital, Rozzano, Milan, Italy
| | - Antonio Nicolato
- Unit of Stereotaxic Neurosurgery, Department of Neurosciences, Hospital Trust of Verona, Verona, Italy
| | - Andrea Salmaggi
- Neurology Unit, Department of Neurosciences, A. Manzoni Hospital, Lecco, Italy
| | - Andrea Pace
- IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Alessandra Fabi
- Division of Medical Oncology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Maria Caffo
- Section of Neurosurgery, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Giuseppe Lombardi
- Unit of Oncology 1, Department of Oncology, Veneto Institute of Oncology-IRCCS, Padua, Italy
| | | | - Giannantonio Spena
- Neurosurgery Unit, Department of Neurosciences, A. Manzoni Hospital, Lecco, Italy
| | - Maurizio Iacoangeli
- Department of Neurosurgery, Marche Polytechnic University, Umberto I General University Hospital, Ancona, Italy
| | - Marco Fontanella
- Division of Neurosurgery, Department of Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Antonino F Germanò
- Section of Neurosurgery, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Alessandro Olivi
- Neurosurgery Unit, Department of Neurosciences, Università Cattolica del Sacro Cuore, Fondazione Policlinico "A. Gemelli", Rome, Italy
| | - Lorenzo Bello
- Unit of Oncologic Neurosurgery, Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Vincenzo Esposito
- Sapienza University, Rome, Italy.,Giampaolo Cantore Department of Neurosurgery, IRCCS Neuromed, Pozzilli, Isernia, Italy
| | - Miran Skrap
- Neurosurgery Unit, Department of Neurosciences, Santa Maria della Misericordia University Hospital, Udine, Italy
| | - Riccardo Soffietti
- Department of Neuro-Oncology, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | | |
Collapse
|
18
|
Transformation Foci in IDH1-mutated Gliomas Show STAT3 Phosphorylation and Downregulate the Metabolic Enzyme ETNPPL, a Negative Regulator of Glioma Growth. Sci Rep 2020; 10:5504. [PMID: 32218467 PMCID: PMC7099072 DOI: 10.1038/s41598-020-62145-1] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Accepted: 02/27/2020] [Indexed: 01/07/2023] Open
Abstract
IDH1-mutated gliomas are slow-growing brain tumours which progress into high-grade gliomas. The early molecular events causing this progression are ill-defined. Previous studies revealed that 20% of these tumours already have transformation foci. These foci offer opportunities to better understand malignant progression. We used immunohistochemistry and high throughput RNA profiling to characterize foci cells. These have higher pSTAT3 staining revealing activation of JAK/STAT signaling. They downregulate RNAs involved in Wnt signaling (DAAM2, SFRP2), EGFR signaling (MLC1), cytoskeleton and cell-cell communication (EZR, GJA1). In addition, foci cells show reduced levels of RNA coding for Ethanolamine-Phosphate Phospho-Lyase (ETNPPL/AGXT2L1), a lipid metabolism enzyme. ETNPPL is involved in the catabolism of phosphoethanolamine implicated in membrane synthesis. We detected ETNPPL protein in glioma cells as well as in astrocytes in the human brain. Its nuclear localization suggests additional roles for this enzyme. ETNPPL expression is inversely correlated to glioma grade and we found no ETNPPL protein in glioblastomas. Overexpression of ETNPPL reduces the growth of glioma stem cells indicating that this enzyme opposes gliomagenesis. Collectively, these results suggest that a combined alteration in membrane lipid metabolism and STAT3 pathway promotes IDH1-mutated glioma malignant progression.
Collapse
|
19
|
Gates EDH, Lin JS, Weinberg JS, Prabhu SS, Hamilton J, Hazle JD, Fuller GN, Baladandayuthapani V, Fuentes DT, Schellingerhout D. Imaging-Based Algorithm for the Local Grading of Glioma. AJNR Am J Neuroradiol 2020; 41:400-407. [PMID: 32029466 DOI: 10.3174/ajnr.a6405] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 12/16/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND PURPOSE Gliomas are highly heterogeneous tumors, and optimal treatment depends on identifying and locating the highest grade disease present. Imaging techniques for doing so are generally not validated against the histopathologic criterion standard. The purpose of this work was to estimate the local glioma grade using a machine learning model trained on preoperative image data and spatially specific tumor samples. The value of imaging in patients with brain tumor can be enhanced if pathologic data can be estimated from imaging input using predictive models. MATERIALS AND METHODS Patients with gliomas were enrolled in a prospective clinical imaging trial between 2013 and 2016. MR imaging was performed with anatomic, diffusion, permeability, and perfusion sequences, followed by image-guided stereotactic biopsy before resection. An imaging description was developed for each biopsy, and multiclass machine learning models were built to predict the World Health Organization grade. Models were assessed on classification accuracy, Cohen κ, precision, and recall. RESULTS Twenty-three patients (with 7/9/7 grade II/III/IV gliomas) had analyzable imaging-pathologic pairs, yielding 52 biopsy sites. The random forest method was the best algorithm tested. Tumor grade was predicted at 96% accuracy (κ = 0.93) using 4 inputs (T2, ADC, CBV, and transfer constant from dynamic contrast-enhanced imaging). By means of the conventional imaging only, the overall accuracy decreased (89% overall, κ = 0.79) and 43% of high-grade samples were misclassified as lower-grade disease. CONCLUSIONS We found that local pathologic grade can be predicted with a high accuracy using clinical imaging data. Advanced imaging data improved this accuracy, adding value to conventional imaging. Confirmatory imaging trials are justified.
Collapse
Affiliation(s)
- E D H Gates
- From the Departments of Imaging Physics (E.D.H.G., J.S.L., J.D.H., D.T.F.), Neurosurgery (J.S.W., S.S.P.), Pathology (G.N.F.), Neuroradiology (D.S.), and Cancer Systems Imaging (D.S.), University of Texas MD Anderson Cancer Center, Houston, Texas.,University of Texas MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences (E.D.H.G.), Houston, Texas
| | - J S Lin
- From the Departments of Imaging Physics (E.D.H.G., J.S.L., J.D.H., D.T.F.), Neurosurgery (J.S.W., S.S.P.), Pathology (G.N.F.), Neuroradiology (D.S.), and Cancer Systems Imaging (D.S.), University of Texas MD Anderson Cancer Center, Houston, Texas.,Baylor College of Medicine (J.S.L.), Houston, Texas.,Department of Bioengineering (J.S.L.), Rice University, Houston, Texas
| | - J S Weinberg
- From the Departments of Imaging Physics (E.D.H.G., J.S.L., J.D.H., D.T.F.), Neurosurgery (J.S.W., S.S.P.), Pathology (G.N.F.), Neuroradiology (D.S.), and Cancer Systems Imaging (D.S.), University of Texas MD Anderson Cancer Center, Houston, Texas
| | - S S Prabhu
- From the Departments of Imaging Physics (E.D.H.G., J.S.L., J.D.H., D.T.F.), Neurosurgery (J.S.W., S.S.P.), Pathology (G.N.F.), Neuroradiology (D.S.), and Cancer Systems Imaging (D.S.), University of Texas MD Anderson Cancer Center, Houston, Texas
| | - J Hamilton
- Radiology Partners (J.H.), Houston, Texas
| | - J D Hazle
- From the Departments of Imaging Physics (E.D.H.G., J.S.L., J.D.H., D.T.F.), Neurosurgery (J.S.W., S.S.P.), Pathology (G.N.F.), Neuroradiology (D.S.), and Cancer Systems Imaging (D.S.), University of Texas MD Anderson Cancer Center, Houston, Texas
| | - G N Fuller
- From the Departments of Imaging Physics (E.D.H.G., J.S.L., J.D.H., D.T.F.), Neurosurgery (J.S.W., S.S.P.), Pathology (G.N.F.), Neuroradiology (D.S.), and Cancer Systems Imaging (D.S.), University of Texas MD Anderson Cancer Center, Houston, Texas
| | - V Baladandayuthapani
- Department of Computational Medicine and Bioinformatics (V.B.), University of Michigan School of Public Health, Ann Arbor, Michigan
| | - D T Fuentes
- From the Departments of Imaging Physics (E.D.H.G., J.S.L., J.D.H., D.T.F.), Neurosurgery (J.S.W., S.S.P.), Pathology (G.N.F.), Neuroradiology (D.S.), and Cancer Systems Imaging (D.S.), University of Texas MD Anderson Cancer Center, Houston, Texas
| | - D Schellingerhout
- From the Departments of Imaging Physics (E.D.H.G., J.S.L., J.D.H., D.T.F.), Neurosurgery (J.S.W., S.S.P.), Pathology (G.N.F.), Neuroradiology (D.S.), and Cancer Systems Imaging (D.S.), University of Texas MD Anderson Cancer Center, Houston, Texas
| |
Collapse
|
20
|
Darlix A, Rigau V, Fraisse J, Gozé C, Fabbro M, Duffau H. Postoperative follow-up for selected diffuse low-grade gliomas with WHO grade III/IV foci. Neurology 2020; 94:e830-e841. [PMID: 31969465 DOI: 10.1212/wnl.0000000000008877] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Accepted: 08/28/2019] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Diffuse low-grade gliomas (DLGG) are defined by continuous growth and an almost unavoidable malignant transformation. Foci of malignant glioma can be found within DLGG samples obtained from surgical resections. As the medical management of patients is classically based on the higher tumor grade, an immediate adjuvant treatment is usually proposed. To determine whether postponing the medical treatment in selected patients is feasible, we conducted a single-center retrospective study. METHODS This was a single-center retrospective analysis of a consecutive series of DLGG managed with this conservative strategy. Inclusion criteria were at least 1 focus of malignant tumor (grade III-IV, WHO 2016), no previous chemotherapy or radiotherapy, no less than a subtotal resection of the fluid-attenuated inversion recovery tumor volume, no intention of treating with immediate adjuvant therapy, and minimum 2 years of follow-up. The time interval to the following oncologic medical treatment was analyzed, as well as the functional and survival results. RESULTS Forty-four patients met the inclusion criteria (median age 36, median time interval from diagnosis 7 months). Most tumors (88%) were IDH-mutant and 1p19q intact (59%); 9 presented with grade IV foci. With a median follow-up of 6.7 years, 75% of patients received a subsequent medical treatment, after a median time of 3.4 years since surgery. At the time of analysis, 9 patients (20.0%) had died (5- and 7-year survival rates: 95% and 67.0%). Most surviving patients were still active professionally, without seizures. CONCLUSIONS Postponing the medical treatment in DLGG with foci of malignant tumor following total or subtotal resection should be considered in selected patients.
Collapse
Affiliation(s)
- Amélie Darlix
- From the Department of Medical Oncology (A.D., M.F.) and Biometrics Unit (J.F.), Institut du Cancer de Montpellier, University of Montpellier; INSERM U1051 (A.D., V.R., C.G., H.D.), Montpellier Neurosciences Institute; and Department of Pathology (V.R.), Pathology and Oncobiology Department, Laboratory of Solid Tumors Biology (C.G.), and Department of Neurosurgery (H.D.), Montpellier University Hospital, France.
| | - Valérie Rigau
- From the Department of Medical Oncology (A.D., M.F.) and Biometrics Unit (J.F.), Institut du Cancer de Montpellier, University of Montpellier; INSERM U1051 (A.D., V.R., C.G., H.D.), Montpellier Neurosciences Institute; and Department of Pathology (V.R.), Pathology and Oncobiology Department, Laboratory of Solid Tumors Biology (C.G.), and Department of Neurosurgery (H.D.), Montpellier University Hospital, France
| | - Julien Fraisse
- From the Department of Medical Oncology (A.D., M.F.) and Biometrics Unit (J.F.), Institut du Cancer de Montpellier, University of Montpellier; INSERM U1051 (A.D., V.R., C.G., H.D.), Montpellier Neurosciences Institute; and Department of Pathology (V.R.), Pathology and Oncobiology Department, Laboratory of Solid Tumors Biology (C.G.), and Department of Neurosurgery (H.D.), Montpellier University Hospital, France
| | - Catherine Gozé
- From the Department of Medical Oncology (A.D., M.F.) and Biometrics Unit (J.F.), Institut du Cancer de Montpellier, University of Montpellier; INSERM U1051 (A.D., V.R., C.G., H.D.), Montpellier Neurosciences Institute; and Department of Pathology (V.R.), Pathology and Oncobiology Department, Laboratory of Solid Tumors Biology (C.G.), and Department of Neurosurgery (H.D.), Montpellier University Hospital, France
| | - Michel Fabbro
- From the Department of Medical Oncology (A.D., M.F.) and Biometrics Unit (J.F.), Institut du Cancer de Montpellier, University of Montpellier; INSERM U1051 (A.D., V.R., C.G., H.D.), Montpellier Neurosciences Institute; and Department of Pathology (V.R.), Pathology and Oncobiology Department, Laboratory of Solid Tumors Biology (C.G.), and Department of Neurosurgery (H.D.), Montpellier University Hospital, France
| | - Hugues Duffau
- From the Department of Medical Oncology (A.D., M.F.) and Biometrics Unit (J.F.), Institut du Cancer de Montpellier, University of Montpellier; INSERM U1051 (A.D., V.R., C.G., H.D.), Montpellier Neurosciences Institute; and Department of Pathology (V.R.), Pathology and Oncobiology Department, Laboratory of Solid Tumors Biology (C.G.), and Department of Neurosurgery (H.D.), Montpellier University Hospital, France
| |
Collapse
|
21
|
Al-Tamimi YZ, Palin MS, Patankar T, MacMullen-Price J, O'Hara DJ, Loughrey C, Chakrabarty A, Ismail A, Roberts P, Duffau H, Goodden JR, Chumas PD. Low-Grade Glioma with Foci of Early Transformation Does Not Necessarily Require Adjuvant Therapy After Radical Surgical Resection. World Neurosurg 2018; 110:e346-e354. [DOI: 10.1016/j.wneu.2017.10.172] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 10/29/2017] [Accepted: 10/31/2017] [Indexed: 10/18/2022]
|
22
|
Mandonnet E, Duffau H. An attempt to conceptualize the individual onco-functional balance: Why a standardized treatment is an illusion for diffuse low-grade glioma patients. Crit Rev Oncol Hematol 2017; 122:83-91. [PMID: 29458793 DOI: 10.1016/j.critrevonc.2017.12.008] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2017] [Revised: 11/19/2017] [Accepted: 12/12/2017] [Indexed: 12/15/2022] Open
Abstract
In the era of evidence-based medicine, clinicians aim to establish standards of care from randomized studies. Following, personalized medicine has emerged, as new individualized biomarkers could help to predict sensitivity to specific treatment. In this paper, we show that, for diffuse low-grade glioma, some specificities - dual goal of both survival and functional gain, long duration of the disease with multistep treatments, multiparametric evaluation of the onco-functional balance of each treatment modality - call for a change of paradigm. After summarizing how to weight the benefits and risks of surgery, chemotherapy and radiotherapy, we show that the overall efficacy of a treatment modality cannot be assessed per se, as it depends on its integration in the whole sequence. Then, we revisit the notion of personalized medicine: instead of decision-making based solely on molecular profile, we plead for a recursive algorithm, allowing a dynamic evaluation of the onco-functional balance, integrating many individual characteristics of the patient's tumor and brain function.
Collapse
Affiliation(s)
- Emmanuel Mandonnet
- Department of Neurosurgery, Lariboisière Hospital, APHP, Paris, France; University Paris 7, Paris, France; Institut du Cerveau de la Moelle (ICM), Paris, France.
| | - Hugues Duffau
- Department of Neurosurgery, Hôpital Gui de Chauliac, Montpellier Medical University Center, Montpellier, France; Institute of Neuroscience of Montpellier, INSERM U1051, Montpellier, France; University of Montpellier, Montpellier, France
| |
Collapse
|
23
|
Zhao H, Yuan H, Hu J, Xu C, Liao G, Yin W, Xu L, Wang L, Zhang X, Shi A, Li J, Xiao Y. Optimizing prognosis-related key miRNA-target interactions responsible for cancer metastasis. Oncotarget 2017; 8:109522-109535. [PMID: 29312626 PMCID: PMC5752539 DOI: 10.18632/oncotarget.22724] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Accepted: 07/26/2017] [Indexed: 12/12/2022] Open
Abstract
Increasing evidence suggests that the abnormality of microRNAs (miRNAs) and their downstream targets is frequently implicated in the pathogenesis of human cancers, however, the clinical benefit of causal miRNA-target interactions has been seldom studied. Here, we proposed a computational method to optimize prognosis-related key miRNA-target interactions by combining transcriptome and clinical data from thousands of TCGA tumors across 16 cancer types. We obtained a total of 1,956 prognosis-related key miRNA-target interactions between 112 miRNAs and 1,443 their targets. Interestingly, these key target genes are specifically involved in tumor progression-related functions, such as ‘cell adhesion’ and ‘cell migration’. Furthermore, they are most significantly correlated with ‘tissue invasion and metastasis’, a hallmark of metastasis, in ten distinct types of cancer through the hallmark analysis. These results implicated that the prognosis-related key miRNA-target interactions were highly associated with cancer metastasis. Finally, we observed that the combination of these key miRNA-target interactions allowed to distinguish patients with good prognosis from those with poor prognosis both in most TCGA cancer types and independent validation sets, highlighting their roles in cancer metastasis. We provided a user-friendly database named miRNATarget (freely available at http://biocc.hrbmu.edu.cn/miRNATar/), which provides an overview of the prognosis-related key miRNA-target interactions across 16 cancer types.
Collapse
Affiliation(s)
- Hongying Zhao
- College of Bioinformatics Science and Technology, Harbin Medical University, Harbin 150081, China
| | - Huating Yuan
- College of Bioinformatics Science and Technology, Harbin Medical University, Harbin 150081, China
| | - Jing Hu
- College of Bioinformatics Science and Technology, Harbin Medical University, Harbin 150081, China
| | - Chaohan Xu
- College of Bioinformatics Science and Technology, Harbin Medical University, Harbin 150081, China
| | - Gaoming Liao
- College of Bioinformatics Science and Technology, Harbin Medical University, Harbin 150081, China
| | - Wenkang Yin
- College of Bioinformatics Science and Technology, Harbin Medical University, Harbin 150081, China
| | - Liwen Xu
- College of Bioinformatics Science and Technology, Harbin Medical University, Harbin 150081, China
| | - Li Wang
- College of Bioinformatics Science and Technology, Harbin Medical University, Harbin 150081, China
| | - Xinxin Zhang
- College of Bioinformatics Science and Technology, Harbin Medical University, Harbin 150081, China
| | - Aiai Shi
- College of Bioinformatics Science and Technology, Harbin Medical University, Harbin 150081, China
| | - Jing Li
- Department of Ultrasonic Medicine, The 1st Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin 150040, China
| | - Yun Xiao
- College of Bioinformatics Science and Technology, Harbin Medical University, Harbin 150081, China
| |
Collapse
|
24
|
Li B, Zhou C, Yi L, Xu L, Xu M. Effect and molecular mechanism of mTOR inhibitor rapamycin on temozolomide-induced autophagic death of U251 glioma cells. Oncol Lett 2017; 15:2477-2484. [PMID: 29434961 DOI: 10.3892/ol.2017.7537] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2015] [Accepted: 11/08/2016] [Indexed: 01/10/2023] Open
Abstract
Glioma is a malignant tumor of the glial tissue that is difficult to excise through surgery, with poor patient prognosis. The use of chemotherapeutic drugs alone to treat glioma following surgery results in a high probability of sequelae, such as tumor recurrence. The present study investigated the effects of a novel treatment combination on glioma cells and determined the molecular mechanisms underlying its action. The effect of temozolomide (TMZ) combined with rapamycin (RAPA) on the TMZ-induced autophagic death of U251 glioma cells was examined. The U251 cell line was treated with TMZ combined with RAPA, and the cell survival rate and half maximal inhibitory concentration (IC50) of TMZ/RAPA was detected using the Cell Counting Kit-8 (CCK-8) assay. Flow cytometry was used to detect changes in cell cycle distribution. The formation of acidic vesicular organelles (AVOs) in the cytoplasm was identified using fluorescence microscopy and quantitatively analyzed. Western blotting was performed to detect the expression levels of autophagy-associated proteins Beclin-1 and microtubule associated protein 1 light chain 3 alpha (MAP1LC3A)-I and II. RAPA (1.25 nM) combined with 5 µM TMZ markedly inhibited U251 cell growth. RAPA reinforced TMZ-induced autophagic death, reducing the IC50 value of treatment when combined (TMZ alone, 22.5±3.23 µM vs. TMZ and RAPA, 10.35±2.81 µM). Compared with the control group, the proportion of cells in G2/M were markedly increased following treatment with TMZ combined with RAPA. Acridine orange staining demonstrated that TMZ combined with RAPA could markedly enhance the generation of intracellular AVOs compared with TMZ or RAPA alone. In addition, Beclin-1 and LC3-II protein expression was markedly increased compared with the control and single treatment groups (P<0.05). The results of the present study indicate that RAPA reinforces TMZ-induced autophagic death of U251 glioma cells, providing a novel therapeutic combination for the treatment of malignant glioma.
Collapse
Affiliation(s)
- Bing Li
- Department of Neurosurgery, Daping Hospital, Third Military Medical University, Yuzhong, Chongqing 400042, P.R. China
| | - Chun Zhou
- Department of Neurosurgery, Daping Hospital, Third Military Medical University, Yuzhong, Chongqing 400042, P.R. China
| | - Liang Yi
- Department of Neurosurgery, Daping Hospital, Third Military Medical University, Yuzhong, Chongqing 400042, P.R. China
| | - Lunshan Xu
- Department of Neurosurgery, Daping Hospital, Third Military Medical University, Yuzhong, Chongqing 400042, P.R. China
| | - Minhui Xu
- Department of Neurosurgery, Daping Hospital, Third Military Medical University, Yuzhong, Chongqing 400042, P.R. China
| |
Collapse
|
25
|
Bowden SG, Neira JA, Gill BJA, Ung TH, Englander ZK, Zanazzi G, Chang PD, Samanamud J, Grinband J, Sheth SA, McKhann GM, Sisti MB, Canoll P, D’Amico RS, Bruce JN. Sodium Fluorescein Facilitates Guided Sampling of Diagnostic Tumor Tissue in Nonenhancing Gliomas. Neurosurgery 2017. [DOI: 10.1093/neuros/nyx271] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
BACKGROUND
Accurate tissue sampling in nonenhancing (NE) gliomas is a unique surgical challenge due to their intratumoral histological heterogeneity and absence of contrast enhancement as a guide for intraoperative stereotactic guidance. Instead, T2/fluid-attenuated inversion-recovery (FLAIR) hyperintensity on MRI is commonly used as an imaging surrogate for pathological tissue, but sampling from this region can yield nondiagnostic or underdiagnostic brain tissue. Sodium fluorescein is an intraoperative fluorescent dye that has a high predictive value for tumor identification in areas of contrast enhancement and NE in glioblastomas. However, the underlying histopathological alterations in fluorescent regions of NE gliomas remain undefined.
OBJECTIVE
To evaluate whether fluorescein can identify diagnostic tissue and differentiate regions with higher malignant potential during surgery for NE gliomas, thus improving sampling accuracy.
METHODS
Thirteen patients who presented with NE, T2/FLAIR hyperintense lesions suspicious for glioma received fluorescein (10%, 3 mg/kg intravenously) during surgical resection.
RESULTS
Patchy fluorescence was identified within the T2/FLAIR hyperintense area in 10 of 13 (77%) patients. Samples taken from fluorescent regions were more likely to demonstrate diagnostic glioma tissue and cytologic atypia (P < .05). Fluorescein demonstrated a 95% positive predictive value for the presence of diagnostic tissue. Samples from areas of fluorescence also demonstrated greater total cell density and higher Ki-67 labeling than nonfluorescent biopsies (P < .05).
CONCLUSION
Fluorescence in NE gliomas is highly predictive of diagnostic tumor tissue and regions of higher cell density and proliferative activity.
Collapse
Affiliation(s)
- Stephen G Bowden
- Department of Neurological Surgery, College of Physicians and Surgeons at Columbia University, New York, New York
| | - Justin A Neira
- Department of Neurological Surgery, College of Physicians and Surgeons at Columbia University, New York, New York
| | - Brian J A Gill
- Department of Neurological Surgery, College of Physicians and Surgeons at Columbia University, New York, New York
| | - Timothy H Ung
- Department of Neurological Surgery, University of Colorado, Aurora, Colorado
| | - Zachary K Englander
- Department of Neurological Surgery, College of Physicians and Surgeons at Columbia University, New York, New York
| | - George Zanazzi
- Department of Pathology and Cell Biology, College of Physicians and Surgeons at Columbia University, New York, New York
| | - Peter D Chang
- Department of Radiology, College of Physicians and Surgeons at Columbia University, New York, New York
| | - Jorge Samanamud
- Department of Neurological Surgery, College of Physicians and Surgeons at Columbia University, New York, New York
| | - Jack Grinband
- Department of Radiology, College of Physicians and Surgeons at Columbia University, New York, New York
| | - Sameer A Sheth
- Department of Neurological Surgery, College of Physicians and Surgeons at Columbia University, New York, New York
| | - Guy M McKhann
- Department of Neurological Surgery, College of Physicians and Surgeons at Columbia University, New York, New York
| | - Michael B Sisti
- Department of Neurological Surgery, College of Physicians and Surgeons at Columbia University, New York, New York
| | - Peter Canoll
- Department of Pathology and Cell Biology, College of Physicians and Surgeons at Columbia University, New York, New York
| | - Randy S D’Amico
- Department of Neurological Surgery, College of Physicians and Surgeons at Columbia University, New York, New York
| | - Jeffrey N Bruce
- Department of Neurological Surgery, College of Physicians and Surgeons at Columbia University, New York, New York
| |
Collapse
|
26
|
Narsia N, Ramagiri P, Ehrmann J, Kolar Z. Transcriptome analysis reveals distinct gene expression profiles in astrocytoma grades II-IV. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2017; 161:261-271. [PMID: 28452381 DOI: 10.5507/bp.2017.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Accepted: 04/18/2017] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Astrocytoma is the most prevalent form of primary brain cancer categorized into four histological grades by the World Health Organization. Investigation into individual grades of astrocytoma by previous studies has provided some insight into dysregulation of regulatory networks associated with increasing astrocytoma grades. However, further understanding of key mechanisms that distinguish different astrocytoma grades is required to facilitate targeted therapies. METHODS In this study, we utilized a large cohort of publicly available RNA sequencing data from patients with diffuse astrocytoma (grade II), anaplastic astrocytoma (grade III), primary glioblastoma (grade IV), secondary glioblastoma (grade IV), recurrent glioblastoma (grade IV), and normal brain samples to identify genetic similarities and differences between these grades using bioinformatics applications. RESULTS Our analysis revealed a distinct gene expression pattern between grade II astrocytoma and grade IV glioblastoma (GBM). We also identified genes that were exclusively expressed in each of the astrocytoma grades. Furthermore, we identified known and novel genes involved in key pathways in our study. Gene set enrichment analysis revealed a distinct expression pattern of transcriptional regulators in primary GBM. Further investigation into molecular processes showed that the genes involved in cell proliferation and invasion were shared across all subtypes of astrocytoma. Also, the number of genes involved in metastasis, regulation of cell proliferation, and apoptosis increased with tumor grade. CONCLUSIONS We confirmed existing findings and shed light on some important genes and molecular processes that will improve our understanding of glioma biology.
Collapse
Affiliation(s)
- Nato Narsia
- Department of Clinical and Molecular Pathology and Laboratory of Molecular Pathology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Czech Republic
| | - Pradeep Ramagiri
- Institute of Cancer and Genomic Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Jiri Ehrmann
- Department of Clinical and Molecular Pathology and Laboratory of Molecular Pathology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Czech Republic
| | - Zdenek Kolar
- Department of Clinical and Molecular Pathology and Laboratory of Molecular Pathology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Czech Republic
| |
Collapse
|
27
|
Keil VC, Pintea B, Gielen GH, Greschus S, Fimmers R, Gieseke J, Simon M, Schild HH, Hadizadeh DR. Biopsy targeting with dynamic contrast-enhanced versus standard neuronavigation MRI in glioma: a prospective double-blinded evaluation of selection benefits. J Neurooncol 2017; 133:155-163. [PMID: 28425048 DOI: 10.1007/s11060-017-2424-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Accepted: 04/11/2017] [Indexed: 12/30/2022]
Abstract
Current biopsy planning based on contrast-enhanced T1W (CET1W) or FLAIR sequences frequently delivers biopsy samples that are not in concordance with the gross tumor diagnosis. This study investigates whether the quantitative information of transfer constant Ktrans maps derived from T1W dynamic contrast-enhanced MRI (DCE-MRI) can help enhance the quality of biopsy target selection in glioma. 28 patients with suspected glioma received MRI including DCE-MRI and a standard neuronavigation protocol of 3D FLAIR- and CET1W data sets (0.1 mmol/kg gadobutrol) at 3.0 T. After exclusion of five cases with no Ktrans-elevation, 2-6 biopsy targets were independently selected by a neurosurgeon (samples based on standard imaging) and a neuroradiologist (samples based on kinetic parameter Ktrans) per case and tissue samples corresponding to these targets were collected by a separate independent neurosurgeon. Standard technique and Ktrans-based samples were rated for diagnostic concordance with the gross tumor resection reference diagnosis (67 WHO IV; 24 WHO III and II) by a neuropathologist blinded for selection mode. Ktrans-based sample targets differed from standard technique sample targets in 90/91 cases. More Ktrans-based than standard imaging-based samples could be extracted. Diagnoses from Ktrans-based samples were more frequently concordant with the reference gross tumor diagnoses than those from standard imaging-based samples (WHO IV: 30/39 vs. 11/20; p = 0.08; WHO III/II: 12/13 vs. 6/11; p = 0.06). In 4/5 non-contrast-enhancing gliomas, Ktrans-based selection revealed significantly more accurate samples than standard technique sample-selection (10/12 vs. 2/8 samples; p = 0.02). If Ktrans elevation is present, Ktrans-based biopsy targeting provides significantly more diagnostic tissue samples in non-contrast-enhancing glioma than selection based on CET1W and FLAIR-weighted images alone.
Collapse
Affiliation(s)
- Vera C Keil
- Department of Radiology, University Hospital Bonn, Sigmund-Freud-Strasse 25, 53105, Bonn, Germany
| | - Bogdan Pintea
- Department of Neurosurgery, University Hospital Bonn, Sigmund-Freud-Strasse 25, 53105, Bonn, Germany
| | - Gerrit H Gielen
- Department of Neuropathology, University Hospital Bonn, Sigmund-Freud-Strasse 25, 53105, Bonn, Germany
| | - Susanne Greschus
- Department of Radiology, University Hospital Bonn, Sigmund-Freud-Strasse 25, 53105, Bonn, Germany
| | - Rolf Fimmers
- University Hospital Bonn, IMBIE, Sigmund-Freud-Strasse 25, 53105, Bonn, Germany
| | - Jürgen Gieseke
- Department of Radiology, University Hospital Bonn, Sigmund-Freud-Strasse 25, 53105, Bonn, Germany.,PHILIPS Healthcare, Lübeckertordamm 1-3, 20099, Hamburg, Germany
| | - Matthias Simon
- Department of Neurosurgery, University Hospital Bonn, Sigmund-Freud-Strasse 25, 53105, Bonn, Germany.,Department of Neurosurgery, Ev. Krankenhaus Bielefeld, Kantensiek 11, 33617, Bielefeld, Germany
| | - Hans H Schild
- Department of Radiology, University Hospital Bonn, Sigmund-Freud-Strasse 25, 53105, Bonn, Germany
| | - Dariusch R Hadizadeh
- Department of Radiology, University Hospital Bonn, Sigmund-Freud-Strasse 25, 53105, Bonn, Germany.
| |
Collapse
|
28
|
Zetterling M, Roodakker KR, Berntsson SG, Edqvist PH, Latini F, Landtblom AM, Pontén F, Alafuzoff I, Larsson EM, Smits A. Extension of diffuse low-grade gliomas beyond radiological borders as shown by the coregistration of histopathological and magnetic resonance imaging data. J Neurosurg 2016; 125:1155-1166. [PMID: 26918468 DOI: 10.3171/2015.10.jns15583] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Magnetic resonance imaging tends to underestimate the extent of diffuse low-grade gliomas (DLGGs). With the aim of studying the presence of tumor cells outside the radiological border, the authors developed a method of correlating MRI findings with histological data in patients with suspected DLGGs in whom en bloc resections were performed. METHODS Five patients with suspected DLGG suitable for en bloc resection were recruited from an ongoing prospective study. Sections of the entire tumor were immunostained with antibodies against mutated IDH1 protein (IDH1-R132H). Magnetic resonance images were coregistered with corresponding IDH1 images. The growth pattern of tumor cells in white and gray matter was assessed in comparison with signal changes on corresponding MRI slices. RESULTS Neuropathological assessment revealed DLGG in 4 patients and progression to WHO Grade III glioma in 1 patient. The tumor core consisted of a high density of IDH1-R132H-positive tumor cells and was located in both gray and white matter. Tumor cells infiltrated along the peripheral fibers of the white matter tracts. In all cases, tumor cells were found outside the radiological tumor border delineated on T2-FLAIR MRI sequences. CONCLUSIONS The authors present a new method for the coregistration of histological and radiological characteristics of en bloc-removed infiltrative brain tumors that discloses tumor invasion at the radiological tumor borders. This technique can be applied to evaluate the sensitivity of alternative imaging methods to detect scattered tumor cells at tumor borders. Accurate methods for detection of infiltrative tumor cells will improve the possibility of performing radical tumor resection. In future studies, the method could also be used for in vivo studies of tumor invasion.
Collapse
Affiliation(s)
- Maria Zetterling
- Department of Neuroscience, Neurosurgery, Uppsala University.,Department of Neurosurgery, Uppsala University Hospital
| | | | - Shala Ghaderi Berntsson
- Department of Neuroscience, Neurology, Uppsala University.,Department of Neurology, Uppsala University Hospital
| | - Per-Henrik Edqvist
- Department of Immunology, Genetics and Pathology and Science for Life Laboratory, Uppsala University
| | | | - Anne-Marie Landtblom
- Department of Neuroscience, Neurology, Uppsala University.,Department of Neurology, Uppsala University Hospital.,Center for Medical Image Science and Visualization, Linköpings University, Linköping, Sweden; and
| | - Fredrik Pontén
- Department of Immunology, Genetics and Pathology and Science for Life Laboratory, Uppsala University
| | - Irina Alafuzoff
- Department of Immunology, Genetics and Pathology, Uppsala University.,Department of Pathology and Cytology, Uppsala University Hospital
| | - Elna-Marie Larsson
- Department of Surgical Sciences, Radiology, Uppsala University.,Department of Radiology, Uppsala University Hospital, Uppsala
| | - Anja Smits
- Department of Neuroscience, Neurology, Uppsala University.,Department of Neurology, Uppsala University Hospital.,Danish Epilepsy Center, Dianalund, Denmark
| |
Collapse
|
29
|
Ding B, Gao M, Li Z, Xu C, Fan S, He W. Expression of TYMS in lymph node metastasis from low-grade glioma. Oncol Lett 2015; 10:1569-1574. [PMID: 26622711 DOI: 10.3892/ol.2015.3419] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Accepted: 05/26/2015] [Indexed: 11/06/2022] Open
Abstract
The aim of the present study was to investigate the expression of thymidylate synthase (TYMS) in the primary foci and metastatic lymph nodes of low-grade glioma, and to analyze the function of TYMS in the lymph node metastases from low-grade glioma. The study included 93 cases of surgically resected and pathologically confirmed low-grade glioma, form patients treated at Huaihe Hospital of Henan University (Kaifeng, China). The following clinical data was obtained from each patient: Gender, age, subjective symptoms (dizziness, headache, a feeling of pressure in the head, etc.), site of disease, tumor type, pathological stage, degree of differentiation and lymph node involvement. The surgically resected gliomas and dissected cervical lymph nodes were immunohistochemically stained, and DNA was extracted from the tumor and lymph node tissues samples for polymerase chain reaction sequencing and amplification. The expression of TYMS in the primary foci and metastatic lymph nodes of low-grade glioma was examined. Additionally, the association between pathological features and the postoperative survival rate of the patients was analyzed. The primary lesions of all 93 cases exhibited positive TYMS expression and 43/157 (27.39%) lymph nodes exhibited positive TYMS expression. Factors that significantly influenced the postoperative survival rate of the patients, included the metastasis of the cervical lymph nodes (P<0.01), the number of dissected cervical lymph nodes (P<0.01) and the degree of differentiation (P<0.05). The metastasis of the cervical lymph nodes was the only independent risk factor affecting postoperative disease-free survival. The risk of recurrence in patients with metastasis of the cervical lymph nodes was 6.3-fold higher than in those without metastasis (P<0.01). Thus, the results of the present study provide a theoretical basis for accurately predicting the prognosis of patients with low-grade malignant brain glioma, reducing the conjecture involved in selecting postoperative treatment strategies and improving therapeutic efficacy.
Collapse
Affiliation(s)
- Bingqian Ding
- Department of Neurosurgery, Huaihe Hospital of Henan University, Kaifeng, Henan 475000, P.R. China
| | - Ming Gao
- Department of Neurosurgery, Huaihe Hospital of Henan University, Kaifeng, Henan 475000, P.R. China
| | - Zhenjiang Li
- Department of Neurosurgery, Huaihe Hospital of Henan University, Kaifeng, Henan 475000, P.R. China
| | - Chenyang Xu
- Department of Neurosurgery, Huaihe Hospital of Henan University, Kaifeng, Henan 475000, P.R. China
| | - Shaokang Fan
- Department of Neurosurgery, Huaihe Hospital of Henan University, Kaifeng, Henan 475000, P.R. China
| | - Weiya He
- Department of Neurology, Huaihe Hospital of Henan University, Kaifeng, Henan 475000, P.R. China
| |
Collapse
|