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Lv P, Li J, Yao Y, Fan X, Liu C, Li H, Zhou H. A novel pyrosequencing strategy for RHD zygosity for predicting risk of hemolytic disease of the fetus and newborn. Lab Med 2024; 55:145-152. [PMID: 37307496 DOI: 10.1093/labmed/lmad051] [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] [Indexed: 06/14/2023] Open
Abstract
OBJECTIVE The aim of this study was the development of an accurate and quantitative pyrosequence (PSQ) method for paternal RHD zygosity detection to help risk management of hemolytic disease of the fetus and newborn (HDFN). METHODS Blood samples from 96 individuals were genotyped for RHD zygosity using pyrosequencing assay. To validate the accuracy of pyrosequencing results, all the samples were then detected by the mismatch polymerase chain reaction with sequence-specific primers (PCR-SSP) method and Sanger DNA sequencing. Serological tests were performed to assess RhD phenotypes. RESULTS Serological results revealed that 36 cases were RhD-positive and 60 cases were RhD-negative. The concordance rate between pyrosequencing assay and mismatch PCR-SSP assay was 94.8% (91/96). There were 5 discordant results between pyrosequencing and the mismatch PCR-SSP assay. Sanger sequencing confirmed that the pyrosequencing assay correctly assigned zygosity for the 5 samples. CONCLUSION This DNA pyrosequencing method accurately detect RHD zygosity and will help risk management of pregnancies that are at risk of HDFN.
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Affiliation(s)
- Piao Lv
- Department of Blood Transfusion, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Jixin Li
- Department of Blood Transfusion, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yuan Yao
- Department of Blood Transfusion, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Xinxin Fan
- Department of Blood Transfusion, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Chixiang Liu
- Department of Blood Transfusion, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Hui Li
- Department of Hematology, Guangdong Provincial Hospital of Traditional Chinese Medicine (The Second Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine), Guangzhou, China
| | - Huayou Zhou
- Department of Blood Transfusion, Nanfang Hospital, Southern Medical University, Guangzhou, China
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Varachev V, Shekhtman A, Guskov D, Rogozhin D, Zasedatelev A, Nasedkina T. Diagnostics of IDH1/2 Mutations in Intracranial Chondroid Tumors: Comparison of Molecular Genetic Methods and Immunohistochemistry. Diagnostics (Basel) 2024; 14:200. [PMID: 38248076 PMCID: PMC10814347 DOI: 10.3390/diagnostics14020200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 01/11/2024] [Accepted: 01/13/2024] [Indexed: 01/23/2024] Open
Abstract
Intracranial chondroid tumors are a heterogeneous group of neoplasms characterized by the presence of a cartilage matrix. These tumors exhibit overlapping clinical and histological features. Mutations in IDH1/2 genes serve as important diagnostic markers of tumor type, particularly chondrosarcoma. To improve the accuracy of IDH1/2 diagnostics, we compared three methods: biochip assay, real-time PCR with DNA melting analysis using TaqMan probes and sequencing (qPCR-DMA-Sanger), and immunohistochemistry (IHC). Tumor samples from 96 patients were investigated. The IDH1 mutations were detected in 34/64 (53%) chondrosarcomas; IHC detected 27/56 (48.2%) mutations, the qPCR-DMA-Sanger method 27/59 (46%) mutations, and the biochip assay revealed 29/60 (48.3%) mutations. The detection of IDH1 mutations in chordoma (2/15) and osteosarcoma (2/7) suggested the need for a revised diagnosis. In benign tumors, IDH1 mutations were present in chondroma (4/6), but absent in chondromyxoid fibroma (0/4). The most frequent IDH1 mutations were R132C (60%), R132L, and R132G (13.5% each), R132H (8%), and R132S (5%). The concordance between the biochip assay and IHC was 90%, between IHC and PCR-DMA-Sanger 83%, and between biochip assay and qPCR-DMA-Sanger was 98%, respectively. No IDH2 mutations were found. The use of independent diagnostic methods may improve the detection of IDH-mutant specimens in chondroid tumors.
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Affiliation(s)
- Vyacheslav Varachev
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, 119991 Moscow, Russia; (V.V.); (D.G.); (A.Z.)
| | - Anastasia Shekhtman
- N.N. Burdenko National Medical Research Center of Neurosurgery, Ministry of Health of the Russian Federation, 125047 Moscow, Russia;
- Russian Children’s Clinical Hospital, N.I. Pirogov Russian National Research Medical University, Ministry of Health of the Russian Federation, 119571 Moscow, Russia;
| | - Dmitrii Guskov
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, 119991 Moscow, Russia; (V.V.); (D.G.); (A.Z.)
| | - Dmitrii Rogozhin
- Russian Children’s Clinical Hospital, N.I. Pirogov Russian National Research Medical University, Ministry of Health of the Russian Federation, 119571 Moscow, Russia;
- N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of the Russian Federation, 115522 Moscow, Russia
| | - Alexander Zasedatelev
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, 119991 Moscow, Russia; (V.V.); (D.G.); (A.Z.)
| | - Tatiana Nasedkina
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, 119991 Moscow, Russia; (V.V.); (D.G.); (A.Z.)
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Kawauchi D, Ohno M, Miyakita Y, Takahashi M, Yanagisawa S, Omura T, Yoshida A, Kubo Y, Igaki H, Ichimura K, Narita Y. Consulting a neurosurgeon upon initial medical assessment reduces the time to the first surgery and potentially contributes to improved prognosis for glioblastoma patients. Jpn J Clin Oncol 2023; 53:1027-1033. [PMID: 37534529 DOI: 10.1093/jjco/hyad093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 07/17/2023] [Indexed: 08/04/2023] Open
Abstract
BACKGROUND The neurological status of glioblastoma patients rapidly deteriorates. We recently demonstrated that early diagnosis and surgery within 3 weeks from the initial symptoms are associated with improved survival. While glioblastoma is a semi-urgent disease, the prehospital behaviors and clinical outcomes of glioblastoma patients are poorly understood. We aimed to disclose how prehospital patient behavior influences the clinical outcomes of glioblastoma patients. METHODS Isocitrate dehydrogenase-wildtype glioblastoma patients treated at our institution between January 2010 and December 2019 were reviewed. Patients were divided into two groups, neurosurgeon and non-neurosurgeon groups, based on the primary doctor whom patients sought for an initial evaluation. Patient demographics and prognoses were examined. RESULTS Of 170 patients, 109 and 61 were classified into the neurosurgeon and non-neurosurgeon groups, respectively. The median age of neurosurgeon group was significantly younger than the non-neurosurgeon group (61 vs. 69 years old, P = 0.019) and in better performance status (preoperative Karnofsky performance status scores $\ge$80: 72.5 vs. 55.7%, P = 0.027). The neurosurgeon group exhibited a significantly shorter duration from the first hospital visit to the first surgery than the non-neurosurgeon group (18 vs. 29 days, P < 0.0001). Furthermore, the overall survival of the neurosurgeon group was significantly more prolonged than that of the non-neurosurgeon group (22.9 vs. 14.0 months, P = 0.038). CONCLUSION Seeking an initial evaluation by a neurosurgeon was potentially associated with prolonged survival in glioblastoma patients. A short duration from the first hospital visit to the first surgery is essential in enhancing glioblastoma patient prognosis.
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Affiliation(s)
- Daisuke Kawauchi
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Makoto Ohno
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Yasuji Miyakita
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Masamichi Takahashi
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Shunsuke Yanagisawa
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Takaki Omura
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Akihiko Yoshida
- Department of Diagnostic Pathology, National Cancer Center Hospital, Tokyo, Japan
| | - Yuko Kubo
- Department of Diagnostic Radiology, National Cancer Center Hospital, Tokyo, Japan
| | - Hiroshi Igaki
- Department of Radiation Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Koichi Ichimura
- Department of Brain Disease Translational Research, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Yoshitaka Narita
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, Tokyo, Japan
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Shimizu Y, Suzuki M, Akiyama O, Ogino I, Matsushita Y, Satomi K, Yanagisawa S, Ohno M, Takahashi M, Miyakita Y, Narita Y, Ichimura K, Kondo A. Utility of real-time polymerase chain reaction for the assessment of CDKN2A homozygous deletion in adult-type IDH-mutant astrocytoma. Brain Tumor Pathol 2023; 40:93-100. [PMID: 36788155 DOI: 10.1007/s10014-023-00450-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 02/03/2023] [Indexed: 02/16/2023]
Abstract
The World Health Organization Classification of Tumors of the Central Nervous System 5th Edition (WHO CNS5) introduced a newly defined astrocytoma, IDH-mutant grade 4, for adult diffuse glioma classification. One of the diagnostic criteria is the presence of a CDKN2A/B homozygous deletion (HD). Here, we report a robust and cost-effective quantitative polymerase chain reaction (qPCR)-based test for assessing CDKN2A HD. A TaqMan copy number assay was performed using a probe located within CDKN2A. The linear correlation between the Ct values and relative CDKN2A copy number was confirmed using a serial mixture of DNA from normal blood and U87MG cells. The qPCR assay was performed in 109 IDH-mutant astrocytomas, including 14 tumors with CDKN2A HD, verified either by multiplex ligation-dependent probe amplification (MLPA) or CytoScan HD microarray platforms. Receiver operating characteristic curve analysis indicated that a cutoff value of 0.85 yielded optimal sensitivity (100%) and specificity (99.0%) for determining CDKN2A HD. The assay applies to DNA extracted from frozen or formalin-fixed paraffin-embedded tissue samples. Survival was significantly shorter in patients with than in those without CDKN2A HD, assessed by either MLPA/CytoScan or qPCR. Thus, our qPCR method is clinically applicable for astrocytoma grading and prognostication, compatible with the WHO CNS5.
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Affiliation(s)
- Yuzaburo Shimizu
- Department of Neurosurgery, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo, 113-8421, Japan
| | - Mario Suzuki
- Department of Neurosurgery, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo, 113-8421, Japan
| | - Osamu Akiyama
- Department of Neurosurgery, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo, 113-8421, Japan
| | - Ikuko Ogino
- Department of Neurosurgery, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo, 113-8421, Japan
| | - Yuko Matsushita
- Department of Brain Disease Translational Research, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Kaishi Satomi
- Department of Pathology, Kyorin University School of Medicine, Tokyo, Japan.,Department of Diagnostic Pathology, National Cancer Center Hospital, Tokyo, Japan
| | - Shunsuke Yanagisawa
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Makoto Ohno
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Masamichi Takahashi
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Yasuji Miyakita
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Yoshitaka Narita
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Koichi Ichimura
- Department of Brain Disease Translational Research, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Akihide Kondo
- Department of Neurosurgery, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo, 113-8421, Japan.
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Derived Polymorphic Amplified Cleaved Sequence (dPACS) Assay. Methods Mol Biol 2023; 2638:373-385. [PMID: 36781657 DOI: 10.1007/978-1-0716-3024-2_27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
The derived polymorphic amplified cleaved sequence (dPACS) assay is a simple polymerase chain reaction/restriction fragment length polymorphism (PCR-RFLP)-based procedure for detecting known single-nucleotide polymorphisms (SNPs) and deletion-insertion polymorphisms (DIPs). It is relatively straightforward to carry out using basic and commonly available molecular biology kits. The method differs from other PCR-RFLP assays in that it employs 35-55 bp primer pairs that encompass the entire targeted DNA region except for a few diagnostic nucleotides being examined. In so doing, it allows for the introduction of nucleotide mismatches in one or both primers for differentiating wild from mutant sequences following polymerase chain reaction, restriction digestion and MetaPhor gel electrophoresis. Primer design and the selection of discriminating enzymes are achieved with the help of the dPACS 1.0 program. The method is exemplified here with the positive detection of serine 264-psbA, a key determinant for the effective binding of some photosystem II inhibitors to their target. A serine-to-glycine mutation at codon 264 of psbA causes resistance to serine-binding photosystem II herbicides in several grasses and broad-leaf weeds, including Amaranthus retroflexus, which is employed in this study.
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Kawauchi D, Ohno M, Honda-Kitahara M, Miyakita Y, Takahashi M, Yanagisawa S, Tamura Y, Kikuchi M, Ichimura K, Narita Y. Clinical characteristics and prognosis of Glioblastoma patients with infratentorial recurrence. BMC Neurol 2023; 23:9. [PMID: 36609238 PMCID: PMC9824996 DOI: 10.1186/s12883-022-03047-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 12/28/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Glioblastoma (GBM) infrequently recurs in the infratentorial region. Such Infratentorial recurrence (ITR) has some clinically unique characteristics, such as presenting unspecific symptoms and providing patients a chance to receive additional radiotherapy. However, the clinical significances of ITR are not well studied. METHODS We reviewed newly diagnosed isocitrate dehydrogenase (IDH)-wildtype GBM patients treated at our institution between October 2008 and December 2018. ITR was defined as any type of recurrence in GBM, including dissemination or distant recurrence, which primarily developed in the supratentorial region and recurred in the infratentorial region. RESULTS Of 134 patients with newly diagnosed IDH-wildtype GBM, six (4.5%) were classified as having ITR. There was no significant difference in median duration from the first surgery to ITR development between patients with and without ITR (12.2 vs. 10.2 months, P = 0.65). The primary symptoms of ITR were gait disturbance (100%, n = 6), dizziness (50.0%, n = 3), nausea (33.3%, n = 2), and cerebellar mutism (16.7%, n = 1). In four cases (66.7%), symptoms were presented before ITR development. All patients received additional treatments for ITR. The median post-recurrence survival (PRS) of ITR patients was significantly shorter than that of general GBM patients (5.5 vs. 9.1 months, P = 0.023). However, chemoradiotherapy contributed to palliating symptoms such as nausea. CONCLUSIONS ITR is a severe recurrence type in GBM patients. Its symptoms are neurologically unspecific and can be overlooked or misdiagnosed as side effects of treatments. Carefully checking the infratentorial region, especially around the fourth ventricle, is essential during the GBM patient follow-up.
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Affiliation(s)
- Daisuke Kawauchi
- grid.272242.30000 0001 2168 5385Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-Ku, Tokyo, 104-0045 Japan
| | - Makoto Ohno
- grid.272242.30000 0001 2168 5385Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-Ku, Tokyo, 104-0045 Japan
| | - Mai Honda-Kitahara
- grid.272242.30000 0001 2168 5385Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-Ku, Tokyo, 104-0045 Japan
| | - Yasuji Miyakita
- grid.272242.30000 0001 2168 5385Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-Ku, Tokyo, 104-0045 Japan
| | - Masamichi Takahashi
- grid.272242.30000 0001 2168 5385Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-Ku, Tokyo, 104-0045 Japan
| | - Shunsuke Yanagisawa
- grid.272242.30000 0001 2168 5385Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-Ku, Tokyo, 104-0045 Japan
| | - Yukie Tamura
- grid.272242.30000 0001 2168 5385Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-Ku, Tokyo, 104-0045 Japan
| | - Miyu Kikuchi
- grid.272242.30000 0001 2168 5385Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-Ku, Tokyo, 104-0045 Japan
| | - Koichi Ichimura
- grid.258269.20000 0004 1762 2738Department of Brain Disease Translational Research, Faculty of Medicine, Juntendo University, Tokyo, Japan
| | - Yoshitaka Narita
- grid.272242.30000 0001 2168 5385Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-Ku, Tokyo, 104-0045 Japan
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Zhou J, Shi LF, Wang Z, Li M, Zhang JS, Mao Y, Hua W. OLIG2 expression level could be used as an independent prognostic factor for patients with cerebellar Glioblastoma (cGBM). Clinics (Sao Paulo) 2023; 78:100120. [PMID: 37001387 PMCID: PMC10126729 DOI: 10.1016/j.clinsp.2022.100120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 08/10/2022] [Accepted: 09/12/2022] [Indexed: 04/04/2023] Open
Abstract
OBJECTIVES The incidence of cerebellar Glioblastoma Multiforme (cGBM) is rare. Database like TCGA have not distinguish cGBM from GBM, our knowledge on cGBM gene expression characteristics is limited. The expression status of Oligodendrocyte Lineage Transcription factor 2 (OLIG2) and its clinical significance in cGBM is still unclear. METHODS The clinical data and tissue specimens of 73 cGBM patients were retrospectively studied. The association between OLIG2 expression level and the demographic characteristics of cGBM patients was identified by the Chi-Square test. The survival curves were drawn by Kaplan-Meier analysis. The independent prognostic factors was calculated according to Cox regression analysis. RESULTS The OLIG2 high expression was observed in about 57.5% (42/73) of the cGBM patients. Patients with high OLIG2 expression levels had a higher alive ratio at the end of follow-up (alive ratio: 70.6% vs. 29.4%, p = 0.04). The median survival time was 21 months and 13 months for high and low expression of OLIG2 (p < 0 .05). Univariate analysis and Multivariate analysis indicated that EOR (HR = 3.89, 95% CI 1.23‒12.26, p = 0.02), low OLIG2 expression (HR = 5.26, 95% CI 1.13‒24.59, p = 0.04), and without adjuvant therapy (HR = 4.95, 95% CI 1.22‒20.00, p = 0.03) were independent risk factors for the OS of cGBM patients. CONCLUSION High expression level of OLIG2 could be used as an independent favorable prognosis indicator in cGBM patients and be recognized as a characteristic biomarker of cGBM.
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Affiliation(s)
- Jia Zhou
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, China; Cancer Center, Department of Neurosurgery, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, China.
| | - Ling-Fei Shi
- Department of Geriatics, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, China
| | - Zheng Wang
- Cancer Center, Department of Neurosurgery, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, China
| | - Min Li
- Cancer Center, Department of Neurosurgery, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, China
| | - Jin-Seng Zhang
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, China
| | - Ying Mao
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, China
| | - Wei Hua
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, China
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Ohno M, Kitano S, Satomi K, Yoshida A, Miyakita Y, Takahashi M, Yanagisawa S, Tamura Y, Ichimura K, Narita Y. Assessment of radiographic and prognostic characteristics of programmed death-ligand 1 expression in high-grade gliomas. J Neurooncol 2022; 160:463-472. [DOI: 10.1007/s11060-022-04165-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 10/12/2022] [Indexed: 10/31/2022]
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Volumetric Analysis of Glioblastoma for Determining Which CpG Sites Should Be Tested by Pyrosequencing to Predict Temozolomide Efficacy. Biomolecules 2022; 12:biom12101379. [DOI: 10.3390/biom12101379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 09/18/2022] [Accepted: 09/24/2022] [Indexed: 11/16/2022] Open
Abstract
The aim of the present study was to determine which individual or combined CpG sites among O6-methylguanine DNA methyltransferase CpG 74–89 in glioblastoma mainly affects the response to temozolomide resulting from CpG methylation using statistical analyses focused on the tumor volume ratio (TVR). We retrospectively examined 44 patients who had postoperative volumetrically measurable residual tumor tissue and received adjuvant temozolomide therapy for at least 6 months after initial chemoradiotherapy. TVR was defined as the tumor volume 6 months after the initial chemoradiotherapy divided by that before the start of chemoradiotherapy. Predictive values for TVR as a response to adjuvant therapy were compared among the averaged methylation percentages of individual or combined CpGs using the receiver operating characteristic curve. Our data revealed that combined CpG 78 and 79 showed a high area under the curve (AUC) and a positive likelihood ratio and that combined CpG 76–79 showed the highest AUC among all combinations. AUCs of consecutive CpG combinations tended to be higher for CpG 74–82 in exon 1 than for CpG 83–89 in intron 1. In conclusion, the methylation status at CpG sites in exon 1 was strongly associated with TVR reduction in glioblastoma.
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10
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Ohno M, Kitanaka C, Miyakita Y, Tanaka S, Sonoda Y, Mishima K, Ishikawa E, Takahashi M, Yanagisawa S, Ohashi K, Nagane M, Narita Y. Metformin with Temozolomide for Newly Diagnosed Glioblastoma: Results of Phase I Study and a Brief Review of Relevant Studies. Cancers (Basel) 2022; 14:cancers14174222. [PMID: 36077758 PMCID: PMC9454846 DOI: 10.3390/cancers14174222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 08/22/2022] [Accepted: 08/23/2022] [Indexed: 11/16/2022] Open
Abstract
Glioblastoma (GBM) inevitably recurs due to a resistance to current standard therapy. We showed that the antidiabetic drug metformin (MF) can induce the differentiation of stem-like glioma-initiating cells and suppress tumor formation through AMPK-FOXO3 activation. In this study, we design a phase I/II study to examine the clinical effect of MF. We aim to determine a recommended phase II MF dose with maintenance temozolomide (TMZ) in patients with newly diagnosed GBM who completed standard concomitant radiotherapy and TMZ. MF dose-escalation was planned using a 3 + 3 design. Dose-limiting toxicities (DLTs) were assessed during the first six weeks after MF initiation. Three patients were treated with 1500 mg/day MF and four patients were treated with 2250 mg/day MF between February 2021 and January 2022. No DLTs were observed. The most common adverse effects were appetite loss, nausea, and diarrhea, all of which were manageable. Two patients experienced tumor progression at 6.0 and 6.1 months, and one died 12.2 months after initial surgery. The other five patients remained stable at the last follow-up session. The MF dose of up to 2250 mg/day combined with maintenance TMZ appeared to be well tolerated, and we proceeded to a phase II study with 2250 mg/day MF.
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Affiliation(s)
- Makoto Ohno
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, Tokyo 104-0045, Japan
| | - Chifumi Kitanaka
- Department of Molecular Cancer Science, Faculty of Medicine, Yamagata University, Yamagata 990-9585, Japan
| | - Yasuji Miyakita
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, Tokyo 104-0045, Japan
| | - Shota Tanaka
- Department of Neurosurgery, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan
| | - Yukihiko Sonoda
- Department of Neurosurgery, Faculty of Medicine, Yamagata University, Yamagata 990-9585, Japan
| | - Kazuhiko Mishima
- Department of Neuro-Oncology/Neurosurgery, International Medical Center, Saitama Medical University, Hidaka 350-1298, Japan
| | - Eiichi Ishikawa
- Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tsukuba 350-8576, Japan
| | - Masamichi Takahashi
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, Tokyo 104-0045, Japan
| | - Shunsuke Yanagisawa
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, Tokyo 104-0045, Japan
| | - Ken Ohashi
- Department of General Internal Medicine, National Cancer Center Hospital, Tokyo 104-0045, Japan
| | - Motoo Nagane
- Department of Neurosurgery, Kyorin University Faculty of Medicine, Mitaka 181-8611, Japan
| | - Yoshitaka Narita
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, Tokyo 104-0045, Japan
- Correspondence: ; Tel.: +81-3-3542-2511
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11
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Satomi K, Yoshida A, Matsushita Y, Sugino H, Fujimoto K, Honda-Kitahara M, Takahashi M, Ohno M, Miyakita Y, Narita Y, Yatabe Y, Shibahara J, Ichimura K. Clinical application of a highly sensitive digital PCR assay to detect a small fraction of IDH1 R132H-mutant alleles in diffuse gliomas. Brain Tumor Pathol 2022; 39:210-217. [PMID: 35902443 DOI: 10.1007/s10014-022-00442-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 07/19/2022] [Indexed: 11/30/2022]
Abstract
The current World Health Organization classification of diffuse astrocytic and oligodendroglial tumors requires the examination of isocitrate dehydrogenase 1 (IDH1) or IDH2 mutations. Conventional analysis tools, including Sanger DNA sequencing or pyrosequencing, fail in detecting these variants of low frequency owing to their limited sensitivity. Digital polymerase chain reaction (dPCR) is a recently developed, highly sensitive, and precise quantitative rare variant assay. This study aimed to establish a robust limit of quantitation of the dPCR assay to detect a small fraction of IDH1 R132H mutation. The dPCR assays with serially diluted IDH1 R132H constructs detected 0.05% or more of mutant IDH1 R132H in samples containing mutant DNA. The measured target/total value of the experiments was proportional to the dilution factors and was almost equal to the actual frequencies of the mutant alleles. Based on the average target/total values, together with a twofold standard deviation of the normal DNA, a limit of quantitation of 0.25% was set to secure a safe margin to judge the mutation status of the IDH1 R132H dPCR assay. In clinical settings, detecting IDH1 R132H using dPCR assays can validate ambiguous immunohistochemistry results even when conventional DNA sequencing cannot detect the mutation and assure diagnostic quality.
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Affiliation(s)
- Kaishi Satomi
- Department of Diagnostic Pathology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan. .,Division of Brain Tumor Translational Research, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan. .,Department of Pathology, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka-shi, Tokyo, 181-8611, Japan.
| | - Akihiko Yoshida
- Department of Diagnostic Pathology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Yuko Matsushita
- Division of Brain Tumor Translational Research, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.,Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.,Department of Brain Disease Translational Research, Faculty of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Hirokazu Sugino
- Department of Diagnostic Pathology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Kenji Fujimoto
- Division of Brain Tumor Translational Research, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.,Department of Neurosurgery, Graduate School of Life Sciences, Kumamoto University, 1-1-1 Honjo, Kumamoto-shi, Kumamoto, 860-8555, Japan
| | - Mai Honda-Kitahara
- Division of Brain Tumor Translational Research, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.,Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Masamichi Takahashi
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Makoto Ohno
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Yasuji Miyakita
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Yoshitaka Narita
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Yasushi Yatabe
- Department of Diagnostic Pathology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Junji Shibahara
- Department of Pathology, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka-shi, Tokyo, 181-8611, Japan
| | - Koichi Ichimura
- Division of Brain Tumor Translational Research, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.,Department of Brain Disease Translational Research, Faculty of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
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12
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Ohno M, Miyakita Y, Takahashi M, Yanagisawa S, Tamura Y, Narita Y. Continuing maintenance temozolomide therapy beyond 12 cycles confers no clinical benefit over discontinuation at 12 cycles in patients with IDH1/2-wildtype glioblastoma. Jpn J Clin Oncol 2022; 52:1134-1142. [PMID: 35858227 DOI: 10.1093/jjco/hyac114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 06/30/2022] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE The optimal duration of maintenance temozolomide therapy is controversial. We aimed to examine the clinical benefits of continuing temozolomide therapy beyond 12 cycles in patients with glioblastoma. METHODS We included 41 patients with isocitrate dehydrogenase 1/2-wildtype glioblastoma, who received 12 or more cycles of temozolomide therapy between June 2006 and December 2019. We evaluated the outcome between 16 patients who continued temozolomide therapy beyond 12 cycles up to 24 cycles (≥13 cycles group) and 25 patients wherein temozolomide therapy was discontinued at 12 cycles (12 cycles group). RESULTS The median progression-free survival and survival time after completing 12 cycles (residual progression-free survival and residual overall survival) did not differ between the 12 cycles group and ≥13 cycles group (residual progression-free survival: 11.3 vs. 9.2 months, P = 0.61, residual overall survival: 25.7 vs. 30.2 months, P = 0.76). Multivariate analysis including temozolomide therapy beyond 12 cycles, age at 12 cycles, Karnofsky performance status at 12 cycles, residual tumor at 12 cycles, maintenance therapy regimen and O-6-methylguanine deoxyribonucleic acid methyltransferase promoter methylation status revealed that extended temozolomide therapy beyond 12 cycles was not correlated with residual progression-free survival and residual overall survival (P = 0.80 and P = 0.41, respectively) but Karnofsky performance status at 12 cycles ≥80 was significantly associated with increased residual overall survival (P = 0.0012). CONCLUSIONS Continuing temozolomide beyond 12 cycles confers no clinical benefit over the discontinuation of temozolomide at 12 cycles. Karnofsky performance status at 12 cycles ≥80 may serve as a novel predictive factor for long-term survival.
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Affiliation(s)
- Makoto Ohno
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Yasuji Miyakita
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Masamichi Takahashi
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Shunsuke Yanagisawa
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Yukie Tamura
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Yoshitaka Narita
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
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13
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Suzuki H, Ono T, Koyota S, Takahashi M, Sugai T, Nanjo H, Shimizu H. Clinical, histopathological, and molecular features of IDH-wildtype indolent diffuse glioma: comparison with typical glioblastoma. J Neurooncol 2022; 159:397-408. [PMID: 35779193 DOI: 10.1007/s11060-022-04074-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 06/17/2022] [Indexed: 11/24/2022]
Abstract
PURPOSE IDH-wildtype (IDHwt) diffuse gliomas are treated as glioblastoma, however, some of these may show less aggressive clinical courses. The authors investigated the clinical, histopathological, and molecular characteristics of such IDHwt indolent diffuse gliomas (iDGwt), which have not been well documented in the literature. METHODS Adult patients with IDHwt gliomas admitted between 2011 and 2020 were surveyed. In this particular study, the clinical indolence was defined mainly as having a small enhancing lesion and a stable period for more than 1 month before surgery. The current WHO diagnostic criteria were adapted for the diagnoses. Gene mutations and copy number changes in 43 representative glioma-associated genes, MGMT promoter methylation status, and survival data were compared with those of The Cancer Genome Atlas reference cohort. RESULTS Nine out of 180 surveyed cases (5.0%) fulfilled the present criteria of the iDGwt. Considering the representative regulatory pathways, 8 (88.9%), 4 (44.4%), and 1 (11.1%) case had genetic alterations in the PI3K/MAPK, TP53, and RB pathways, respectively. The frequency of the RB pathway alteration was significantly lower than that in the reference cohort (281 of 362 cases: 77.6%). Two cases (22.2%) showing EGFR amplification met the diagnostic criteria for glioblastoma, and the frequency was significantly lower than that in the reference cohort (412 of 426 cases: 96.7%). The overall survival (median: 37.5 months) in the present series was significantly longer than that in the reference cohort (n = 426, median: 13.9 months). CONCLUSIONS iDGwt lacked the molecular features of glioblastoma except for the PI3K/MAPK pathway alteration.
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Affiliation(s)
- Hayato Suzuki
- Department of Neurosurgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, Akita, 010-8543, Japan
| | - Takahiro Ono
- Department of Neurosurgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, Akita, 010-8543, Japan.
| | - Souichi Koyota
- Molecular Medicine Laboratory, Bioscience Education and Research Support Center, Akita University School of Medicine, 1-1-1 Hondo, Akita, Akita, 010-8543, Japan
| | - Masataka Takahashi
- Department of Neurosurgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, Akita, 010-8543, Japan
| | - Tamotsu Sugai
- Department of Pathology, Iwate Medical University, 1-1-1 Idaidori, Yahaba-cho, Shiwa-gun, Iwate, 028-3694, Japan
| | - Hiroshi Nanjo
- Department of Surgical Pathology, Akita University Hospital, 44-2 Hasunuma Hiroomote, Akita, Akita, 010-8543, Japan
| | - Hiroaki Shimizu
- Department of Neurosurgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, Akita, 010-8543, Japan
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14
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Ohno M, Miyakita Y, Takahashi M, Yanagisawa S, Tamura Y, Kawauchi D, Kikuchi M, Igaki H, Yoshida A, Satomi K, Matsushita Y, Ichimura K, Narita Y. Assessment of therapeutic outcome and role of reirradiation in patients with radiation-induced glioma. Radiat Oncol 2022; 17:85. [PMID: 35505351 PMCID: PMC9066974 DOI: 10.1186/s13014-022-02054-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Accepted: 04/15/2022] [Indexed: 11/26/2022] Open
Abstract
Background We sought to clarify the optimal follow-up, therapeutic strategy, especially the role of reirradiation, and the diagnostic impact of isocitrate dehydrogenase (IDH) 1 and 2 mutation status in patients with radiation-induced glioma (RIG). Methods We retrospectively reviewed the clinical characteristics and treatment outcomes of 11 patients with high-grade glioma who satisfied Cahan’s criteria for RIG in our database during 2001–2021. IDH 1/2 mutations were analyzed by Sanger sequencing and/or pyrosequencing. Results The RIGs included glioblastoma with IDH 1/2 wild-type (n = 7), glioblastoma not otherwise specified (n = 2), anaplastic astrocytoma with IDH1/2 wild-type (n = 1), and anaplastic astrocytoma not otherwise specified (n = 1). The median period from primary disease and RIG diagnosis was 17 years (range: 9–30 years). All patients underwent tumor removal or biopsy, 5 patients postoperatively received reirradiation combined with chemotherapy, and 6 patients were treated with chemotherapy alone. The median progression-free and survival times were 11.3 and 28.3 months. The median progression-free survival time of patients treated with reirradiation and chemotherapy (n = 5) tended to be longer than that of patients that received chemotherapy alone (n = 6) (17.0 vs 8.1 months). However, the median survival time was similar (29.6 vs 27.4 months). Local recurrence was observed in 5 patients treated with chemotherapy alone, whereas in 2 patients among 4 patients treated with reirradiation and chemotherapy. None of the patients developed radiation necrosis. In one case, the primary tumor was diffuse astrocytoma with IDH2 mutant, and the secondary tumor was glioblastoma with IDH 1/2 wild-type. Based on the difference of IDH2 mutation status, the secondary tumor with IDH 1/2 wild-type was diagnosed as a de novo tumor that was related to the previous radiation therapy. Conclusions RIG can occur beyond 20 years after successfully treating the primary disease using radiotherapy; thus, cancer survivors should be informed of the long-term risk of developing RIG and the need for timely neuroimaging evaluation. Reirradiation combined with chemotherapy appears to be feasible and has favorable outcomes. Determining the IDH1/2 mutational status is useful to establish RIG diagnosis when the primary tumor is glioma.
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Affiliation(s)
- Makoto Ohno
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.
| | - Yasuji Miyakita
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Masamichi Takahashi
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Shunsuke Yanagisawa
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Yukie Tamura
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Daisuke Kawauchi
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Miyu Kikuchi
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Hiroshi Igaki
- Department of Radiation Oncology, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Akihiko Yoshida
- Department of Diagnostic Pathology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Kaishi Satomi
- Department of Diagnostic Pathology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Yuko Matsushita
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Koichi Ichimura
- Division of Brain Tumor Translational Research, National Cancer Center Research Institute, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.,Department of Brain Disease Translational Research, Faculty of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Yoshitaka Narita
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.
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15
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MGMT gene promoter methylation by pyrosequencing method correlates volumetric response and neurological status in IDH wild-type glioblastomas. J Neurooncol 2022; 157:561-571. [PMID: 35397757 PMCID: PMC9072488 DOI: 10.1007/s11060-022-03999-5] [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] [Received: 02/25/2022] [Accepted: 03/24/2022] [Indexed: 01/03/2023]
Abstract
Purpose Although the usefulness of O6-methylguanine DNA methyltransferase (MGMT) promoter methylation analysis for predicting response to chemoradiotherapy and the prognosis of patients with glioblastoma has been widely reported, there is still no consensus regarding how to define MGMT promoter methylation percentage (MGMTpm%) cutoffs by pyrosequencing method. The aim of this study was to determine the optimal cutoff value of MGMT promoter methylation status using volumetric analysis focused on the tumor volume ratio (TVR) measured by MRI. Methods This retrospective study included newly diagnosed IDH wild-type glioblastoma patients with residual tumor after surgery, followed by local radiotherapy with temozolomide. TVR was defined as the tumor volume at 6 months after the initial chemoradiotherapy administration divided by the tumor volume before the start of therapy. The mean MGMTpm% of 16 CpG islands (74–89) was analyzed using pyrosequencing. We statistically analyzed the correlation between MGMTpm%, TVR, and change in Karnofsky performance status. Results The study included 44 patients with residual tumors. Thirteen (92.9%) of 14 patients with MGMTpm% ≥ 23.9% showed 50% or more volumetric response, leading to prolonged survival, and 17 (70.8%) of 24 patients with MGMTpm% < 8.2% had progressive disease after initial chemoradiotherapy administration. Three (50.0%) of six patients with MGMTpm% 8.2% to < 23.9% had stable disease or partial response. Conclusion Evaluation of MGMTpm% by pyrosequencing is important in predicting the volumetric response and prognosis of glioblastoma patients with residual tumors.
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16
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Kit OI, Pushkin AA, Alliluyev IA, Timoshkina NN, Gvaldin DY, Rostorguev EE, Kuznetsova NS. Differential expression of microRNAs targeting genes associated with the development of high-grade gliomas. EGYPTIAN JOURNAL OF MEDICAL HUMAN GENETICS 2022. [DOI: 10.1186/s43042-022-00245-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Highly malignant high-grade gliomas are tumors of the central nervous system (CNS). They are solid tumors arising from transformed cells of the brain and/or the spinal cord. In recent years, the expression of genes and regulating miRNAs in glial brain tumors has been actively studied. The present study is devoted to assessing the expression levels of miR-215-5p, miR-22-3p, miR-122-5p, miR-107, miR-324-5p, miR-34a-5p, miR-155. -5p, miR-21-5p, miR-497-5p, miR-330-3p, miR-146a-5p, miR-92a-1-5p, miR-326 and target genes EGFR, SMAD4, SMAD7, SMO, NOTCH1, NOTCH2, HIF1A, EGLIN1/3, KDM1B, KDM1A, MSI1, MSI2, TET1 in high-grade glioma tissues.
Results
As a result of the analysis of the levels of relative expression of the studied genes, there are significant changes (p < 0.05) in tumor tissue for genes: EGFR, SMAD4, SMAD7, SMO, HIF1A, EGLN1/3. We obtained data on a significant change (p < 0.05) in the levels of relative expression for microRNA: hsa-miR-215-5p, hsa-miR-22-3p, hsa-miR-122-5p, hsa-miR-107, hsa-miR-324-5p, hsa-miR-155-5p, hsa-miR-21-5p, hsa-miR-330-3p, hsa-miR-326. Data on the association of overall survival in patients with high-grade glioma and the level of relative expression of the EGFR and HIF1A genes were obtained. The obtained data demonstrate the association of overall survival of patients with high-grade glioma and the level of relative expression of EGFR, HIF1A and hsa-miR-22-3p, hsa-miR-107 and hsa-miR-330-3p.
Conclusions
The obtained data on the expression of genes and microRNAs expand the understanding of the biology of the development of high-grade glial tumors. These data demonstrate new potential therapeutic and prognostic goals in high-grade gliomas.
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17
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The clinical characteristics and outcomes of incidentally discovered glioblastoma. J Neurooncol 2022; 156:551-557. [PMID: 34985720 DOI: 10.1007/s11060-021-03931-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 12/17/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVE With an increase in the number of imaging examinations and the development of imaging technology, a small number of glioblastomas (GBMs) are identified by incidental radiological images. These incidentally discovered glioblastomas (iGBMs) are rare, and their clinical features are not well understood. Here, we investigated the clinical characteristics and outcomes of iGBM. METHODS Data of newly diagnosed iGBM patients who were treated at our institution between August 2005 and October 2019 were reviewed. An iGBM was defined as a GBM without a focal sign, discovered on radiological images obtained for reasons unrelated to the tumor. Kaplan-Meier analysis was performed to calculate progression-free survival (PFS) and overall survival (OS). RESULTS Of 315 patients with newly diagnosed GBM, four (1.3%) were classified as having iGBM. Health screening was the most common reason for tumor discovery (75.0%). The preoperative Karnofsky performance status score was 100 in three patients. Tumors were found on the right side in three cases. The mean volume of preoperative enhanced tumor lesion was 16.8 cm3. The median duration from confirmation of an enhanced lesion to surgery was 13.5 days. In all cases, either total (100%) or subtotal (95-99%) resections were achieved. The median PFS and OS were 10.5 and 20.0 months, respectively. CONCLUSIONS The iGBMs were often small and in the right non-eloquent area, and the patients had good performance status. We found that timely therapeutic intervention provided iGBM patients with favorable outcomes. This report suggests that early detection of GBM may lead to a better prognosis.
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18
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Ohno M, Hayashi Y, Aikawa H, Hayashi M, Miyakita Y, Takahashi M, Matsushita Y, Yoshida A, Satomi K, Ichimura K, Hamada A, Narita Y. Tissue 2-Hydroxyglutarate and Preoperative Seizures in Patients With Diffuse Gliomas. Neurology 2021; 97:e2114-e2123. [PMID: 34610989 DOI: 10.1212/wnl.0000000000012893] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 09/20/2021] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Mutant isocitrate dehydrogenase (IDH) 1/2 gene products gain a new ability to produce D-2-hydroxyglutarate (D2HG). IDH1/2 mutations are thought to be associated with seizures owing to the structural similarity between D2HG and glutamate. However, the effects of D2HG on seizures in clinical settings are not fully understood. We sought to investigate the relationship between tissue 2-hydroxyglutarate (2HG) concentration and preoperative seizures using clinical samples. METHODS We included 104 consecutive patients with diffuse glioma who underwent surgery from August 2008 to May 2016 and whose clinical presentation and IDH1/2 status were identified. The presence of preoperative seizures, tumor location, histopathologic diagnosis, IDH1/2 status, and 1p/19q codeletion were assessed from the patient charts. Tissue 2HG concentration was measured using liquid chromatography-tandem mass spectrometry. To evaluate 2HG distribution without artefactual tissue disruption, we applied matrix-assisted laser desorption/ionization high-resolution mass spectrometry imaging (MALDI-MSI) in 12 patients' surgically resected samples. We assessed the correlation of preoperative seizures with tissue 2HG concentration, IDH1/2 status, WHO grade, and 1p/19q codeletion. RESULTS Tissue 2HG concentration was higher in IDH1/2 mutant tumors (IDH-Mut, n = 42) than in IDH1/2 wild-type tumors (IDH-WT, n = 62) (median 4,860 ng/mg vs 75 ng/mg) (p < 0.0001). MALDI-MSI could detect 2HG signals in IDH-Mut, but not in IDH-WT. Preoperative seizures were observed in 64.3% of patients with IDH-Mut and 21.0% patients with IDH-WT (p < 0.0001). The optimal cutoff value of tissue 2HG concentration for predicting preoperative seizures was 1,190 ng/mg, as calculated by the receiver operating characteristic curve. Increased preoperative seizure risk was only observed in tumors with 2HG concentration above the cutoff value among IDH-Mut (IDH-Mut with above the cutoff value: 71.4% vs IDH-Mut with below the cutoff value: 28.6%; p = 0.031). Multivariate analysis, including IDH1/2 mutation status, tissue 2HG concentration, WHO grade, and 1p/19q codeletion, revealed that only increased tissue 2HG concentration was associated with preoperative seizures (odds ratio 5.86, 95% confidence interval 1.02-48.5; p = 0.048). DISCUSSION We showed that high tissue 2HG concentration was associated with preoperative seizures, suggesting that excess 2HG increases risk of preoperative seizures in IDH1/2 mutant tumors.
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Affiliation(s)
- Makoto Ohno
- From the Departments of Neurosurgery and Neuro-Oncology (M.O., Y. Miyakita, M.T., Y. Matsushita, Y.N.) and Diagnostic Pathology (A.Y., K.S.), National Cancer Center Hospital; Divisions of Molecular Pharmacology (Y.H., A.H.) and Brain Tumor Translational Research (K.I.), National Cancer Center Research Institute; Division of Clinical Pharmacology and Translational Research, Exploratory Oncology Research and Clinical Trial Center (Y.H., H.A., M.H., A.H.), National Cancer Center; and Department of Medical Oncology and Translational Research (Y.H., A.H.), Graduate School of Medical Sciences, Kumamoto University, Tokyo, Japan.
| | - Yoshiharu Hayashi
- From the Departments of Neurosurgery and Neuro-Oncology (M.O., Y. Miyakita, M.T., Y. Matsushita, Y.N.) and Diagnostic Pathology (A.Y., K.S.), National Cancer Center Hospital; Divisions of Molecular Pharmacology (Y.H., A.H.) and Brain Tumor Translational Research (K.I.), National Cancer Center Research Institute; Division of Clinical Pharmacology and Translational Research, Exploratory Oncology Research and Clinical Trial Center (Y.H., H.A., M.H., A.H.), National Cancer Center; and Department of Medical Oncology and Translational Research (Y.H., A.H.), Graduate School of Medical Sciences, Kumamoto University, Tokyo, Japan
| | - Hiroaki Aikawa
- From the Departments of Neurosurgery and Neuro-Oncology (M.O., Y. Miyakita, M.T., Y. Matsushita, Y.N.) and Diagnostic Pathology (A.Y., K.S.), National Cancer Center Hospital; Divisions of Molecular Pharmacology (Y.H., A.H.) and Brain Tumor Translational Research (K.I.), National Cancer Center Research Institute; Division of Clinical Pharmacology and Translational Research, Exploratory Oncology Research and Clinical Trial Center (Y.H., H.A., M.H., A.H.), National Cancer Center; and Department of Medical Oncology and Translational Research (Y.H., A.H.), Graduate School of Medical Sciences, Kumamoto University, Tokyo, Japan
| | - Mitsuhiro Hayashi
- From the Departments of Neurosurgery and Neuro-Oncology (M.O., Y. Miyakita, M.T., Y. Matsushita, Y.N.) and Diagnostic Pathology (A.Y., K.S.), National Cancer Center Hospital; Divisions of Molecular Pharmacology (Y.H., A.H.) and Brain Tumor Translational Research (K.I.), National Cancer Center Research Institute; Division of Clinical Pharmacology and Translational Research, Exploratory Oncology Research and Clinical Trial Center (Y.H., H.A., M.H., A.H.), National Cancer Center; and Department of Medical Oncology and Translational Research (Y.H., A.H.), Graduate School of Medical Sciences, Kumamoto University, Tokyo, Japan
| | - Yasuji Miyakita
- From the Departments of Neurosurgery and Neuro-Oncology (M.O., Y. Miyakita, M.T., Y. Matsushita, Y.N.) and Diagnostic Pathology (A.Y., K.S.), National Cancer Center Hospital; Divisions of Molecular Pharmacology (Y.H., A.H.) and Brain Tumor Translational Research (K.I.), National Cancer Center Research Institute; Division of Clinical Pharmacology and Translational Research, Exploratory Oncology Research and Clinical Trial Center (Y.H., H.A., M.H., A.H.), National Cancer Center; and Department of Medical Oncology and Translational Research (Y.H., A.H.), Graduate School of Medical Sciences, Kumamoto University, Tokyo, Japan
| | - Masamichi Takahashi
- From the Departments of Neurosurgery and Neuro-Oncology (M.O., Y. Miyakita, M.T., Y. Matsushita, Y.N.) and Diagnostic Pathology (A.Y., K.S.), National Cancer Center Hospital; Divisions of Molecular Pharmacology (Y.H., A.H.) and Brain Tumor Translational Research (K.I.), National Cancer Center Research Institute; Division of Clinical Pharmacology and Translational Research, Exploratory Oncology Research and Clinical Trial Center (Y.H., H.A., M.H., A.H.), National Cancer Center; and Department of Medical Oncology and Translational Research (Y.H., A.H.), Graduate School of Medical Sciences, Kumamoto University, Tokyo, Japan
| | - Yuko Matsushita
- From the Departments of Neurosurgery and Neuro-Oncology (M.O., Y. Miyakita, M.T., Y. Matsushita, Y.N.) and Diagnostic Pathology (A.Y., K.S.), National Cancer Center Hospital; Divisions of Molecular Pharmacology (Y.H., A.H.) and Brain Tumor Translational Research (K.I.), National Cancer Center Research Institute; Division of Clinical Pharmacology and Translational Research, Exploratory Oncology Research and Clinical Trial Center (Y.H., H.A., M.H., A.H.), National Cancer Center; and Department of Medical Oncology and Translational Research (Y.H., A.H.), Graduate School of Medical Sciences, Kumamoto University, Tokyo, Japan
| | - Akihiko Yoshida
- From the Departments of Neurosurgery and Neuro-Oncology (M.O., Y. Miyakita, M.T., Y. Matsushita, Y.N.) and Diagnostic Pathology (A.Y., K.S.), National Cancer Center Hospital; Divisions of Molecular Pharmacology (Y.H., A.H.) and Brain Tumor Translational Research (K.I.), National Cancer Center Research Institute; Division of Clinical Pharmacology and Translational Research, Exploratory Oncology Research and Clinical Trial Center (Y.H., H.A., M.H., A.H.), National Cancer Center; and Department of Medical Oncology and Translational Research (Y.H., A.H.), Graduate School of Medical Sciences, Kumamoto University, Tokyo, Japan
| | - Kaishi Satomi
- From the Departments of Neurosurgery and Neuro-Oncology (M.O., Y. Miyakita, M.T., Y. Matsushita, Y.N.) and Diagnostic Pathology (A.Y., K.S.), National Cancer Center Hospital; Divisions of Molecular Pharmacology (Y.H., A.H.) and Brain Tumor Translational Research (K.I.), National Cancer Center Research Institute; Division of Clinical Pharmacology and Translational Research, Exploratory Oncology Research and Clinical Trial Center (Y.H., H.A., M.H., A.H.), National Cancer Center; and Department of Medical Oncology and Translational Research (Y.H., A.H.), Graduate School of Medical Sciences, Kumamoto University, Tokyo, Japan
| | - Koichi Ichimura
- From the Departments of Neurosurgery and Neuro-Oncology (M.O., Y. Miyakita, M.T., Y. Matsushita, Y.N.) and Diagnostic Pathology (A.Y., K.S.), National Cancer Center Hospital; Divisions of Molecular Pharmacology (Y.H., A.H.) and Brain Tumor Translational Research (K.I.), National Cancer Center Research Institute; Division of Clinical Pharmacology and Translational Research, Exploratory Oncology Research and Clinical Trial Center (Y.H., H.A., M.H., A.H.), National Cancer Center; and Department of Medical Oncology and Translational Research (Y.H., A.H.), Graduate School of Medical Sciences, Kumamoto University, Tokyo, Japan
| | - Akinobu Hamada
- From the Departments of Neurosurgery and Neuro-Oncology (M.O., Y. Miyakita, M.T., Y. Matsushita, Y.N.) and Diagnostic Pathology (A.Y., K.S.), National Cancer Center Hospital; Divisions of Molecular Pharmacology (Y.H., A.H.) and Brain Tumor Translational Research (K.I.), National Cancer Center Research Institute; Division of Clinical Pharmacology and Translational Research, Exploratory Oncology Research and Clinical Trial Center (Y.H., H.A., M.H., A.H.), National Cancer Center; and Department of Medical Oncology and Translational Research (Y.H., A.H.), Graduate School of Medical Sciences, Kumamoto University, Tokyo, Japan
| | - Yoshitaka Narita
- From the Departments of Neurosurgery and Neuro-Oncology (M.O., Y. Miyakita, M.T., Y. Matsushita, Y.N.) and Diagnostic Pathology (A.Y., K.S.), National Cancer Center Hospital; Divisions of Molecular Pharmacology (Y.H., A.H.) and Brain Tumor Translational Research (K.I.), National Cancer Center Research Institute; Division of Clinical Pharmacology and Translational Research, Exploratory Oncology Research and Clinical Trial Center (Y.H., H.A., M.H., A.H.), National Cancer Center; and Department of Medical Oncology and Translational Research (Y.H., A.H.), Graduate School of Medical Sciences, Kumamoto University, Tokyo, Japan
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Development of a Rapid and Sensitive IDH1/2 Mutation Detection Method for Glial Tumors and a Comparative Mutation Analysis of 236 Glial Tumor Samples. Mol Diagn Ther 2021; 24:327-338. [PMID: 32274701 DOI: 10.1007/s40291-020-00461-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND The presence of mutations in the isocitrate dehydrogenase 1 and 2 genes (IDH1/2) in glioma tumors is correlated with good prognosis upon standard-of-care treatment. Therefore, information on whether the glioma tumor has IDH1/2 mutations could be used in the correct diagnosis and management of glial tumors. The two most common techniques used to detect IDH1/2 mutations, immunohistochemistry (IHC) and Sanger sequencing, are prone to missing these mutations, especially if the tumor cells that carry the mutations constitute a small minority of the tumor itself. OBJECTIVES We developed and validated a rapid method (3-mismatch-amplification refractory mutation system [3m-ARMS]) that can be used for pre-, intra- and postoperative detection of the most common IDH1/2 mutations in glial tumors with high specificity and sensitivity. We also conducted a comprehensive IDH1/2 mutation analysis in 236 glial tumor samples comparing 3m-ARMS, IHC and Sanger sequencing. METHODS 3m-ARMS was optimized and validated for the specific and sensitive detection of the most common IDH1 and IDH2 mutations. We then analyzed 236 glial tumor samples for the presence of IDH1/2 mutations using 3m-ARMS, Sanger sequencing and IHC techniques. We then analyzed and compared the results, evaluating the diagnostic and screening potential of 3m-ARMS. RESULTS Comparison of the three techniques used in the mutation analysis showed that 3m-ARMS-based IDH1/2 mutation detection was superior to IHC and Sanger sequencing-based IDH1/2 mutation detection in terms of accuracy, specificity and sensitivity, especially for tumor samples in which only a small minority of the cell population carried the mutation. 3m-ARMS could detect the presence of femtogram levels of IDH1/2 mutant DNA in DNA samples in which the mutant DNA-to-wild-type DNA ratio was as low as 1:100,000. CONCLUSION Sanger sequencing and IHC-based methods have shortcomings when detecting mutations in glial tumors so can miss IDH1/2 mutations in glial tumors when used alone without proper modifications. 3m-ARMS-based mutation detection is fast and simple with potential for use as a diagnostic test for the majority of hot spot mutations in IDH1/2 genes. It can detect IDH1/2 mutations within an hour so can be adapted for intraoperative diagnosis.
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20
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Satomi K, Ohno M, Matsushita Y, Takahashi M, Miyakita Y, Narita Y, Ichimura K, Yoshida A. Utility of methylthioadenosine phosphorylase immunohistochemical deficiency as a surrogate for CDKN2A homozygous deletion in the assessment of adult-type infiltrating astrocytoma. Mod Pathol 2021; 34:688-700. [PMID: 33077924 DOI: 10.1038/s41379-020-00701-w] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 09/25/2020] [Accepted: 09/27/2020] [Indexed: 01/01/2023]
Abstract
Homozygous deletion (HD) of CDKN2A is one of the most promising biomarkers for predicting poor prognosis of IDH-mutant diffuse gliomas. The Consortium to Inform Molecular and Practical Approaches to CNS Tumor Taxonomy (cIMPACT-NOW) recommendations propose that IDH-mutant lower-grade astrocytomas with CDKN2A/B HD be classified as grade IV tumors. Loss of methylthioadenosine phosphorylase (MTAP) immunohistochemistry staining has been proposed as a surrogate of CDKN2A HD in various tumors but its performance has not been fully investigated in diffuse glioma. This study determined whether MTAP immunoreactivity could serve as a proxy for CDKN2A HD in adult-type diffuse glioma, thereby contributing to stratifying patient outcome. MTAP immunohistochemistry staining using clone EPR6893 was scored in 178 diffuse glioma specimens consisting of 77 IDH-mutant astrocytomas, 13 IDH-mutant oligodendrogliomas, and 88 IDH-wildtype glioblastomas. The use of MTAP immunohistochemical deficiency to predict CDKN2A HD was good for IDH-mutant astrocytomas (sensitivity, 88%; specificity, 98%) and IDH-wildtype glioblastomas (sensitivity, 89%; specificity, 100%), but poor for IDH-mutant oligodendrogliomas (sensitivity, 67%; specificity, 57%). Both CDKN2A HD and MTAP immunohistochemical deficiency were significant adverse prognostic factors of overall survival for IDH-mutant astrocytoma (P < 0.001 each), but neither were prognostically significant for oligodendroglioma or IDH-wildtype glioblastoma. IDH-mutant lower-grade astrocytoma with CDKN2A HD and deficient MTAP immunoreactivity exhibited overlapping unfavorable outcome with IDH-mutant glioblastoma. MTAP immunostaining was easily interpreted in 61% of the cases tested, but scoring required greater care in the remaining cases. An alternative MTAP antibody clone (2G4) produced identical scoring results in all but 1 case, and a slightly larger proportion (66%) of cases were considered easy to interpret compared to using EPR6893. In summary, loss of MTAP immunoreactivity could serve as a reasonable predictive surrogate for CDKN2A HD in IDH-mutant astrocytomas and IDH-wildtype glioblastomas and could provide significant prognostic value for IDH-mutant astrocytoma, comparable to CDKN2A HD.
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Affiliation(s)
- Kaishi Satomi
- Department of Diagnostic Pathology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.
| | - Makoto Ohno
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Yuko Matsushita
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Masamichi Takahashi
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Yasuji Miyakita
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Yoshitaka Narita
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.,Rare Cancer Center, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Koichi Ichimura
- Rare Cancer Center, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.,Division of Brain Tumor Translational Research, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Akihiko Yoshida
- Department of Diagnostic Pathology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan. .,Rare Cancer Center, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.
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21
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Hartanto RA, Dwianingsih EK, Panggabean AS, Wicaksono AS, Dananjoyo K, Asmedi A, Malueka RG. Seizure in Indonesian Glioma Patients: Associated Risk Factors and Impact on Survival. Asian Pac J Cancer Prev 2021; 22:691-697. [PMID: 33773530 PMCID: PMC8286685 DOI: 10.31557/apjcp.2021.22.3.691] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Indexed: 12/26/2022] Open
Abstract
Objective: Seizure is commonly found in patients with glioma. This study aimed to find risk factors for seizures in Indonesian patients with glioma. We also sought to determine the association between seizure and survival in this patient population. Methods: Patients with glioma were enrolled from the Dr. Sardjito General Hospital and other hospitals in Yogyakarta Province, Indonesia. Detailed demographic and clinical data were collected from medical records. DNA extraction and polymerase chain reaction (PCR) were performed to detect IDH1 mutation. Tumor tissue samples were stained by hematoxylin-eosin and classified according to the 2016 World Health Organization (WHO) classification of central nervous system (CNS) tumors. Expression of Ki-67 was detected by immunohistochemistry staining. Survival data were also collected. Results: In total, 107 patients were included in the analysis. Age, gender, history of smoking, tumor side, tumor grade, Ki-67 expression, and IDH1 mutation were not associated with seizure. Tumors involving the frontal lobe (p=0.037) and oligodendroglioma histology (p=0.031) were associated with the development of seizures in this study. However, multivariate analysis showed that only oligodendrogial histology was associated with seizure [p=0.032, odds ratio (OR) = 4.77, 95% confidence interval (CI) = 1.146-19.822]. Patients with seizures have significantly longer median overall survival than patients without seizures (69.3±25.01 vs. 10.6±6.14 months, respectively, p=0.04). Conclusion: This study showed that seizure in patients with glioma in Indonesia is associated with frontal lobe location and oligodendroglioma histology. Patients with seizures also have significantly longer overall survival.
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Affiliation(s)
- Rahmat Andi Hartanto
- Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Ery Kus Dwianingsih
- Department of Anatomical Pathology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Andre Stefanus Panggabean
- Neurology Department, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Dr Sardjito General Hospital, Yogyakarta, Indonesia
| | - Adiguno Suryo Wicaksono
- Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Kusumo Dananjoyo
- Neurology Department, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Dr Sardjito General Hospital, Yogyakarta, Indonesia
| | - Ahmad Asmedi
- Neurology Department, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Dr Sardjito General Hospital, Yogyakarta, Indonesia
| | - Rusdy Ghazali Malueka
- Neurology Department, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Dr Sardjito General Hospital, Yogyakarta, Indonesia
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22
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Arita H, Matsushita Y, Machida R, Yamasaki K, Hata N, Ohno M, Yamaguchi S, Sasayama T, Tanaka S, Higuchi F, Iuchi T, Saito K, Kanamori M, Matsuda KI, Miyake Y, Tamura K, Tamai S, Nakamura T, Uda T, Okita Y, Fukai J, Sakamoto D, Hattori Y, Pareira ES, Hatae R, Ishi Y, Miyakita Y, Tanaka K, Takayanagi S, Otani R, Sakaida T, Kobayashi K, Saito R, Kurozumi K, Shofuda T, Nonaka M, Suzuki H, Shibuya M, Komori T, Sasaki H, Mizoguchi M, Kishima H, Nakada M, Sonoda Y, Tominaga T, Nagane M, Nishikawa R, Kanemura Y, Kuchiba A, Narita Y, Ichimura K. TERT promoter mutation confers favorable prognosis regardless of 1p/19q status in adult diffuse gliomas with IDH1/2 mutations. Acta Neuropathol Commun 2020; 8:201. [PMID: 33228806 PMCID: PMC7685625 DOI: 10.1186/s40478-020-01078-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Accepted: 11/11/2020] [Indexed: 11/17/2022] Open
Abstract
TERT promoter mutations are commonly associated with 1p/19q codeletion in IDH-mutated gliomas. However, whether these mutations have an impact on patient survival independent of 1p/19q codeletion is unknown. In this study, we investigated the impact of TERT promoter mutations on survival in IDH-mutated glioma cases. Detailed clinical information and molecular status data were collected for a cohort of 560 adult patients with IDH-mutated gliomas. Among these patients, 279 had both TERT promoter mutation and 1p/19q codeletion, while 30 had either TERT promoter mutation (n = 24) or 1p/19q codeletion (n = 6) alone. A univariable Cox proportional hazard analysis for survival using clinical and genetic factors indicated that a Karnofsky performance status score (KPS) of 90 or 100, WHO grade II or III, TERT promoter mutation, 1p/19q codeletion, radiation therapy, and extent of resection (90-100%) were associated with favorable prognosis (p < 0.05). A multivariable Cox regression model revealed that TERT promoter mutation had a significantly favorable prognostic impact (hazard ratio = 0.421, p = 0.049), while 1p/19q codeletion did not have a significant impact (hazard ratio = 0.648, p = 0.349). Analyses incorporating patient clinical and genetic information were further conducted to identify subgroups showing the favorable prognostic impact of TERT promoter mutation. Among the grade II-III glioma patients with a KPS score of 90 or 100, those with IDH-TERT co-mutation and intact 1p/19q (n = 17) showed significantly longer survival than those with IDH mutation, wild-type TERT, and intact 1p/19q (n = 185) (5-year overall survival, 94% and 77%, respectively; p = 0.032). Our results demonstrate that TERT promoter mutation predicts favorable prognosis independent of 1p/19q codeletion in IDH-mutated gliomas. Combined with its adverse effect on survival among IDH-wild glioma cases, the bivalent prognostic impact of TERT promoter mutation may help further refine the molecular diagnosis and prognostication of diffuse gliomas.
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Affiliation(s)
- Hideyuki Arita
- Division of Brain Tumor Translational Research, National Cancer Center Research Institute, 5-1-1, Tsukiji, Chuo-ku, Tokyo 104-0045 Japan
- Department of Neurosurgery, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita-City, Osaka 565-0871 Japan
| | - Yuko Matsushita
- Division of Brain Tumor Translational Research, National Cancer Center Research Institute, 5-1-1, Tsukiji, Chuo-ku, Tokyo 104-0045 Japan
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo 104-0045 Japan
| | - Ryunosuke Machida
- Biostatistics Division, Center for Research Administration and Support, National Cancer Center, 5-1-1, Tsukiji, Chuo-ku, Tokyo 104-0045 Japan
| | - Kai Yamasaki
- Division of Brain Tumor Translational Research, National Cancer Center Research Institute, 5-1-1, Tsukiji, Chuo-ku, Tokyo 104-0045 Japan
- Department of Pediatric Hematology and Oncology, Osaka City General Hospital, 2-13-22, Miyakojima-hondori, Miyakojima-ku, Osaka-City, Osaka 534-0021 Japan
| | - Nobuhiro Hata
- Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka-City, Fukuoka 812-8582 Japan
| | - Makoto Ohno
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo 104-0045 Japan
| | - Shigeru Yamaguchi
- Department of Neurosurgery, Faculty of Medicine, Hokkaido University, North 15 West 7, Kita-ku, Sapporo-City, Hokkaido 060-8638 Japan
| | - Takashi Sasayama
- Department of Neurosurgery, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe-City, Hyogo 650-0017 Japan
| | - Shota Tanaka
- Department of Neurosurgery, Faculty of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-8655 Japan
| | - Fumi Higuchi
- Department of Neurosurgery, Dokkyo Medical University, 880, Kitakobayashi, Mibu-City, Tochigi 321-0293 Japan
| | - Toshihiko Iuchi
- Division of Neurological Surgery, Chiba Cancer Center, 666-2 Nitonacho, Chuo-ku, Chiba-City, Chiba 260-8717 Japan
| | - Kuniaki Saito
- Department of Neurosurgery, Kyorin University Faculty of Medicine, 6-20-2, Shinkawa, Mitaka-City, Tokyo 181-8611 Japan
| | - Masayuki Kanamori
- Department of Neurosurgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai-City, Miyagi 980-8574 Japan
| | - Ken-ichiro Matsuda
- Department of Neurosurgery, Faculty of Medicine, Yamagata University, 2-2, Iida-Nishi, Yamagata-City, Yamagata 990-9585 Japan
| | - Yohei Miyake
- Department of Neuro-Oncology/Neurosurgery, Saitama Medical University International Medical Center, 1397-1, Yamane, Hidaka-City, Saitama 350-1298 Japan
- Department of Neurosurgery, Graduate School of Medicine, Yokohama City University, 3-9, Fukuura, Kanazawa-ku, Yokohama-City, Kanagawa 236-0004 Japan
| | - Kaoru Tamura
- Department of Neurosurgery, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8519 Japan
| | - Sho Tamai
- Department of Neurosurgery, Graduate School of Medical Science, Kanazawa University, 13-1, Takara-machi, Kanazawa-City, Ishikawa 920-8641 Japan
| | - Taishi Nakamura
- Department of Neurosurgery, Graduate School of Medicine, Yokohama City University, 3-9, Fukuura, Kanazawa-ku, Yokohama-City, Kanagawa 236-0004 Japan
| | - Takehiro Uda
- Department of Neurosurgery, Osaka City University Graduate School of Medicine, 1-5-7, Asahi-machi, Abeno-ku, Osaka-City, Osaka 545-8586 Japan
| | - Yoshiko Okita
- Department of Neurosurgery, National Hospital Organization Osaka National Hospital, 2-1-14 Hoenzaka, Chuo-ku, Osaka-City, Osaka 540-0006 Japan
- Department of Neurosurgery, Osaka International Cancer Institute, 3-1-69, Otemae, Chuo-ku, Osaka-City, Osaka 541-8567 Japan
| | - Junya Fukai
- Department of Neurological Surgery, Wakayama Medical University, 811-1, Kimiidera, Wakayama-City, Wakayama 641-0012 Japan
| | - Daisuke Sakamoto
- Department of Neurosurgery, Hyogo College of Medicine, 1-1 Mukogawa, Nishinomiya-City, Hyogo 663-8501 Japan
| | - Yasuhiko Hattori
- Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama-City, Okayama 700-8558 Japan
| | - Eriel Sandika Pareira
- Department of Neurosurgery, Keio University School of Medicine, 35, Shinano-machi, Tokyo, Shinjuku-ku 160-8582 Japan
| | - Ryusuke Hatae
- Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka-City, Fukuoka 812-8582 Japan
| | - Yukitomo Ishi
- Department of Neurosurgery, Faculty of Medicine, Hokkaido University, North 15 West 7, Kita-ku, Sapporo-City, Hokkaido 060-8638 Japan
| | - Yasuji Miyakita
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo 104-0045 Japan
| | - Kazuhiro Tanaka
- Department of Neurosurgery, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe-City, Hyogo 650-0017 Japan
| | - Shunsaku Takayanagi
- Department of Neurosurgery, Faculty of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-8655 Japan
| | - Ryohei Otani
- Department of Neurosurgery, Dokkyo Medical University, 880, Kitakobayashi, Mibu-City, Tochigi 321-0293 Japan
- Department of Neurosurgery, Tokyo Metropolitan Komagome Hospital, 3-18-22, Honkomagome, Bunkyo-ku, Tokyo 113-8677 Japan
| | - Tsukasa Sakaida
- Division of Neurological Surgery, Chiba Cancer Center, 666-2 Nitonacho, Chuo-ku, Chiba-City, Chiba 260-8717 Japan
| | - Keiichi Kobayashi
- Department of Neurosurgery, Kyorin University Faculty of Medicine, 6-20-2, Shinkawa, Mitaka-City, Tokyo 181-8611 Japan
| | - Ryuta Saito
- Department of Neurosurgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai-City, Miyagi 980-8574 Japan
| | - Kazuhiko Kurozumi
- Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama-City, Okayama 700-8558 Japan
| | - Tomoko Shofuda
- Department of Biomedical Research and Innovation Research, Institute for Clinical Research, National Hospital Organization Osaka National Hospital, 2-1-14, Hoenzaka, Chuo-ku, Osaka-City, Osaka 540-0006 Japan
| | - Masahiro Nonaka
- Department of Neurosurgery, National Hospital Organization Osaka National Hospital, 2-1-14 Hoenzaka, Chuo-ku, Osaka-City, Osaka 540-0006 Japan
- Department of Neurosurgery, Kansai Medical University, 3-1, Shinmachi 2 Chome, Hirakata-City, Osaka 573-1191 Japan
| | - Hiroyoshi Suzuki
- Department of Pathology and Laboratory Medicine, National Hospital Organization, Sendai Medical Center, 2-11-12, Miyagino, Miyagino-ku, Sendai-City, Miyagi 983-8520 Japan
| | - Makoto Shibuya
- Central Clinical Laboratory, Hachioji Medical Center, Tokyo Medical University, 1163, Tatemachi, Hachioji-City, Tokyo 193-0998 Japan
| | - Takashi Komori
- Department of Laboratory Medicine and Pathology (Neuropathology), Tokyo Metropolitan Neurological Hospital, 2-6-1 Musashidai, Fuchu, Tokyo 183-0042 Japan
| | - Hikaru Sasaki
- Department of Neurosurgery, Keio University School of Medicine, 35, Shinano-machi, Tokyo, Shinjuku-ku 160-8582 Japan
| | - Masahiro Mizoguchi
- Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka-City, Fukuoka 812-8582 Japan
| | - Haruhiko Kishima
- Department of Neurosurgery, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita-City, Osaka 565-0871 Japan
| | - Mitsutoshi Nakada
- Department of Neurosurgery, Graduate School of Medical Science, Kanazawa University, 13-1, Takara-machi, Kanazawa-City, Ishikawa 920-8641 Japan
| | - Yukihiko Sonoda
- Department of Neurosurgery, Faculty of Medicine, Yamagata University, 2-2, Iida-Nishi, Yamagata-City, Yamagata 990-9585 Japan
| | - Teiji Tominaga
- Department of Neurosurgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai-City, Miyagi 980-8574 Japan
| | - Motoo Nagane
- Department of Neurosurgery, Kyorin University Faculty of Medicine, 6-20-2, Shinkawa, Mitaka-City, Tokyo 181-8611 Japan
| | - Ryo Nishikawa
- Department of Neuro-Oncology/Neurosurgery, Saitama Medical University International Medical Center, 1397-1, Yamane, Hidaka-City, Saitama 350-1298 Japan
| | - Yonehiro Kanemura
- Department of Neurosurgery, National Hospital Organization Osaka National Hospital, 2-1-14 Hoenzaka, Chuo-ku, Osaka-City, Osaka 540-0006 Japan
- Department of Biomedical Research and Innovation Research, Institute for Clinical Research, National Hospital Organization Osaka National Hospital, 2-1-14, Hoenzaka, Chuo-ku, Osaka-City, Osaka 540-0006 Japan
| | - Aya Kuchiba
- Biostatistics Division, Center for Research Administration and Support, National Cancer Center, 5-1-1, Tsukiji, Chuo-ku, Tokyo 104-0045 Japan
| | - Yoshitaka Narita
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo 104-0045 Japan
| | - Koichi Ichimura
- Division of Brain Tumor Translational Research, National Cancer Center Research Institute, 5-1-1, Tsukiji, Chuo-ku, Tokyo 104-0045 Japan
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23
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Malueka RG, Theresia E, Fitria F, Argo IW, Donurizki AD, Shaleh S, Innayah MR, Wicaksono AS, Dananjoyo K, Asmedi A, Hartanto RA, Dwianingsih EK. Comparison of Polymerase Chain Reaction-Restriction Fragment Length Polymorphism, Immunohistochemistry, and DNA Sequencing for the Detection of IDH1 Mutations in Gliomas. Asian Pac J Cancer Prev 2020; 21:3229-3234. [PMID: 33247679 PMCID: PMC8033136 DOI: 10.31557/apjcp.2020.21.11.3229] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND IDH1 mutation shows diagnostic, prognostic, and predictive value in gliomas. Direct Sanger sequencing is considered the gold standard to detect IDH1 mutation. However, this technology is not available in most neuropathological centers in developing countries such as Indonesia. Immunohistochemistry (IHC) and polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) have also been used to detect IDH1 mutation. This study aimed to compare DNA sequencing, IHC, and PCR-RFLP in detecting IDH1 mutations in gliomas. METHODS Research subjects were recruited from Dr. Sardjito Hospital. Genomic DNA was extracted from fresh or formalin-fixed paraffin-embedded samples of tumor tissue. DNA sequencing, PCR-RFLP and IHC were performed to detect IDH1 mutation. Sensitivity, specificity, and accuracy of PCR-RFLP and IHC were calculated by comparing them to DNA sequencing as the gold standard. RESULTS Among 61 recruited patients, 13 (21.3%) of them carried a mutation in codon 132 of the IDH1 gene, as shown by DNA sequencing. PCR-RFLP and DNA sequencing have a concordance value of 100%. Meanwhile, the concordance value between IDH1 R132H IHC and DNA sequencing was 96.7%. The sensitivity, specificity, positive predictive values, negative predictive values, and accuracy for PCR-RFLP were all 100%. On the other hand, the sensitivity, specificity, and accuracy of IHC were 92.3%, 97.9%, and 96.7%, respectively. CONCLUSION This study showed that both PCR-RFLP and IHC have high accuracy in detecting IDH1 mutation. We recommend a combination of PCR-RFLP and IHC to detect IDH1 mutation in resource-limited settings.<br />.
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Affiliation(s)
- Rusdy Ghazali Malueka
- Department of Neurology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Emilia Theresia
- Department of Anatomical Pathology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Fitria Fitria
- Department of Anatomical Pathology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Ibnu Widya Argo
- Department of Neurology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Aditya Dwi Donurizki
- Department of Neurology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Sabillal Shaleh
- Department of Neurology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Meutia Rizki Innayah
- Department of Neurology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Adiguno Suryo Wicaksono
- Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Kusumo Dananjoyo
- Department of Neurology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Ahmad Asmedi
- Department of Neurology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Rachmat Andi Hartanto
- Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Ery Kus Dwianingsih
- Department of Anatomical Pathology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Dr. Sardjito General Hospital, Yogyakarta, Indonesia
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Malueka RG, Dwianingsih EK, Bayuangga HF, Panggabean AS, Argo IW, Donurizki AD, Shaleh S, Wicaksono AS, Dananjoyo K, Asmedi A, Hartanto RA. Clinicopathological Features and Prognosis of Indonesian Patients with Gliomas with IDH Mutation: Insights into Its Significance in a Southeast Asian Population. Asian Pac J Cancer Prev 2020; 21:2287-2295. [PMID: 32856857 PMCID: PMC7771930 DOI: 10.31557/apjcp.2020.21.8.2287] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Indexed: 12/28/2022] Open
Abstract
Background: Gliomas remain one of the most common primary brain tumors. Mutations in the isocitrate dehydrogenase (IDH) gene are associated with a distinct set of clinicopathological profiles. However, the distribution and significance of these mutations have never been studied in the Indonesian population. This study aimed to elucidate the association between IDH mutations and clinicopathological as well as prognostic profiles of Indonesian patients with gliomas. Methods: In total, 106 patients with gliomas were recruited from a tertiary academic medical center in Yogyakarta, Indonesia. Formalin-fixed paraffin-embedded and fresh tissue specimens were obtained and sectioned for hematoxylin-eosin staining and immunohistochemical examinations. Genomic DNA was isolated and analyzed for the presence of IDH mutations using standard polymerase chain reaction and nucleotide sequencing methods. Clinicopathological data were collected from medical records. Results: Although no IDH2 mutation was identified, IDH1 mutations were found in 23 (21.7%) of the patients. Patients with IDH1 mutations tended to have a history of smoking and a shorter interval between onset of symptoms and initial surgical interventions. Frontal lobe involvement, oligodendroglial histology, lower Ki67 expression, WHO grades II and III gliomas, and methylated O6-methylguanine-DNA methyltransferase (MGMT) promoters were significantly associated with the presence of IDH1 mutations. Compared with patients with IDH1-wild-type, patients with IDH1 mutation were observed to have a longer overall survival. Conclusions: IDH1 mutations are associated with certain clinicopathological and prognostic profiles in Indonesian patients with gliomas. This finding demonstrates the importance of identifying IDH mutations as part of the management of patients with glioma in Indonesia.
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Affiliation(s)
- Rusdy Ghazali Malueka
- Department of Neurology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Ery Kus Dwianingsih
- Department of Anatomical Pathology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Halwan Fuad Bayuangga
- Department of Neurology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Andre Stefanus Panggabean
- Department of Neurology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Ibnu Widya Argo
- Department of Neurology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Aditya Dwi Donurizki
- Department of Neurology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Sabillal Shaleh
- Department of Neurology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Adiguno Suryo Wicaksono
- Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Kusumo Dananjoyo
- Department of Neurology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Ahmad Asmedi
- Department of Neurology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Rachmat Andi Hartanto
- Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Dr. Sardjito General Hospital, Yogyakarta, Indonesia
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25
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Cantero D, Mollejo M, Sepúlveda JM, D'Haene N, Gutiérrez-Guamán MJ, Rodríguez de Lope Á, Fiaño C, Castresana JS, Lebrun L, Rey JA, Salmon I, Meléndez B, Hernández-Laín A. TP53, ATRX alterations, and low tumor mutation load feature IDH-wildtype giant cell glioblastoma despite exceptional ultra-mutated tumors. Neurooncol Adv 2020; 2:vdz059. [PMID: 32642724 PMCID: PMC7212869 DOI: 10.1093/noajnl/vdz059] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Background Giant cell glioblastoma (gcGBM) is a rare morphological variant of IDH-wildtype (IDHwt) GBM that occurs in young adults and have a slightly better prognosis than "classic" IDHwt GBM. Methods We studied 36 GBMs, 14 with a histopathological diagnosis of gcGBM and 22 with a giant cell component. We analyzed the genetic profile of the most frequently mutated genes in gliomas and assessed the tumor mutation load (TML) by gene-targeted next-generation sequencing. We validated our findings using The Cancer Genome Atlas (TCGA) data. Results p53 was altered by gene mutation or protein overexpression in all cases, while driver IDH1, IDH2, BRAF, or H3F3A mutations were infrequent or absent. Compared to IDHwt GBMs, gcGBMs had a significant higher frequency of TP53, ATRX, RB1, and NF1 mutations, while lower frequency of EGFR amplification, CDKN2A deletion, and TERT promoter mutation. Almost all tumors had low TML values. The high TML observed in only 2 tumors was consistent with POLE and MSH2 mutations. In the histopathological review of TCGA IDHwt, TP53-mutant tumors identified giant cells in 37% of the cases. Considering our series and that of the TCGA, patients with TP53-mutant gcGBMs had better overall survival than those with TP53wt GBMs (log-rank test, P < .002). Conclusions gcGBMs have molecular features that contrast to "classic" IDHwt GBMs: unusually frequent ATRX mutations and few EGFR amplifications and CDKN2A deletions, especially in tumors with a high number of giant cells. TML is frequently low, although exceptional high TML suggests a potential for immune checkpoint therapy in some cases, which may be relevant for personalized medicine.
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Affiliation(s)
- Diana Cantero
- Department of Pathology (Neuropathology) and Instituto de Investigación i+12, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Manuela Mollejo
- Department of Pathology, Virgen de la Salud Hospital, Toledo, Spain
| | - Juan M Sepúlveda
- Department of Medical Oncology, University Hospital 12 de Octubre, Madrid, Spain
| | - Nicky D'Haene
- Department of Pathology, Erasme Hospital, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Myriam J Gutiérrez-Guamán
- Department of Pathology (Neuropathology) and Instituto de Investigación i+12, Hospital Universitario 12 de Octubre, Madrid, Spain
| | | | | | - Javier S Castresana
- Department of Biochemistry and Genetics, University of Navarra School of Sciences, Pamplona, Spain
| | - Laetitia Lebrun
- Department of Pathology, Erasme Hospital, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Juan A Rey
- IdiPaz Research Unit, La Paz University Hospital, Madrid, Spain
| | - Isabelle Salmon
- Department of Pathology, Erasme Hospital, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Bárbara Meléndez
- Department of Pathology, Virgen de la Salud Hospital, Toledo, Spain.,Department of Pathology, Erasme Hospital, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Aurelio Hernández-Laín
- Department of Pathology (Neuropathology) and Instituto de Investigación i+12, Hospital Universitario 12 de Octubre, Madrid, Spain
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26
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Classe M, Yao H, Mouawad R, Creighton CJ, Burgess A, Allanic F, Wassef M, Leroy X, Verillaud B, Mortuaire G, Bielle F, Le Tourneau C, Kurtz JE, Khayat D, Su X, Malouf GG. Integrated Multi-omic Analysis of Esthesioneuroblastomas Identifies Two Subgroups Linked to Cell Ontogeny. Cell Rep 2019; 25:811-821.e5. [PMID: 30332658 DOI: 10.1016/j.celrep.2018.09.047] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 07/18/2018] [Accepted: 09/12/2018] [Indexed: 12/23/2022] Open
Abstract
Esthesioneuroblastoma (ENB) is a rare cancer of the olfactory mucosa, with no established molecular stratification to date. We report similarities of ENB with tumors arising in the neural crest and perform integrative analysis of these tumors. We propose a molecular-based subtype classification of ENB as basal or neural, both of which have distinct pathological, transcriptomic, proteomic, and immune features. Among the basal subtype, we uncovered an IDH2 R172 mutant-enriched subgroup (∼35%) harboring a CpG island methylator phenotype reminiscent of IDH2 mutant gliomas. Compared with the basal ENB methylome, the neural ENB methylome shows genome-wide reprogramming with loss of DNA methylation at the enhancers of axonal guidance genes. Our study reveals insights into the molecular pathogenesis of ENB and provides classification information of potential therapeutic relevance.
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Affiliation(s)
- Marion Classe
- Department of Medical Oncology, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique Hôpitaux de Paris, Sorbonnes-Universités, University Pierre and Marie Curie, Paris, France.
| | - Hui Yao
- Department of Bioinformatics and Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Roger Mouawad
- Department of Medical Oncology, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique Hôpitaux de Paris, Sorbonnes-Universités, University Pierre and Marie Curie, Paris, France
| | - Chad J Creighton
- Department of Bioinformatics and Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; Division of Biostatistics, Department of Medicine and Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX 77030, USA
| | - Alice Burgess
- Department of Otolaryngology-Head and Neck Surgery, Lariboisière Hospital, Assistance Publique Hôpitaux de Paris, Université Paris-Diderot Paris VII, Paris, France
| | - Frederick Allanic
- Department of Medical Oncology, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique Hôpitaux de Paris, Sorbonnes-Universités, University Pierre and Marie Curie, Paris, France
| | - Michel Wassef
- Department of Pathology, Lariboisière, Assistance Publique-Hôpitaux de Paris, Université Paris-Diderot Paris VII, Paris, France
| | - Xavier Leroy
- Department of Pathology, CHRU de Lille, Université Lille 2, Lille, France
| | - Benjamin Verillaud
- Department of Otolaryngology-Head and Neck Surgery, Lariboisière Hospital, Assistance Publique Hôpitaux de Paris, Université Paris-Diderot Paris VII, Paris, France
| | - Geoffrey Mortuaire
- Department of Otolaryngology-Head and Neck Surgery, CHRU de Lille, Université Lille 2, Lille, France
| | - Franck Bielle
- Department of Neuropathology Raymond Escourolle, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, 75013, France
| | - Christophe Le Tourneau
- Department of Drug Development and Innovation, Institut Curie, Saint-Cloud, France; INSERM U900 Research Unit, Saint-Cloud, France; Versailles-Saint-Quentin-en-Yvelines University, Montigny-le-Bretonneux, France
| | - Jean-Emmanuel Kurtz
- Department of Hematology and Medical Oncology, CHRU Strasbourg, Hôpital Hautepierre, Strasbourg, France
| | - David Khayat
- Department of Medical Oncology, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique Hôpitaux de Paris, Sorbonnes-Universités, University Pierre and Marie Curie, Paris, France
| | - Xiaoping Su
- Department of Bioinformatics and Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Gabriel G Malouf
- Department of Medical Oncology, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique Hôpitaux de Paris, Sorbonnes-Universités, University Pierre and Marie Curie, Paris, France; Department of Hematology and Medical Oncology, CHRU Strasbourg, Hôpital Hautepierre, Strasbourg, France; Institut Génomique et de Biologie Moléculaire et Cellulaire (IGBMC), Illkirch-Graffenstaden, France.
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27
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Ohno M, Miyakita Y, Takahashi M, Igaki H, Matsushita Y, Ichimura K, Narita Y. Survival benefits of hypofractionated radiotherapy combined with temozolomide or temozolomide plus bevacizumab in elderly patients with glioblastoma aged ≥ 75 years. Radiat Oncol 2019; 14:200. [PMID: 31718669 PMCID: PMC6852964 DOI: 10.1186/s13014-019-1389-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 10/02/2019] [Indexed: 11/29/2022] Open
Abstract
Background and purpose The purpose of this study was to evaluate the outcomes of elderly patients (aged ≥75 years) with newly diagnosed glioblastoma (GBM), who were treated with hypofractionated radiotherapy comprising 45 Gy in 15 fractions combined with temozolomide (TMZ) or TMZ and bevacizumab (TMZ/Bev). Materials and methods Between October 2007 and August 2018, 30 patients with GBM aged ≥75 years were treated with hypofractionated radiotherapy consisting of 45 Gy in 15 fractions. Twenty patients received TMZ and 10 received TMZ/Bev as upfront chemotherapy. O-6-methylguanine DNA methyltransferase (MGMT) promoter methylation status was analyzed by pyrosequencing. The cutoff value of the mean level of methylation at the 16 CpG sites was 16%. Results Median overall survival (OS) and progression-free survival (PFS) were 12.9 months and 9.9 months, respectively. The 1-year OS and PFS rates were 64.7 and 34.7%, respectively. Median OS and PFS did not differ significantly between patients with MGMT promoter hypermethylation (N = 11) and those with hypomethylation (N = 16) (17.4 vs. 11.8 months, p = 0.32; and 13.1 vs. 7.3 months, p = 0.11, respectively). The median OS and PFS were not significantly different between TMZ (N = 20) and TMZ/Bev (N = 10) chemotherapy (median OS: TMZ 12.9 months vs. TMZ/Bev 14.6 months, p = 0.93, median PFS: TMZ 8.5 months vs TMZ/Bev 10.0 months, p = 0.64, respectively). The median time until Karnofsky performance status (KPS) score decreasing below 60 points was 7.9 months. The best radiological responses included 11 patients with a partial response (36.7%). Grade 3/4 toxicities included leukopenia in 15 patients (50%), anorexia in 4 (13.3%), and hyponatremia during concomitant chemotherapy in 3 (10%). Conclusion Our hypofractionated radiotherapy regimen combined with TMZ or TMZ/Bev showed benefits in terms of OS, PFS, and KPS maintenance with acceptable toxicities in elderly patients with GBM aged ≥75 years.
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Affiliation(s)
- Makoto Ohno
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Yasuji Miyakita
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Masamichi Takahashi
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Hiroshi Igaki
- Department of Radiation Oncology, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Yuko Matsushita
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Koichi Ichimura
- Division of Brain Tumor Translational Research, National Cancer Center Research Institute, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Yoshitaka Narita
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.
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28
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Cantero D, Rodríguez de Lope Á, Moreno de la Presa R, Sepúlveda JM, Borrás JM, Castresana JS, D'Haene N, García JF, Salmon I, Mollejo M, Rey JA, Hernández-Laín A, Meléndez B. Molecular Study of Long-Term Survivors of Glioblastoma by Gene-Targeted Next-Generation Sequencing. J Neuropathol Exp Neurol 2019; 77:710-716. [PMID: 30010995 DOI: 10.1093/jnen/nly048] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Glioblastoma (GBM) is the most common malignant adult primary brain tumor. Despite its high lethality, a small proportion of patients have a relatively long overall survival (OS). Here we report a study of a series of 74 GBM samples from 29 long-term survivors ([LTS] OS ≥36 months) and 45 non-LTS. Using next-generation sequencing, we analyzed genetic alterations in the genes most frequently altered in gliomas. Approximately 20% of LTS had a mutation in the IDH1 or IDH2 (IDH) genes, denoting the relevance of this molecular prognostic factor. A new molecular group of GBMs harbored alterations in ATRX or DAXX genes in the absence of driver IDH or H3F3A mutations. These patients tended to have a slightly better prognosis, to be younger at diagnosis, and to present frontal or temporal tumors, and, morphologically, to present giant tumor cells. A significant fraction of LTS GBM patients had tumors with 1 or more alterations in the relevant GBM signaling pathways (RTK/PI3K, TP53 and RB1). In these patients, the PDGFRA alteration is suggested to be a favorable molecular factor. Our findings here are relevant for developing future targeted therapies and for identifying molecular prognostic factors in GBM patients.
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Affiliation(s)
| | | | | | - Juan M Sepúlveda
- Department of Medical Oncology, 12 de Octubre University Hospital, Madrid, Spain
| | - José M Borrás
- Department of Neurosurgery, Ciudad Real University Hospital, Ciudad Real, Spain
| | - Javier S Castresana
- Department of Biochemistry and Genetics, University of Navarra School of Sciences, Pamplona, Spain
| | - Nicky D'Haene
- Department of Pathology, Erasme Hospital, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Juan F García
- Department of Pathology, MD Anderson Cancer Center, Madrid, Spain
| | - Isabelle Salmon
- Department of Pathology, Erasme Hospital, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Manuela Mollejo
- Department of Pathology, Virgen de la Salud Hospital, Toledo, Spain
| | - Juan A Rey
- IdiPaz Research Unit, La Paz University Hospital, Madrid, Spain
| | | | - Bárbara Meléndez
- Department of Pathology, Virgen de la Salud Hospital, Toledo, Spain
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29
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Guo XB, Zhang XC, Chen P, Ma LM, Shen ZQ. miR‑378a‑3p inhibits cellular proliferation and migration in glioblastoma multiforme by targeting tetraspanin 17. Oncol Rep 2019; 42:1957-1971. [PMID: 31432186 PMCID: PMC6775804 DOI: 10.3892/or.2019.7283] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Accepted: 08/01/2019] [Indexed: 12/16/2022] Open
Abstract
Glioblastoma multiforme (GBM) is the most common and aggressive brain tumor and patients with this disease tend to have poor clinical outcome. MicroRNAs (miRs) are important regulators of a number of key pathways implicated in tumor pathogenesis. Recently, the expression of miR‑378 was shown to be dysregulated in several different types of cancer, including gastric cancer, colorectal cancer and oral carcinoma. Additional studies have demonstrated that miR‑378 may serve as a potential therapeutic target against human breast cancer. However, the underlying mechanisms and potential targets of miR‑378a‑3p involved in GBM remain unknown. The aim of the present of was to determine the effects of miR‑378a‑3p and its potential targets. Tetraspanin 17 (TSPAN17) is involved in the neoplastic events in GBM and is a member of the tetraspanin family of proteins. The tetraspanins are involved in the regulation of cell growth, migration and invasion of several different types of cancer cell lines, and may potentially act as an oncogene associated with GBM pathology. The results of the present study showed that high miR‑378a‑3p and low TSPAN17 expression levels were associated with improved survival in patients with GBM. Additionally, high levels of TSPAN17 were linked to the poor prognosis of patients with GBM aged 50‑60, larger tumor sizes (≥5 cm) and an advanced World Health Organization stage. TSPAN17 was identified and confirmed as a direct target of miR‑378a‑3p using a luciferase reporter assay in human glioma cell lines. Overexpression of miR‑378a‑3p in either of U87MG or MT‑330 cells decreased the expression of TSPAN17, promoted apoptosis and decreased proliferation, migration and invasion. Overexpression of TSPAN17 attenuated the aforementioned effects induced by miR‑378a‑3p overexpression. The present study indicated that miR‑378a‑3p suppresses the progression of GBM by reducing TSPAN17 expression, and may thus serve as a potential therapeutic target for treating patients with GBM.
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Affiliation(s)
- Xiao-Bing Guo
- Department of Anatomy and Histology/Embryology, Faculty of Basic Medical Sciences, Kunming Medical University, Kunming, Yunnan 650500, P.R. China
| | - Xiao-Chao Zhang
- School of Pharmaceutical Sciences and Yunnan Key Laboratory of Pharmacology for Natural Products, Kunming Medical University, Kunming, Yunnan 650500, P.R. China
| | - Peng Chen
- School of Pharmaceutical Sciences and Yunnan Key Laboratory of Pharmacology for Natural Products, Kunming Medical University, Kunming, Yunnan 650500, P.R. China
| | - Li-Mei Ma
- Department of Anatomy and Histology/Embryology, Faculty of Basic Medical Sciences, Kunming Medical University, Kunming, Yunnan 650500, P.R. China
| | - Zhi-Qiang Shen
- School of Pharmaceutical Sciences and Yunnan Key Laboratory of Pharmacology for Natural Products, Kunming Medical University, Kunming, Yunnan 650500, P.R. China
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30
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Fukushima H, Nakano Y, Ishii N, Nozuchi N, Okuno T, Yamasaki K, Okada K, Fujisaki H, Kunihiro N, Matsusaka Y, Sakamoto H, Honda-Kitahara M, Ichimura K, Hara J, Inoue T. Histological and genetic analysis of anaplastic pleomorphic xanthoastrocytoma suspected of malignant progression over a 12-year clinical course. Pathol Int 2019; 69:608-613. [PMID: 31397529 DOI: 10.1111/pin.12840] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 07/07/2019] [Indexed: 12/19/2022]
Abstract
We report a case of anaplastic PXA for which histological study and molecular analysis were performed at the time of the first resection and two recurrences. A 15-year-old girl had a temporal lobe tumor that had been followed as a cystic lesion from three years of age without histopathological examination. The first and second surgical specimens exhibited typical histological features of PXA such as nuclear and cytoplasmic pleomorphism. In addition, microvascular proliferation was observed in the second surgical specimen. On the other hand, nuclear pleomorphism was unclear in the third surgical specimen and it was mainly composed of spindle cells. Palisading necrosis was observed. Mitotic figures and the Ki-67 proliferation index gradually increased. BRAF V600E and TERT promoter mutation were detected in the first, second, and third surgical specimens. In addition, PTEN mutation and CDNK2A deletion were detected in the third surgical specimen. Considering the histopathological and genetic changes over time, we concluded that our case of anaplastic PXA underwent malignant progression.
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Affiliation(s)
- Hiroko Fukushima
- Department of Pathology, Osaka City General Hospital, Osaka, Japan
| | - Yoshiko Nakano
- Division of Brain Tumor Translational Research, National Cancer Center Research Institute, Tokyo, Japan.,Department of Pediatric Hematology/Oncology, Osaka City General Hospital, Osaka, Japan
| | - Naomi Ishii
- Department of Pathology, Osaka City General Hospital, Osaka, Japan
| | - Nozomi Nozuchi
- Department of Pathology, Osaka City General Hospital, Osaka, Japan
| | - Takahiro Okuno
- Department of Pathology, Osaka City General Hospital, Osaka, Japan.,Department of Molecular Pathology, Osaka City University Medical School, Osaka, Japan
| | - Kai Yamasaki
- Department of Pediatric Hematology/Oncology, Osaka City General Hospital, Osaka, Japan
| | - Keiko Okada
- Department of Pediatric Hematology/Oncology, Osaka City General Hospital, Osaka, Japan
| | - Hiroyuki Fujisaki
- Department of Pediatric Hematology/Oncology, Osaka City General Hospital, Osaka, Japan
| | - Noritsugu Kunihiro
- Department of Pediatric Neurosurgery, Osaka City General Hospital, Osaka, Japan
| | - Yasuhiro Matsusaka
- Department of Pediatric Neurosurgery, Osaka City General Hospital, Osaka, Japan
| | - Hiroaki Sakamoto
- Department of Pediatric Neurosurgery, Osaka City General Hospital, Osaka, Japan
| | - Mai Honda-Kitahara
- Division of Brain Tumor Translational Research, National Cancer Center Research Institute, Tokyo, Japan
| | - Koichi Ichimura
- Division of Brain Tumor Translational Research, National Cancer Center Research Institute, Tokyo, Japan
| | - Junichi Hara
- Department of Pediatric Hematology/Oncology, Osaka City General Hospital, Osaka, Japan
| | - Takeshi Inoue
- Department of Pathology, Osaka City General Hospital, Osaka, Japan
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31
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Kaundun SS, Marchegiani E, Hutchings SJ, Baker K. Derived Polymorphic Amplified Cleaved Sequence (dPACS): A Novel PCR-RFLP Procedure for Detecting Known Single Nucleotide and Deletion-Insertion Polymorphisms. Int J Mol Sci 2019; 20:E3193. [PMID: 31261867 PMCID: PMC6651057 DOI: 10.3390/ijms20133193] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 06/21/2019] [Accepted: 06/27/2019] [Indexed: 12/21/2022] Open
Abstract
Most methods developed for detecting known single nucleotide polymorphisms (SNP) and deletion-insertion polymorphisms (DIP) are dependent on sequence conservation around the SNP/DIP and are therefore not suitable for application to heterogeneous organisms. Here we describe a novel, versatile and simple PCR-RFLP procedure baptised 'derived Polymorphic Amplified Cleaved Sequence' (dPACS) for genotyping individual samples. The notable advantage of the method is that it employs a pair of primers that cover the entire fragment to be amplified except for one or few diagnostic bases around the SNP/DIP being investigated. As such, it provides greater opportunities to introduce mismatches in one or both of the 35-55 bp primers for creating a restriction site that unambiguously differentiates wild from mutant sequences following PCR-RFLP and horizontal MetaPhorTM gel electrophoresis. Selection of effective restriction enzymes and primers is aided by the newly developed dPACS 1.0 software. The highly transferable dPACS procedure is exemplified here with the positive detection (in up to 24 grass and broadleaf species tested) of wild type proline106 of 5-enolpyruvylshikimate-3-phosphate synthase and its serine, threonine and alanine variants that confer resistance to glyphosate, and serine264 and isoleucine2041 which are key target-site determinants for weed sensitivities to some photosystem II and acetyl-CoA carboxylase inhibiting herbicides, respectively.
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Affiliation(s)
- Shiv Shankhar Kaundun
- Herbicide Bioscience, Syngenta Ltd., Jealott's Hill International Research Centre, RG42 6EY Bracknell, UK.
| | - Elisabetta Marchegiani
- Herbicide Bioscience, Syngenta Ltd., Jealott's Hill International Research Centre, RG42 6EY Bracknell, UK
| | - Sarah-Jane Hutchings
- Herbicide Bioscience, Syngenta Ltd., Jealott's Hill International Research Centre, RG42 6EY Bracknell, UK
| | - Ken Baker
- General Bioinformatics, Jealott's Hill International Research Centre, RG42 6EY Bracknell, UK
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Nakano Y, Yamasaki K, Sakamoto H, Matsusaka Y, Kunihiro N, Fukushima H, Inoue T, Honda-Kitahara M, Hara J, Yoshida A, Ichimura K. A long-term survivor of pediatric midline glioma with H3F3A K27M and BRAF V600E double mutations. Brain Tumor Pathol 2019; 36:162-168. [PMID: 31254135 DOI: 10.1007/s10014-019-00347-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 06/24/2019] [Indexed: 12/12/2022]
Abstract
We report a case of 2-year-old female with lateral ventricular glioma harboring both H3F3A K27M and BRAF V600E mutations. By the methylation analysis, the tumor was classified as a diffuse midline glioma H3 K27M mutant, WHO grade IV. However, the tumor was pathologically low-grade and likely localized rather than diffusely infiltrating. Further, the patient has survived more than 8 years after gross total resection of the tumor. Whereas both H3F3A K27M and BRAF V600E have been reported as poor prognostic markers in pediatric glioma, our case, along with several other reported cases, suggests that the coexistence of these two mutations might not indicate poor prognosis. The case emphasizes the importance of comprehensive assessment based on pathological, genetic and clinical findings and calls for further investigations of non-diffuse glioma with H3F3A K27M and glioma with H3F3A K27M and BRAF V600E.
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Affiliation(s)
- Yoshiko Nakano
- Division of Brain Tumor Translational Research, National Cancer Center Research Institute, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan. .,Department of Pediatric Hematology/Oncology, Osaka City General Hospital, Osaka, Japan.
| | - Kai Yamasaki
- Division of Brain Tumor Translational Research, National Cancer Center Research Institute, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.,Department of Pediatric Hematology/Oncology, Osaka City General Hospital, Osaka, Japan
| | - Hiroaki Sakamoto
- Department of Pediatric Neurosurgery, Osaka City General Hospital, Osaka, Japan
| | - Yasuhiro Matsusaka
- Department of Pediatric Neurosurgery, Osaka City General Hospital, Osaka, Japan
| | - Noritsugu Kunihiro
- Department of Pediatric Neurosurgery, Osaka City General Hospital, Osaka, Japan
| | - Hiroko Fukushima
- Department of Pathology, Osaka City General Hospital, Osaka, Japan
| | - Takeshi Inoue
- Department of Pathology, Osaka City General Hospital, Osaka, Japan
| | - Mai Honda-Kitahara
- Division of Brain Tumor Translational Research, National Cancer Center Research Institute, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Junichi Hara
- Department of Pediatric Hematology/Oncology, Osaka City General Hospital, Osaka, Japan
| | - Akihiko Yoshida
- Department of Pathology and Clinical Laboratories, National Cancer Center Hospital, Tokyo, Japan
| | - Koichi Ichimura
- Division of Brain Tumor Translational Research, National Cancer Center Research Institute, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
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Perrech M, Dreher L, Röhn G, Stavrinou P, Krischek B, Toliat M, Goldbrunner R, Timmer M. Qualitative and Quantitative Analysis of IDH1 Mutation in Progressive Gliomas by Allele-Specific qPCR and Western Blot Analysis. Technol Cancer Res Treat 2019; 18:1533033819828396. [PMID: 30943868 PMCID: PMC6457076 DOI: 10.1177/1533033819828396] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
To date, diagnosis of IDH1 mutation is based on DNA sequencing and immunohistochemistry, methods limited in terms of sensitivity and ease of use. Recently, the diagnosis of IDH1 mutation by real-time polymerase chain reaction was introduced as an alternative method. In this study, real-time polymerase chain reaction was validated as a tool for detection of IDH1 mutation, and expression levels were analyzed for correlation with course of the disease. A total of 113 tumor samples were obtained intraoperatively from 84 patients with glioma having a diagnosis of diffuse glioma (World Health Organization II), anaplastic glioma (World Health Organization III), secondary glioblastoma ± chemotherapy, primary glioblastoma ± chemotherapy (World Health Organization IV). Tumor samples were snap frozen and processed for sectioning and RNA and protein isolation. Presence of IDH1 mutation was determined by DNA sequencing. Hereafter, quantitative expression of IDH1 messenger RNA was assessed using real-time polymerase chain reaction with specific primers for IDH1 mutation and -wt; protein expression was verified by Western Blot analysis and immunohistochemistry. Additionally, 19 samples of low-grade glioma and their consecutive high-grade glioma were analyzed at different time points of the disease. IDH1 mutation was identified in 63% of samples by DNA sequencing. In correlation with the real-time polymerase chain reaction results, a cutoff value was determined. Above this threshold, sensitivity and specificity of real-time polymerase chain reaction in detecting IDH1 mutation were 98% and 94%, respectively. Quantitative analysis revealed that IDH1 mutation expression is upregulated in secondary glioblastoma (mean ± standard error of mean: 3.52 ± 0.55) compared to lower grade glioma (II = 1.54 ± 0.22; III = 1.67 ± 0.23). In contrast, IDH1 wt expression is upregulated in all glioma grades (concentration >0.1) compared to control brain tissue (0.007 ± 0.0016). Western Blot analysis showed a high concordance to both sequencing and real-time polymerase chain reaction results in qualitative analysis of IDH1 mutation status (specificity 100% and sensitivity 100%). Moreover, semiquantitative protein expression analysis also showed higher expression levels of mutated IDH1 in secondary glioblastoma. In our study, real-time polymerase chain reaction and Western Blot analysis were found to be highly efficient methods in detecting IDH1 mutation in glioma samples. As cost-effective and time-saving methods, real-time polymerase chain reaction and Western Blot analysis may therefore play an important role in IDH1 mutation analysis in the future. IDH1 mutation expression level was found to correlate with the course of disease to a certain extent. Yet, clinical factors as recurrent disease or prior radiochemotherapy did not alter IDH1 mutation expression level.
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Affiliation(s)
- Moritz Perrech
- 1 Laboratory of Neuro-oncology and Experimental Neurosurgery, Department of General Neurosurgery, Center for Neurosurgery, University Hospital Cologne, Cologne, Germany
| | - Lena Dreher
- 1 Laboratory of Neuro-oncology and Experimental Neurosurgery, Department of General Neurosurgery, Center for Neurosurgery, University Hospital Cologne, Cologne, Germany
| | - Gabriele Röhn
- 1 Laboratory of Neuro-oncology and Experimental Neurosurgery, Department of General Neurosurgery, Center for Neurosurgery, University Hospital Cologne, Cologne, Germany
| | - Pantelis Stavrinou
- 1 Laboratory of Neuro-oncology and Experimental Neurosurgery, Department of General Neurosurgery, Center for Neurosurgery, University Hospital Cologne, Cologne, Germany
| | - Boris Krischek
- 1 Laboratory of Neuro-oncology and Experimental Neurosurgery, Department of General Neurosurgery, Center for Neurosurgery, University Hospital Cologne, Cologne, Germany
| | - Mohammad Toliat
- 2 Cologne Center for Genomics (CCG), University of Cologne, Cologne, Germany
| | - Roland Goldbrunner
- 1 Laboratory of Neuro-oncology and Experimental Neurosurgery, Department of General Neurosurgery, Center for Neurosurgery, University Hospital Cologne, Cologne, Germany
| | - Marco Timmer
- 1 Laboratory of Neuro-oncology and Experimental Neurosurgery, Department of General Neurosurgery, Center for Neurosurgery, University Hospital Cologne, Cologne, Germany
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Castet F, Alanya E, Vidal N, Izquierdo C, Mesia C, Ducray F, Gil-Gil M, Bruna J. Contrast-enhancement in supratentorial low-grade gliomas: a classic prognostic factor in the molecular age. J Neurooncol 2019; 143:515-523. [PMID: 31054099 DOI: 10.1007/s11060-019-03183-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Accepted: 04/26/2019] [Indexed: 11/25/2022]
Abstract
BACKGROUND Contrast enhancement (CE) is found in 10-60% of low-grade gliomas. Its prognostic significance is controversial, and its correlation with IDH mutations and 1p/19q codeletion is elusive. The aim of this study is to investigate whether CE is associated with molecular characteristics of low-grade gliomas and uncover its prognostic value. MATERIALS AND METHODS All confirmed histological cases of low-grade gliomas diagnosed at our institution between years 2000-2016 were reviewed (n = 102). Spinal and brainstem localization, only-biopsied tumours with ring-like enhancement and incomplete medical records were excluded. RESULTS Mean age was 42 years ( ± 13.9 years), and 63.6% were male. The median follow-up time was 79.8 months. CE was present on 25% of preoperative MRI, and 25% of patients were considered high-risk according to Pignatti score. Most were astrocytomas (67%) and 87.2% were surgically removed. IDH mutation was found in 64.6% of tumour samples, and 18.8% had a 1p/19q codeletion. No subgroup differences were observed according to CE except for presurgical performance status and postoperative chemotherapy. IDH status and 1p/19q codeletion were evenly distributed. On univariate analysis, age, size > 6 cm, CE, extent of resection, Pignatti score, IDH mutation and 1p/19q codeletion were significantly associated to OS. On multivariate analysis, only CE and IDH status were independently associated to OS. CE remained a significant prognostic factor in IDH-mutant non-codeleted tumours when analysed by tumour subtype. CONCLUSION CE in low-grade gliomas provides prognostic information in IDH-mutant non-codeleted tumours, although its meaning remains uncertain in IDH-wildtype gliomas.
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Affiliation(s)
- Florian Castet
- Medical Oncology Department, Institut Català D'Oncologia L'Hospitalet, Barcelona, Spain
- Unit of Neuro-Oncology, Hospital Universitari de Bellvitge-Institut Català D'Oncologia L'Hospitalet, IDIBELL (Oncobell Program), Feixa Llarga s/n, 08907, Barcelona, Spain
| | - Enrique Alanya
- Medical Oncology and Radiotherapy Department, Edgardo Rebagliati Martins National Hospital - EsSalud, Lima, Peru
| | - Noemi Vidal
- Pathology Department, Hospital Universitari de Bellvitge, Barcelona, Spain
| | - Cristina Izquierdo
- Unit of Neuro-Oncology, Hospital Universitari de Bellvitge-Institut Català D'Oncologia L'Hospitalet, IDIBELL (Oncobell Program), Feixa Llarga s/n, 08907, Barcelona, Spain
- Groupe Hospitalier Est, Service de Neuro-Oncologie, Hospices Civils de Lyon, Lyon, France
| | - Carlos Mesia
- Medical Oncology Department, Institut Català D'Oncologia L'Hospitalet, Barcelona, Spain
- Unit of Neuro-Oncology, Hospital Universitari de Bellvitge-Institut Català D'Oncologia L'Hospitalet, IDIBELL (Oncobell Program), Feixa Llarga s/n, 08907, Barcelona, Spain
| | - François Ducray
- Groupe Hospitalier Est, Service de Neuro-Oncologie, Hospices Civils de Lyon, Lyon, France
- Department of Cancer Cell Plasticity, Cancer Research Centre of Lyon, INSERM U1052, CNRS UMR5286, Lyon, France
| | - Miguel Gil-Gil
- Medical Oncology Department, Institut Català D'Oncologia L'Hospitalet, Barcelona, Spain
- Unit of Neuro-Oncology, Hospital Universitari de Bellvitge-Institut Català D'Oncologia L'Hospitalet, IDIBELL (Oncobell Program), Feixa Llarga s/n, 08907, Barcelona, Spain
| | - Jordi Bruna
- Unit of Neuro-Oncology, Hospital Universitari de Bellvitge-Institut Català D'Oncologia L'Hospitalet, IDIBELL (Oncobell Program), Feixa Llarga s/n, 08907, Barcelona, Spain.
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35
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Yoshida A, Satomi K, Ohno M, Matsushita Y, Takahashi M, Miyakita Y, Hiraoka N, Narita Y, Ichimura K. Frequent false-negative immunohistochemical staining with IDH1 (R132H)-specific H09 antibody on frozen section control slides: a potential pitfall in glioma diagnosis. Histopathology 2018; 74:350-354. [DOI: 10.1111/his.13756] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2018] [Accepted: 09/13/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Akihiko Yoshida
- Department of Pathology and Clinical Laboratories; National Cancer Centre Hospital; Tokyo Japan
- Rare Cancer Centre; National Cancer Centre Hospital; Tokyo Japan
| | - Kaishi Satomi
- Department of Pathology and Clinical Laboratories; National Cancer Centre Hospital; Tokyo Japan
| | - Makoto Ohno
- Department of Neurosurgery and Neuro-Oncology; National Cancer Centre Hospital; Tokyo Japan
| | - Yuko Matsushita
- Department of Neurosurgery and Neuro-Oncology; National Cancer Centre Hospital; Tokyo Japan
- Division of Brain Tumour Translational Research; National Cancer Centre Research Institute; Tokyo Japan
| | - Masamichi Takahashi
- Department of Neurosurgery and Neuro-Oncology; National Cancer Centre Hospital; Tokyo Japan
| | - Yasuji Miyakita
- Department of Neurosurgery and Neuro-Oncology; National Cancer Centre Hospital; Tokyo Japan
| | - Nobuyoshi Hiraoka
- Department of Pathology and Clinical Laboratories; National Cancer Centre Hospital; Tokyo Japan
| | - Yoshitaka Narita
- Rare Cancer Centre; National Cancer Centre Hospital; Tokyo Japan
- Department of Neurosurgery and Neuro-Oncology; National Cancer Centre Hospital; Tokyo Japan
| | - Koichi Ichimura
- Rare Cancer Centre; National Cancer Centre Hospital; Tokyo Japan
- Division of Brain Tumour Translational Research; National Cancer Centre Research Institute; Tokyo Japan
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36
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Fukuoka K, Kanemura Y, Shofuda T, Fukushima S, Yamashita S, Narushima D, Kato M, Honda-Kitahara M, Ichikawa H, Kohno T, Sasaki A, Hirato J, Hirose T, Komori T, Satomi K, Yoshida A, Yamasaki K, Nakano Y, Takada A, Nakamura T, Takami H, Matsushita Y, Suzuki T, Nakamura H, Makino K, Sonoda Y, Saito R, Tominaga T, Matsusaka Y, Kobayashi K, Nagane M, Furuta T, Nakada M, Narita Y, Hirose Y, Ohba S, Wada A, Shimizu K, Kurozumi K, Date I, Fukai J, Miyairi Y, Kagawa N, Kawamura A, Yoshida M, Nishida N, Wataya T, Yamaoka M, Tsuyuguchi N, Uda T, Takahashi M, Nakano Y, Akai T, Izumoto S, Nonaka M, Yoshifuji K, Kodama Y, Mano M, Ozawa T, Ramaswamy V, Taylor MD, Ushijima T, Shibui S, Yamasaki M, Arai H, Sakamoto H, Nishikawa R, Ichimura K. Significance of molecular classification of ependymomas: C11orf95-RELA fusion-negative supratentorial ependymomas are a heterogeneous group of tumors. Acta Neuropathol Commun 2018; 6:134. [PMID: 30514397 PMCID: PMC6278135 DOI: 10.1186/s40478-018-0630-1] [Citation(s) in RCA: 72] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Accepted: 11/03/2018] [Indexed: 11/10/2022] Open
Abstract
Extensive molecular analyses of ependymal tumors have revealed that supratentorial and posterior fossa ependymomas have distinct molecular profiles and are likely to be different diseases. The presence of C11orf95-RELA fusion genes in a subset of supratentorial ependymomas (ST-EPN) indicated the existence of molecular subgroups. However, the pathogenesis of RELA fusion-negative ependymomas remains elusive. To investigate the molecular pathogenesis of these tumors and validate the molecular classification of ependymal tumors, we conducted thorough molecular analyses of 113 locally diagnosed ependymal tumors from 107 patients in the Japan Pediatric Molecular Neuro-Oncology Group. All tumors were histopathologically reviewed and 12 tumors were re-classified as non-ependymomas. A combination of RT-PCR, FISH, and RNA sequencing identified RELA fusion in 19 of 29 histologically verified ST-EPN cases, whereas another case was diagnosed as ependymoma RELA fusion-positive via the methylation classifier (68.9%). Among the 9 RELA fusion-negative ST-EPN cases, either the YAP1 fusion, BCOR tandem duplication, EP300-BCORL1 fusion, or FOXO1-STK24 fusion was detected in single cases. Methylation classification did not identify a consistent molecular class within this group. Genome-wide methylation profiling successfully sub-classified posterior fossa ependymoma (PF-EPN) into PF-EPN-A (PFA) and PF-EPN-B (PFB). A multivariate analysis using Cox regression confirmed that PFA was the sole molecular marker which was independently associated with patient survival. A clinically applicable pyrosequencing assay was developed to determine the PFB subgroup with 100% specificity using the methylation status of 3 genes, CRIP1, DRD4 and LBX2. Our results emphasized the significance of molecular classification in the diagnosis of ependymomas. RELA fusion-negative ST-EPN appear to be a heterogeneous group of tumors that do not fall into any of the existing molecular subgroups and are unlikely to form a single category.
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Detection of IDH1 and IDH2 Mutation in Formalin-fixed Paraffin-embedded Gliomas Using Allele-specific COLD-PCR and Probe Melting Curve Analysis. Appl Immunohistochem Mol Morphol 2018; 26:e93-e100. [DOI: 10.1097/pai.0000000000000600] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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38
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Lei W, Wang ZL, Feng HJ, Lin XD, Li CZ, Fan D. Long non-coding RNA SNHG12promotes the proliferation and migration of glioma cells by binding to HuR. Int J Oncol 2018; 53:1374-1384. [PMID: 30015836 DOI: 10.3892/ijo.2018.4478] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 06/20/2018] [Indexed: 11/06/2022] Open
Abstract
Long non-coding RNAs (lncRNAs) play important roles in biological processes and provide a novel approach with which to understand the molecular mechanisms responsible for glioma. Previous studies have demonstrated that lncRNA small nucleolar RNA host gene 12 (SNHG12) is involved in cell growth and migration. However, the accurate expression pattern of SNHG12 in glioma and the possible associations between this pattern and the clinicopathological characteristics of glioma cohorts are not yet known. The present study investigated the role of lncRNA SNHG12 in the development and progression of glioma, as well as the potential diagnostic value of SNHG12 in patients with glioma. The levels of SNHG12 were detected in resected specimens from patients and in glioma cell lines using reverse transcription-quantitative polymerase chain reaction. The potential effects of SNHG12 on the viability, mobility and apoptosis of glioma cells were evaluated using in vitro assays. The association between SNHG12 and Hu antigen R (HuR) was also determined using RNA immunoprecipitation (RIP) and RNA pull-down assays. The results revealed that SNHG12 was significantly upregulated in glioma tissues and cell lines. High levels of SNHG12 were associated with the deterioration of patients with glioma. Patients with high levels of SNHG12 exhibited a reduced 5-year overall survival rate (compared to those with lower levels), particularly in cohorts with high-grade carcinoma (III-IV). The silencing of SNHG12 expression by RNA interference led to a reduced viability and mobility, and in an increased apoptosis of human glioma cells. Furthermore, RIP and RNA pull-down assays demonstrated that SNHG12 was associated with and was stabilized by HuR. The findings of the present study thus identify a novel therapeutic target in glioma.
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Affiliation(s)
- Wei Lei
- Institute of Neurology, General Hospital of Shenyang Military Command, Shengyang, Liaoning 110000, P.R. China
| | - Zhi-Long Wang
- Graduate School of Dalian Medical University, Dalian, Liaoning 116044, P.R. China
| | - He-Jun Feng
- Graduate School of Jinzhou Medical University, Jinzhou, Liaoning 121001, P.R. China
| | - Xiang-Dan Lin
- Graduate School of Jinzhou Medical University, Jinzhou, Liaoning 121001, P.R. China
| | - Chuang-Zhong Li
- Institute of Neurology, General Hospital of Shenyang Military Command, Shengyang, Liaoning 110000, P.R. China
| | - Di Fan
- Institute of Neurology, General Hospital of Shenyang Military Command, Shengyang, Liaoning 110000, P.R. China
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39
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De Looze C, Beausang A, Cryan J, Loftus T, Buckley PG, Farrell M, Looby S, Reilly R, Brett F, Kearney H. Machine learning: a useful radiological adjunct in determination of a newly diagnosed glioma's grade and IDH status. J Neurooncol 2018; 139:491-499. [PMID: 29770897 DOI: 10.1007/s11060-018-2895-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 05/02/2018] [Indexed: 12/29/2022]
Abstract
INTRODUCTION Machine learning methods have been introduced as a computer aided diagnostic tool, with applications to glioma characterisation on MRI. Such an algorithmic approach may provide a useful adjunct for a rapid and accurate diagnosis of a glioma. The aim of this study is to devise a machine learning algorithm that may be used by radiologists in routine practice to aid diagnosis of both: WHO grade and IDH mutation status in de novo gliomas. METHODS To evaluate the status quo, we interrogated the accuracy of neuroradiology reports in relation to WHO grade: grade II 96.49% (95% confidence intervals [CI] 0.88, 0.99); III 36.51% (95% CI 0.24, 0.50); IV 72.9% (95% CI 0.67, 0.78). We derived five MRI parameters from the same diagnostic brain scans, in under two minutes per case, and then supplied these data to a random forest algorithm. RESULTS Machine learning resulted in a high level of accuracy in prediction of tumour grade: grade II/III; area under the receiver operating characteristic curve (AUC) = 98%, sensitivity = 0.82, specificity = 0.94; grade II/IV; AUC = 100%, sensitivity = 1.0, specificity = 1.0; grade III/IV; AUC = 97%, sensitivity = 0.83, specificity = 0.97. Furthermore, machine learning also facilitated the discrimination of IDH status: AUC of 88%, sensitivity = 0.81, specificity = 0.77. CONCLUSIONS These data demonstrate the ability of machine learning to accurately classify diffuse gliomas by both WHO grade and IDH status from routine MRI alone-without significant image processing, which may facilitate usage as a diagnostic adjunct in clinical practice.
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Affiliation(s)
- Céline De Looze
- Trinity Centre for Bioengineering, Trinity College Dublin, Dublin, Ireland.,School of Engineering, Trinity College Dublin, Dublin, Ireland
| | - Alan Beausang
- Department of Neuropathology, Beaumont Hospital, Dublin, Ireland
| | - Jane Cryan
- Department of Neuropathology, Beaumont Hospital, Dublin, Ireland
| | - Teresa Loftus
- Department of Molecular Pathology, Beaumont Hospital, Dublin, Ireland
| | - Patrick G Buckley
- Department of Molecular Pathology, Beaumont Hospital, Dublin, Ireland.,Genomics Medicine Ireland, Dublin, Ireland
| | - Michael Farrell
- Department of Neuropathology, Beaumont Hospital, Dublin, Ireland
| | - Seamus Looby
- Department of Neuroradiology, Beaumont Hospital, Dublin, Ireland
| | - Richard Reilly
- Trinity Centre for Bioengineering, Trinity College Dublin, Dublin, Ireland.,Institute of Neurosciences, Trinity College Dublin, Dublin, Ireland.,School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Francesca Brett
- Department of Neuropathology, Beaumont Hospital, Dublin, Ireland
| | - Hugh Kearney
- Department of Neuropathology, Beaumont Hospital, Dublin, Ireland.
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40
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Elevated TERT Expression in TERT-Wildtype Adult Diffuse Gliomas: Histological Evaluation with a Novel TERT-Specific Antibody. BIOMED RESEARCH INTERNATIONAL 2018; 2018:7945845. [PMID: 29693015 PMCID: PMC5859900 DOI: 10.1155/2018/7945845] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Revised: 12/10/2017] [Accepted: 01/17/2018] [Indexed: 11/27/2022]
Abstract
Telomerase reverse transcriptase (TERT) is important for the biology of diffuse gliomas. TERT promoter mutations are selectively observed among 1p/19q-codeleted oligodendrogliomas and isocitrate dehydrogenase gene- (IDH-) wildtype glioblastoma (GBM). However, TERT transcripts range widely in various cancers including gliomas, and TERT protein expression has been rarely investigated thus far. It would be thus critical to examine the expression level of TERT in tumors in addition to its mutational status, and sensitive and specific methods are urgently needed to examine TERT protein expression for the assessment of TERT biology in gliomas. Using our newly developed TERT-specific monoclonal antibody (TMab-6) applicable to human tissue, we found an unexpected increase in TERT expression in TERT-wildtype as well as TERT-mutated gliomas and in tumor vasculature. This is the first extensive analysis on the expression of TERT immunoreactivity in human glioma tissue, suggesting that TERT protein expression may be regulated by several mechanisms in addition to its promoter mutation.
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Li HY, Sun CR, He M, Yin LC, Du HG, Zhang JM. Correlation Between Tumor Location and Clinical Properties of Glioblastomas in Frontal and Temporal Lobes. World Neurosurg 2018; 112:e407-e414. [PMID: 29355809 DOI: 10.1016/j.wneu.2018.01.055] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Revised: 01/06/2018] [Accepted: 01/11/2018] [Indexed: 10/18/2022]
Abstract
BACKGROUND Tumor location is a major prognostic factor in glioblastomas and may be associated with clinical properties. This study established and analyzed the correlation between tumor location and clinical properties of glioblastomas in frontal and temporal lobes. METHODS This retrospective study determined the location of glioblastomas in the frontal lobe (FL) or temporal lobe (TL) based on preoperative magnetic resonance imaging. Clinical, radiologic, and molecular characteristics of FL and TL glioblastomas were compared to define their clinical properties, including sex, age, sides, relationship to ventricle, imaging subtypes, volume, isocitrate dehydrogenase mutation, promoter methylation of O6-methylguanine-DNA methyltransferase, progression-free survival, and overall survival. RESULTS The study enrolled 406 patients (182 [44.83%] in FL group and 224 [55.17%] in TL group) with a mean age of 69.8 years. Compared with FL group, TL group had higher incidence of female patients (P = 0.024), tumor location distant to the ventricle (P = 0.006), isocitrate dehydrogenase mutations (P = 0.021), promoter methylation of O6-methylguanine-DNA methyltransferase (P = 0.012), and prolonged progression-free survival and overall survival (P < 0.05). No significant differences were observed between groups with respect to age ≥60 years at study entry (P = 0.668), sides (P = 0.879), imaging subtypes (P = 0.362), or volume (P = 0.709). CONCLUSIONS This study demonstrated that different tumor locations are associated with diverse clinical properties of glioblastomas in FL and TL. This information will aid in increasing understanding of glioblastoma biology for application in baseline comparisons in future clinical trials.
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Affiliation(s)
- Hong-Yu Li
- Department of Neurosurgery, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China; Department of Neurosurgery, Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Chong-Ran Sun
- Department of Neurosurgery, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Min He
- Department of Neurosurgery, Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Li-Chun Yin
- Department of Neurosurgery, Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Hang-Gen Du
- Department of Neurosurgery, Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Jian-Min Zhang
- Department of Neurosurgery, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
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Wang XP, Shan C, Deng XL, Li LY, Ma W. Long non-coding RNA PAR5 inhibits the proliferation and progression of glioma through interaction with EZH2. Oncol Rep 2017; 38:3177-3186. [PMID: 29048683 DOI: 10.3892/or.2017.5986] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Accepted: 09/01/2017] [Indexed: 11/06/2022] Open
Abstract
Emerging evidence suggests that long non-coding RNAs (lncRNAs) may be involved in modulating various aspects of tumor biology and serve as potential therapeutic targets as well as novel biomarkers in the treatment of glioma. The present study investigated the role of lncRNA, Prader Willi/Angelman region RNA 5 (PAR5; also known as PWAR5), in glioma and its clinical significance in glioma cases. The expression levels of PAR5 were determined in clinical samples and U87, U251 cells using real-time reverse transcription quantitative polymerase chain reaction (qRT-PCR) analysis. The effects of PAR5 on cell proliferation, migration and invasion were determined using in vitro assays. RNA immunoprecipitation (RIP) and RNA pull-down assays, as well as the evauation of the expression of various oncogenes were carried out to reveal the underlying mechanisms. We found that PAR5 was significantly downregulated in glioma tissues and cell lines. Furthermore, PAR5 expression was negatively correlated with tumor size, World Health Organization (WHO) grade and Karnofsky performance score (KPS). Patients with low PAR5 expression in tumors had a worse overall survival compared to those with higher expression. Finally, in vitro restoration of PAR5 expression inhibited human glioma cell proliferation, invasion and migration by binding to EZH2 and regulating oncogene expression. This finding may provide a therapeutic approach for the future treatment of glioma.
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Affiliation(s)
- Xiang-Peng Wang
- Department of Neurosurgery, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650032, P.R. China
| | - Cai Shan
- Department of Neurosurgery, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650032, P.R. China
| | - Xing-Li Deng
- Department of Neurosurgery, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650032, P.R. China
| | - Li-Yan Li
- Institute of Neuroscience, Kunming Medical University, Kunming, Yunnan 650050, P.R. China
| | - Wei Ma
- Institute of Neuroscience, Kunming Medical University, Kunming, Yunnan 650050, P.R. China
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Yasuda T, Nitta M, Komori T, Kobayashi T, Masui K, Maruyama T, Sawada T, Muragaki Y, Kawamata T. Gliosarcoma arising from oligodendroglioma, IDH
mutant and 1p/19q codeleted. Neuropathology 2017; 38:41-46. [DOI: 10.1111/neup.12406] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Revised: 07/02/2017] [Accepted: 07/03/2017] [Indexed: 12/27/2022]
Affiliation(s)
- Takayuki Yasuda
- Department of Neurosurgery; Tokyo Women's Medical University; Tokyo Japan
| | - Masayuki Nitta
- Department of Neurosurgery; Tokyo Women's Medical University; Tokyo Japan
- Faculty of Advanced Techno-Surgery, Institute of Biomedical Engineering and Science; Tokyo Women's Medical University; Tokyo Japan
| | - Takashi Komori
- Department of Laboratory Medicine and Pathology (Neuropathology); Tokyo Metropolitan Neurological Hospital; Tokyo Japan
| | - Tatsuya Kobayashi
- Department of Neurosurgery; Tokyo Women's Medical University; Tokyo Japan
| | - Kenta Masui
- Department of Pathology; Tokyo Women's Medical University; Tokyo Japan
| | - Takashi Maruyama
- Department of Neurosurgery; Tokyo Women's Medical University; Tokyo Japan
- Faculty of Advanced Techno-Surgery, Institute of Biomedical Engineering and Science; Tokyo Women's Medical University; Tokyo Japan
| | - Tatsuo Sawada
- Department of Pathology; Tokyo Women's Medical University; Tokyo Japan
| | - Yoshihiro Muragaki
- Department of Neurosurgery; Tokyo Women's Medical University; Tokyo Japan
- Faculty of Advanced Techno-Surgery, Institute of Biomedical Engineering and Science; Tokyo Women's Medical University; Tokyo Japan
| | - Takakazu Kawamata
- Department of Neurosurgery; Tokyo Women's Medical University; Tokyo Japan
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Komori T. The 2016 WHO Classification of Tumours of the Central Nervous System: The Major Points of Revision. Neurol Med Chir (Tokyo) 2017; 57:301-311. [PMID: 28592714 PMCID: PMC5566703 DOI: 10.2176/nmc.ra.2017-0010] [Citation(s) in RCA: 159] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
The updated 2016 edition of the World Health Organization (WHO) Classification of Tumours of the Central Nervous System (CNS) uses molecular parameters and the histology to define the main tumor categories for the first time. This represents a shift from the traditional principle of using neuropathological diagnoses, which are primarily based on the microscopic features, to using molecularly-oriented diagnoses. Major restructuring was made with regard to diffuse gliomas, medulloblastomas and other embryonal tumors. New entities that are defined by both the histological and molecular features include glioblastoma, isocitrate dehydrogenase (IDH)-wildtype and glioblastoma, IDH-mutant; diffuse midline glioma, H3 K27M-mutant; RELA fusion-positive ependymoma; medulloblastoma, wingless (WNT)-activated and medulloblastoma, sonic hedgehog (SHH)-activated; and embryonal tumor with multilayered rosettes, C19MC-altered. In addition, some entities that are no longer diagnostically relevant—such as CNS-primitive neuroectodermal tumor—have been deleted from this updated edition. The WHO2016 certainly facilitates clinical and basic research to improve the diagnosis of brain tumors and patient care.
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Affiliation(s)
- Takashi Komori
- Department of Laboratory Medicine and Pathology (Neuropathology), Tokyo Metropolitan Neurological Hospital
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45
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Sirirat T, Chuncharunee S, Nipaluk P, Siriboonpiputtana T, Chareonsirisuthigul T, Limsuwannachot N, Rerkamnuaychoke B. Mutation Analysis of Isocitrate Dehydrogenase (IDH1/2) and DNA Methyltransferase 3A (DNMT3A) in Thai Patients with Newly Diagnosed Acute Myeloid Leukemia. Asian Pac J Cancer Prev 2017; 18:413-420. [PMID: 28345823 PMCID: PMC5454736 DOI: 10.22034/apjcp.2017.18.2.413] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Acute myeloid leukemia (AML) is a clonal hematopoietic stem/progenitor cell disorder which features several genetic mutations. Recurrent genetic alterations identified in AML are recognized as causes of the disease, finding application as diagnostic, prognostic and monitoring markers, with potential use as targets for cancer therapy. Here, we performed a pyrosequencing technique to investigate common mutations of IDH1, IDH2 and DNMT3A in 81 newly diagnosed AML patients. The prevalences of IDH1, IDH2 and DNMT3A mutations were 6.2%, 18.5%, and 7.4%, respectively. In addition, exclusive mutations in IDH1 codon 132 (R132H, R132C, R132G and R132S) were identified in all IDH1-mutated cases indicating that these are strongly associated with AML. Interestingly, higher median blast cell counts were significantly associated with IDH1/2 and DNMT3A mutations. In summary, we could establish a routine robust pyrosequencing method to detect common mutations in IDH1/2 and DNMT3A and demonstrate the frequency of those mutations in adult Thai AML patients.
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Affiliation(s)
- Tanasan Sirirat
- Doctoral Program in Clinical Pathology, Department of Pathology, Faculty of Medicine Ramathibodi Hospital, Mahidol University. Bangkok, 10400, Thailand.
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Pyo JS, Kim NY, Kim RHJ, Kang G. Concordance analysis and diagnostic test accuracy review of IDH1 immunohistochemistry in glioblastoma. Brain Tumor Pathol 2016; 33:248-254. [PMID: 27638721 DOI: 10.1007/s10014-016-0272-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Accepted: 09/08/2016] [Indexed: 12/12/2022]
Abstract
The study investigated isocitrate dehydrogenase (IDH) 1 immunohistochemistry (IHC) positive rate and concordance rate between IDH1 IHC and molecular test in glioblastoma. The current study included 1360 glioblastoma cases from sixteen eligible studies. Meta-analysis, including subgroup analysis by antibody clones and cut-off values, for IDH1 IHC positive rate was conducted. In addition, we performed a concordance analysis and diagnostic test accuracy review between IDH1 IHC and molecular tests. The estimated rates of IDH1 IHC were 0.106 [95 % confidence interval (CI) 0.085-0.132]. The IDH1 IHC positive rate of primary and secondary glioblastomas was 0.049 (95 % CI 0.023-0.99) and 0.729 (95 % CI 0.477-0.889), respectively. The overall concordance rate between IDH1 IHC and molecular test was 0.947 (95 % CI 0.878-0.978). In IDH1 IHC-positive and negative subgroups, the concordance rate was 0.842 (95 % CI 0.591-0.952) and 0.982 (95 % CI 0.941-0.995), respectively. The pooled sensitivity and specificity for IDH1 IHC were 1.00 (95 % CI 0.82-1.00) and 0.99 (95 % CI 0.96-1.00), respectively. IDH1 IHC is an accurate test for IDH1 mutation in glioblastoma patients. Further cumulative studies for evaluation criteria of IDH1 IHC will determine how to best apply this approach in daily practice.
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Affiliation(s)
- Jung-Soo Pyo
- Department of Pathology, Eulji University Hospital, Daejeon, Republic of Korea
| | - Nae Yu Kim
- Department of Internal Medicine, Eulji University Hospital, Daejeon, Republic of Korea
| | - Roy Hyun Jai Kim
- Department of Chemistry, University of Washington, Seattle, WA, USA
| | - Guhyun Kang
- Department of Pathology, Inje University Sanggye Paik Hospital, 1342 Dongil-ro, Nowon-gu, Seoul, 139-707, Republic of Korea.
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47
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Precise Detection of IDH1/2 and BRAF Hotspot Mutations in Clinical Glioma Tissues by a Differential Calculus Analysis of High-Resolution Melting Data. PLoS One 2016; 11:e0160489. [PMID: 27529619 PMCID: PMC4987040 DOI: 10.1371/journal.pone.0160489] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Accepted: 07/20/2016] [Indexed: 01/08/2023] Open
Abstract
High resolution melting (HRM) is a simple and rapid method for screening mutations. It offers various advantages for clinical diagnostic applications. Conventional HRM analysis often yields equivocal results, especially for surgically obtained tissues. We attempted to improve HRM analyses for more effective applications to clinical diagnostics. HRM analyses were performed for IDH1R132 and IDH2R172 mutations in 192 clinical glioma samples in duplicate and these results were compared with sequencing results. BRAFV600E mutations were analyzed in 52 additional brain tumor samples. The melting profiles were used for differential calculus analyses. Negative second derivative plots revealed additional peaks derived from heteroduplexes in PCR products that contained mutations; this enabled unequivocal visual discrimination of the mutations. We further developed a numerical expression, the HRM-mutation index (MI), to quantify the heteroduplex-derived peak of the mutational curves. Using this expression, all IDH1 mutation statuses matched those ascertained by sequencing, with the exception of three samples. These discordant results were all derived from the misinterpretation of sequencing data. The effectiveness of our approach was further validated by analyses of IDH2R172 and BRAFV600E mutations. The present analytical method enabled an unequivocal and objective HRM analysis and is suitable for reliable mutation scanning in surgically obtained glioma tissues. This approach could facilitate molecular diagnostics in clinical environments.
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48
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Arita H, Yamasaki K, Matsushita Y, Nakamura T, Shimokawa A, Takami H, Tanaka S, Mukasa A, Shirahata M, Shimizu S, Suzuki K, Saito K, Kobayashi K, Higuchi F, Uzuka T, Otani R, Tamura K, Sumita K, Ohno M, Miyakita Y, Kagawa N, Hashimoto N, Hatae R, Yoshimoto K, Shinojima N, Nakamura H, Kanemura Y, Okita Y, Kinoshita M, Ishibashi K, Shofuda T, Kodama Y, Mori K, Tomogane Y, Fukai J, Fujita K, Terakawa Y, Tsuyuguchi N, Moriuchi S, Nonaka M, Suzuki H, Shibuya M, Maehara T, Saito N, Nagane M, Kawahara N, Ueki K, Yoshimine T, Miyaoka E, Nishikawa R, Komori T, Narita Y, Ichimura K. A combination of TERT promoter mutation and MGMT methylation status predicts clinically relevant subgroups of newly diagnosed glioblastomas. Acta Neuropathol Commun 2016; 4:79. [PMID: 27503138 PMCID: PMC4977715 DOI: 10.1186/s40478-016-0351-2] [Citation(s) in RCA: 174] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Accepted: 07/23/2016] [Indexed: 01/19/2023] Open
Abstract
The prognostic impact of TERT mutations has been controversial in IDH-wild tumors, particularly in glioblastomas (GBM). The controversy may be attributable to presence of potential confounding factors such as MGMT methylation status or patients' treatment. This study aimed to evaluate the impact of TERT status on patient outcome in association with various factors in a large series of adult diffuse gliomas. We analyzed a total of 951 adult diffuse gliomas from two cohorts (Cohort 1, n = 758; Cohort 2, n = 193) for IDH1/2, 1p/19q, and TERT promoter status. The combined IDH/TERT classification divided Cohort 1 into four molecular groups with distinct outcomes. The overall survival (OS) was the shortest in IDH wild-type/TERT mutated groups, which mostly consisted of GBMs (P < 0.0001). To investigate the association between TERT mutations and MGMT methylation on survival of patients with GBM, samples from a combined cohort of 453 IDH-wild-type GBM cases treated with radiation and temozolomide were analyzed. A multivariate Cox regression model revealed that the interaction between TERT and MGMT was significant for OS (P = 0.0064). Compared with TERT mutant-MGMT unmethylated GBMs, the hazard ratio (HR) for OS incorporating the interaction was the lowest in the TERT mutant-MGMT methylated GBM (HR, 0.266), followed by the TERT wild-type-MGMT methylated (HR, 0.317) and the TERT wild-type-MGMT unmethylated GBMs (HR, 0.542). Thus, patients with TERT mutant-MGMT unmethylated GBM have the poorest prognosis. Our findings suggest that a combination of IDH, TERT, and MGMT refines the classification of grade II-IV diffuse gliomas.
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Affiliation(s)
- Hideyuki Arita
- Division of Brain Tumor Translational Research, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.
- Department of Neurosurgery, Osaka University Graduate School of Medicine, Osaka, Japan.
| | - Kai Yamasaki
- Division of Brain Tumor Translational Research, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
- Department of Pediatric Hematology and Oncology, Osaka City General Hospital, Osaka, Japan
| | - Yuko Matsushita
- Division of Brain Tumor Translational Research, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Taishi Nakamura
- Division of Brain Tumor Translational Research, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
- Department of Neurosurgery, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Asanao Shimokawa
- Department of Mathematics, Faculty of Science, Tokyo University of Science, Tokyo, Japan
| | - Hirokazu Takami
- Division of Brain Tumor Translational Research, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
- Department of Neurosurgery, The University of Tokyo, Tokyo, Japan
| | - Shota Tanaka
- Department of Neurosurgery, The University of Tokyo, Tokyo, Japan
| | - Akitake Mukasa
- Department of Neurosurgery, The University of Tokyo, Tokyo, Japan
| | - Mitsuaki Shirahata
- Department of Neuro-Oncology/Neurosurgery, Saitama Medical University International Medical Center, Saitama, Japan
| | - Saki Shimizu
- Department of Neurosurgery, Kyorin University Faculty of Medicine, Tokyo, Japan
| | - Kaori Suzuki
- Department of Neurosurgery, Kyorin University Faculty of Medicine, Tokyo, Japan
| | - Kuniaki Saito
- Department of Neurosurgery, Kyorin University Faculty of Medicine, Tokyo, Japan
| | - Keiichi Kobayashi
- Department of Neurosurgery, Kyorin University Faculty of Medicine, Tokyo, Japan
| | - Fumi Higuchi
- Department of Neurosurgery, Dokkyo Medical University, Tochigi, Japan
| | - Takeo Uzuka
- Department of Neurosurgery, Dokkyo Medical University, Tochigi, Japan
| | - Ryohei Otani
- Department of Neurosurgery, Dokkyo Medical University, Tochigi, Japan
| | - Kaoru Tamura
- Department of Neurosurgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kazutaka Sumita
- Department of Neurosurgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - Makoto Ohno
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Yasuji Miyakita
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Naoki Kagawa
- Department of Neurosurgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Naoya Hashimoto
- Department of Neurosurgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Ryusuke Hatae
- Department of Neurosurgery, Kyushu University Graduate School of Medical Science, Fukuoka, Japan
| | - Koji Yoshimoto
- Department of Neurosurgery, Kyushu University Graduate School of Medical Science, Fukuoka, Japan
| | - Naoki Shinojima
- Department of Neurosurgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Hideo Nakamura
- Department of Neurosurgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Yonehiro Kanemura
- Division of Regenerative Medicine, Institute for Clinical Research, Osaka National Hospital, National Hospital Organization, Osaka, Japan
- Department of Neurosurgery, National Hospital Organization Osaka National Hospital, Osaka, Japan
| | - Yoshiko Okita
- Department of Neurosurgery, National Hospital Organization Osaka National Hospital, Osaka, Japan
| | - Manabu Kinoshita
- Department of Neurosurgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
| | - Kenichi Ishibashi
- Department of Neurosurgery, Osaka City General Hospital, Osaka, Japan
| | - Tomoko Shofuda
- Division of Stem Cell Research, Institute for Clinical Research, Osaka National Hospital, National Hospital Organization, Osaka, Japan
| | - Yoshinori Kodama
- Central Laboratory and Surgical Pathology, Osaka National Hospital, National Hospital Organization, Osaka, Japan
| | - Kanji Mori
- Department of Neurosurgery, Kansai Rosai Hospital, Hyogo, Japan
| | - Yusuke Tomogane
- Department of Neurosurgery, Hyogo College of Medicine, Hyogo, Japan
| | - Junya Fukai
- Department of Neurological Surgery, Wakayama Medical University, Wakayama, Japan
| | - Koji Fujita
- Department of Neurological Surgery, Wakayama Medical University, Wakayama, Japan
| | - Yuzo Terakawa
- Department of Neurosurgery, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Naohiro Tsuyuguchi
- Department of Neurosurgery, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Shusuke Moriuchi
- Department of Neurosurgery, Rinku General Medical Center, Izumisano, Osaka, Japan
| | - Masahiro Nonaka
- Department of Neurosurgery, National Hospital Organization Osaka National Hospital, Osaka, Japan
| | - Hiroyoshi Suzuki
- Department of Pathology and Laboratory Medicine, National Hospital Organization, Sendai Medical Center, Sendai, Japan
| | - Makoto Shibuya
- Central Laboratory, Hachioji Medical Center, Tokyo Medical University, Tokyo, Japan
| | - Taketoshi Maehara
- Department of Neurosurgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - Nobuhito Saito
- Department of Neurosurgery, The University of Tokyo, Tokyo, Japan
| | - Motoo Nagane
- Department of Neurosurgery, Kyorin University Faculty of Medicine, Tokyo, Japan
| | - Nobutaka Kawahara
- Department of Neurosurgery, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Keisuke Ueki
- Department of Neurosurgery, Dokkyo Medical University, Tochigi, Japan
| | - Toshiki Yoshimine
- Department of Neurosurgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Etsuo Miyaoka
- Department of Mathematics, Faculty of Science, Tokyo University of Science, Tokyo, Japan
| | - Ryo Nishikawa
- Department of Neuro-Oncology/Neurosurgery, Saitama Medical University International Medical Center, Saitama, Japan
| | - Takashi Komori
- Department of Laboratory Medicine and Pathology (Neuropathology), Tokyo Metropolitan Neurological Hospital, Tokyo, Japan
| | - Yoshitaka Narita
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Koichi Ichimura
- Division of Brain Tumor Translational Research, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.
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49
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Ohno M, Narita Y, Miyakita Y, Matsushita Y, Arita H, Yonezawa M, Yoshida A, Fukushima S, Takami H, Ichimura K, Shibui S. Glioblastomas with IDH1/2 mutations have a short clinical history and have a favorable clinical outcome. Jpn J Clin Oncol 2015; 46:31-9. [PMID: 26603354 DOI: 10.1093/jjco/hyv170] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Accepted: 10/24/2015] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE Glioblastomas with isocitrate dehydrogenase 1/2 mutations comprise a biologically distinct subgroup of glioblastomas. We studied isocitrate dehydrogenase 1/2 mutant glioblastomas at the clinical, molecular and radiological levels to define their clinical features, including the prognostic value of isocitrate dehydrogenase 1/2 mutations compared with isocitrate dehydrogenase 1/2 wild-type glioblastomas. METHODS We investigated 128 newly diagnosed glioblastoma patients who were treated at our institute between January 2005 and May 2013. Isocitrate dehydrogenase 1/2 mutation status was determined using pyrosequencing. O-6-methylguanine deoxyribonucleic acid methyltransferase promoter methylation and 1p/19q co-deletions were also analyzed using pyrosequencing and multiplex ligation-dependent probe amplification, respectively. RESULTS Isocitrate dehydrogenase 1/2 mutations were detected in 10 of 128 patients (7.8%). Isocitrate dehydrogenase 1/2 mutations were correlated with a younger age, the presence of an oligodendroglial component and 1p/19q co-deletions and a longer survival time. The interval from initial symptom to initial operation did not differ according to isocitrate dehydrogenase 1/2 mutation status (median interval: 2.3 versus 1.2 months; P = 0.13). Two of three isocitrate dehydrogenase 1/2 mutant glioblastomas harboring 1p/19q co-deletions had an oligodendroglial component and were associated with a prolonged survival time. Multivariate analysis of 90 patients treated with temozolomide-based chemoradiotherapy indicated that age, extent of resection, postoperative Karnofsky performance score and O-6-methylguanine deoxyribonucleic acid methyltransferase promoter methylation were correlated with better survival. Isocitrate dehydrogenase 1/2 mutations showed a trend for improved survival (P = 0.068). CONCLUSIONS Most isocitrate dehydrogenase 1/2 mutant glioblastomas have a short clinical history, and some isocitrate dehydrogenase 1/2 mutant glioblastomas harboring 1p/19q co-deletions behave like oligodendroglial tumors. Isocitrate dehydrogenase 1/2 mutations may have a positive prognostic impact on the Japanese population.
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Affiliation(s)
- Makoto Ohno
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, Tokyo, Chuo-ku
| | - Yoshitaka Narita
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, Tokyo, Chuo-ku
| | - Yasuji Miyakita
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, Tokyo, Chuo-ku
| | - Yuko Matsushita
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, Tokyo, Chuo-ku
| | - Hideyuki Arita
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, Tokyo, Chuo-ku Department of Neurosurgery, Osaka University Graduate School of Medicine, Suita, Osaka
| | - Motoki Yonezawa
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, Tokyo, Chuo-ku
| | - Akihiko Yoshida
- Department of Pathology and Clinical Laboratories, National Cancer Center Hospital, Tokyo, Chuo-ku
| | - Shintaro Fukushima
- Department of Pathology and Clinical Laboratories, National Cancer Center Hospital, Tokyo, Chuo-ku Division of Brain Tumor Translational Research, National Cancer Center Research Institute, Tokyo, Chuo-ku
| | - Hirokazu Takami
- Division of Brain Tumor Translational Research, National Cancer Center Research Institute, Tokyo, Chuo-ku
| | - Koichi Ichimura
- Division of Brain Tumor Translational Research, National Cancer Center Research Institute, Tokyo, Chuo-ku
| | - Soichiro Shibui
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, Tokyo, Chuo-ku Department of Neurosurgery, Teikyo University School of medicine University Hospital, Mizonokuchi, Kawasaki, Japan
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50
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A high-sensitive HMab-2 specifically detects IDH1-R132H, the most common IDH mutation in gliomas. Biochem Biophys Res Commun 2015; 466:733-9. [PMID: 26381180 DOI: 10.1016/j.bbrc.2015.09.070] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Accepted: 09/12/2015] [Indexed: 01/12/2023]
Abstract
Isocitrate dehydrogenase 1 (IDH1) mutations have been detected in gliomas and other tumors. Although IDH1 catalyzes the oxidative carboxylation of isocitrate to α-ketoglutarate (α-KG) in cytosol, mutated IDH1 proteins possess the ability to change α-KG into the oncometabolite D-2-hydroxyglutarate (D-2HG). Several monoclonal antibodies (mAbs) specific for IDH1 mutations have been established, such as H09, IMab-1, and HMab-1 against IDH1-R132H, which is the most frequent IDH1 mutation in gliomas. In this study, we established a novel high-sensitive mAb HMab-2, which reacts with IDH1-R132H but not with wild type IDH1 in ELISA. HMab-2 reacted only with IDH1-R132H, not with wild type IDH1/2 and other IDH1/2 mutants in Western-blot analysis. Furthermore, HMab-2 recognized IDH1-R132H more sensitively compared with our previously established HMab-1. HMab-2 detected endogenous IDH1-R132H protein expressed in glioblastoma in immunohistochemical analysis. HMab-2 is expected to be useful for the diagnosis of IDH1-R132H-bearing tumors.
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