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Increased expression of MMP-2 and MMP-9 indicates poor prognosis in glioma recurrence. Biomed Pharmacother 2019; 118:109369. [PMID: 31545229 DOI: 10.1016/j.biopha.2019.109369] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2019] [Revised: 08/20/2019] [Accepted: 08/21/2019] [Indexed: 12/12/2022] Open
Abstract
The main characteristic of glioma is recurrence, even after intensive multidisciplinary treatment. Studies show that enhanced invasive ability will increase the ability of tumor cells to escape from the primary tumor mass, which is a key factor contributing to tumor relapse and recurrence. In this study, we assessed the expression of MMP-2, MMP-9, two important matrix metallopeptidases that increase the invasive ability of glioma, and their suppressors, TIMP-1, TIMP-2 in glioma tissues from primary and recurrent glioma patients by immunohistochemistry. Glioma cells and nude mice were used for in vitro and in vivo studies. Results showed that the expression of MMP-2 and MMP-9 in recurrent gliomas were significantly higher than those in primary gliomas (P = 3.075 × 10-11, P = 1.510 × 10-5, respectively). We also found that radiotherapy increased the expression of MMP-9, but had no effect on MMP-2 and TIMP-1/2. With glioma cell line U251, we found that irradiation increased the expression of MMP-9 in vitro. Tumor tissues from an orthotopic xenograft model showed that after irradiation treatment, the expression of MMP-9 increased significantly in vivo. We also found that knocking down MMP-9 decreased irradiation-induced invasion obviously. Above all, we concluded that higher expressions of MMP-2/-9 indicate poor prognosis in glioma recurrence. The increased expression of MMP-9 after radiotherapy suggests that MMP-9 might be an important target in the radiosensitization of glioma.
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Nahed BV, Redjal N, Brat DJ, Chi AS, Oh K, Batchelor TT, Ryken TC, Kalkanis SN, Olson JJ. Management of patients with recurrence of diffuse low grade glioma: A systematic review and evidence-based clinical practice guideline. J Neurooncol 2015; 125:609-30. [PMID: 26530264 DOI: 10.1007/s11060-015-1910-2] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Accepted: 08/29/2015] [Indexed: 01/28/2023]
Abstract
TARGET POPULATION These recommendations apply to adult patients with recurrent low-grade glioma (LGG) with initial pathologic diagnosis of a WHO grade II infiltrative glioma (oligodendroglioma, astrocytoma, or oligo-astrocytoma). PATHOLOGY AT RECURRENCE QUESTION Do pathologic and molecular characteristics predict outcome/malignant transformation at recurrence? RECOMMENDATIONS IDH STATUS AND RECURRENCE: (Level III) IDH mutation status should be determined as LGGs with IDH mutations have a shortened time to recurrence. It is unclear whether knowledge of IDH mutation status provides benefit in predicting time to progression or overall survival. TP53 STATUS AND RECURRENCE: (Level III) TP53 mutations occur early in LGG pathogenesis, remain stable, and are not recommended as a marker of predisposition to malignant transformation at recurrence or other measures of prognosis. MGMT STATUS AND RECURRENCE: (Level III) Assessment of MGMT status is recommended as an adjunct to assessing prognosis as LGGs with MGMT promoter methylation are associated with shorter PFS (in the absence of TMZ) and longer post-recurrence survival (in the presence of TMZ), ultimately producing similar overall survival to LGGs without MGMT methylation. The available retrospective reports are conflicting and comparisons between reports are limited CDK2NA STATUS AND RECURRENCE: (Level III) Assessment of CDK2NA status is recommended when possible as the loss of expression of the CDK2NA via either methylation or loss of chromosome 9p is associated with malignant progression of LGGs. PROLIFERATIVE INDEX AND RECURRENCE: (Level III) It is recommended that proliferative indices (MIB-1 or BUdR) be measured in LGGs as higher proliferation indices are associated with increased likelihood of recurrence and shorter progression free and overall survival. 1P/19Q STATUS AND RECURRENCE: There is insufficient evidence to make any recommendations. CHEMOTHERAPY AT RECURRENCE QUESTION What role does chemotherapy have in LGG recurrence? RECOMMENDATIONS TEMOZOLOMIDE AND RECURRENCE: (Level III) Temozolomide is recommended in the therapy of recurrent LGG as it may improve clinical symptoms. Oligodendrogliomas and tumors with 1p/19q co-deletion may derive the most benefit. PCV AND RECURRENCE: (Level III) PCV is recommended in the therapy of LGG at recurrence as it may improve clinical symptoms with the strongest evidence being for oligodendrogliomas. CARBOPLATIN AND RECURRENCE : (Level III) Carboplatin is not recommended as there is no significant benefit from carboplatin as single agent therapy for recurrent LGGs. OTHER TREATMENTS (NITROSUREAS, HYDROXYUREA/IMANITIB, IRINOTECAN, PACLITAXEL) AND RECURRENCE: There is insufficient evidence to make any recommendations. It is recommended that individuals with recurrent LGGs be enrolled in a properly designed clinical trial to assess these chemotherapeutic agents. RADIATION AT RECURRENCE QUESTION What role does radiation have in LGG recurrence? RECOMMENDATIONS RADIATION AT RECURRENCE WITH NO PREVIOUS IRRADIATION: (Level III) Radiation is recommended at recurrence if there was no previous radiation treatment. RE-IRRADIATION AT RECURRENCE: (Level III) It is recommended that re-irradiation be considered in the setting of LGG recurrence as it may provide benefit in disease control. SURGERY AT RECURRENCE There is insufficient evidence to make any specific recommendations. It is recommended that individuals with recurrent LGGs be enrolled in a properly designed clinical trial to assess the role of surgery at recurrence.
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Affiliation(s)
- Brian V Nahed
- Department of Neurosurgery, Massachusetts General Hospital, 15 Parkman Street, Wang 745, Boston, MA, 02114, USA.
| | - Navid Redjal
- Department of Neurosurgery, Massachusetts General Hospital, Boston, MA, USA
| | - Daniel J Brat
- Department of Pathology, Emory University School of Medicine, Atlanta, GA, USA
| | - Andrew S Chi
- Laura and Isaac Perlmutter Cancer Center, NYU Langone Medical Center, New York, NY, USA
| | - Kevin Oh
- Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA, USA
| | - Tracy T Batchelor
- Laura and Isaac Perlmutter Cancer Center, NYU Langone Medical Center, New York, NY, USA
| | - Timothy C Ryken
- Department of Neurosurgery, Kansas University Medical Center, Kansas City, KS, USA
| | - Steven N Kalkanis
- Department of Neurosurgery, Henry Ford Health System, Detroit, MI, USA
| | - Jeffrey J Olson
- Department of Neurosurgery, Emory University School of Medicine, Atlanta, GA, USA
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Gasinska A, Skolyszewski J, Glinski B, Niemiec J, Adamczyk A, Krzyszkowski T, Zabek M. Age and bromodeoxyuridine labelling index as prognostic factors in high-grade gliomas treated with surgery and radiotherapy. Clin Oncol (R Coll Radiol) 2006; 18:459-65. [PMID: 16909969 DOI: 10.1016/j.clon.2006.02.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
AIMS To determine the prognostic value of proliferative potential and DNA ploidy in 72 brain tumours (36 grade III and 36 grade IV astrocytomas) using bromodeoxyuridine (BrdUrd) incorporation and flow cytometry. MATERIAL AND METHODS All 72 patients underwent excision, mostly incomplete of the tumour. After surgery, eight patients received conventionally fractionated radiotherapy, 11 patients received accelerated radiotherapy, and 53 patients received hypofractionated radiotherapy. Tumour samples taken during surgery from each patient were incubated in vitro for 1 h at 37 degrees C with BrdUrd using the high pressure oxygen method. The percentage of BrdUrd-labelled cells (BrdUrd labelling index [BrdUrd LI]), and the total DNA content were evaluated: RESULTS The tumours showed variability in the BrdUrd LI values, which ranged from 0.3 to 19.1%. No difference was observed in mean BrdUrd LI between grade III and grade IV sub-groups. A significantly higher percentage of DNA aneuploidy was observed in grade III gliomas (69.4%) than in grade IV gliomas (52.8%). Univariate analysis showed that younger patients (< or = 51 years) (P = 0.021) with grade III gliomas (P = 0.030) and low tumour proliferation rate (BrdUrd LI < or = 2.7%, P = 0.028) had significantly higher 5-year survival rates. Tumour ploidy had no influence on patients' survival (P = 0.591). However, Cox multi-variate analysis showed that only age over 51 years, and high tumour proliferation rate (BrdUrd LI > 2.7%), were significant unfavourable prognostic factors in patient survival. CONCLUSION In this study, independent prognostic factors for patients with high-grade gliomas treated with surgery and post-operative radiotherapy are age and tumour proliferation rate assessed according to the BrdUrd LI.
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Affiliation(s)
- A Gasinska
- Department of Applied Radiobiology, Centre of Oncology, Garncarska, Krakow, Poland.
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Sarkar C, Karak AK, Nath N, Sharma MC, Mahapatra AK, Chattopadhyay P, Sinha S. Apoptosis and proliferation: correlation with p53 in astrocytic tumours. J Neurooncol 2005; 73:93-100. [PMID: 15981097 DOI: 10.1007/s11060-004-3015-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Apoptosis and cell proliferation occur simultaneously in tumour tissue with tumour suppressor gene, p53 being one of the key players in the complex relationship between these two key phenomena. We, as well as several other groups, have earlier demonstrated the association of p53 immunopositivity with increased degree of cell proliferation in astrocytic tumours. Here we have studied the extent of apoptosis in 62 primary human astrocytic tumours [25 Diffuse Astrocytoma (DA), 9 Anaplastic Astrocytoma (AA) and 28 Glioblastoma multiforme (GBM)] in relation to tumour grade, proliferative status and p53 protein expression. Apoptosis was measured by the TUNEL assay while, cell proliferation (MIB-1 index) and p53 protein immunoreactivity were evaluated by immunohistochemical staining using MIB-1 and DO-1 monoclonal antibodies respectively. The apoptotic index (AI) was greater in GBM than in AA or DA, and more in tumours with p53 immunopositivity than in those without. The most striking observation was the strong correlation between Apoptotic index (AI) and proliferation index (PI) in p53 negative GBM (r=0.766, P < 0.005). However this was not observed in p53 +ve GBM or in low grade DA either p53 positive or negative. Taking p53 negativity in IHC as evidence of a functional gene/protein, this extends the link between proliferation and apoptosis, hitherto observed only in cultured cells with functional p53, to a subset of solid tumours.
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Affiliation(s)
- Chitra Sarkar
- Department of Pathology, All India Institute of Medical Sciences, Ansari Nagar, 110029, New Delhi, India.
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Gasińska A, Skołyszewski J, Gliński B, Niemiec J, Adamczyk A, Krzyszkowski T. Prognostic significance of proliferation rate and DNA ploidy in astrocytic gliomas treated with radiotherapy. Rep Pract Oncol Radiother 2005. [DOI: 10.1016/s1507-1367(05)71095-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Beppu T, Inoue T, Shibata Y, Yamada N, Kurose A, Ogasawara K, Ogawa A, Kabasawa H. Fractional anisotropy value by diffusion tensor magnetic resonance imaging as a predictor of cell density and proliferation activity of glioblastomas. ACTA ACUST UNITED AC 2005; 63:56-61; discussion 61. [PMID: 15639528 DOI: 10.1016/j.surneu.2004.02.034] [Citation(s) in RCA: 133] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2003] [Accepted: 02/12/2004] [Indexed: 11/17/2022]
Abstract
BACKGROUND In vivo, water diffusion displays directionality due to presence of complex microstructural barriers in tissue. The extent of directionality of water diffusion can be expressed as a fractional anisotropy (FA) value using diffusion tensor magnetic resonance imaging (DTI). The FA value has been suggested as an indicator of the cell density of astrocytic tumors. The aim of the present study was to confirm beyond doubt that FA values indicate cell density even when limited in glioblastomas and to determine whether the FA value of a given patient predicts proliferation activity in the individual glioblastoma. METHODS We performed DTI in 19 patients with glioblastoma and measured the FA values of tumor and normal brain regions prior to computed tomography-guided stereotactic biopsy. Differences in mean FA value between normal brain regions and glioblastoma lesion were compared. Cell density and MIB-1 indices were examined using tumor specimens obtained from biopsies. Correlation among FA values, cell density, and MIB-1 indices was also evaluated. RESULTS The mean FA value significantly differed between normal brain regions and glioblastoma lesions. Positive correlation was observed between FA value and cell density (r = 0.73, P < 0.05) and between FA value and MIB-1 index (r = 0.80, P < 0.05). CONCLUSIONS Our results suggest that the FA value of glioblastoma as determined by DTI prior to surgery is a good predictor of cell density and, consequently, proliferation activity.
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Affiliation(s)
- Takaaki Beppu
- Department of Neurosurgery, Iwate Medicl university, Morioka 020-8505, Japan.
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Palfi S, Swanson KR, de Boüard S, Chrétien F, Oliveira R, Gherardi RK, Kros JM, Peschanski M, Christov C. Correlation of in vitro infiltration with glioma histological type in organotypic brain slices. Br J Cancer 2004; 91:745-52. [PMID: 15292940 PMCID: PMC2364801 DOI: 10.1038/sj.bjc.6602048] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Diffuse invasion of the brain, an intrinsic property of gliomas, renders these tumours incurable, and is a principal determinant of their spatial and temporal growth. Knowledge of the invasive potential of gliomas is highly desired in order to understand their behaviour in vivo. Comprehensive ex vivo invasion studies including tumours of different histological types and grades are however lacking, mostly because reliable physiological invasion assays have been difficult to establish. Using an organotypic rodent brain slice assay, we evaluated the invasiveness of 42 grade II–IV glioma biopsy specimens, and correlated it with the histological phenotype, the absence or presence of deletions on chromosomes 1p and 19q assessed by fluorescent in situ hybridisation, and proliferation and apoptosis indices assessed by immunocytochemistry. Oligodendroglial tumours with 1p/19q loss were less invasive than astrocytic tumours of similar tumour grade. Correlation analysis of invasiveness cell proliferation and apoptosis further suggested that grade II–III oligodendroglial tumours with 1p/19q loss grow in situ as relatively circumscribed compact masses in contrast to the more infiltrative and more diffuse astrocytomas. Lower invasiveness may be an important characteristic of oligodendroglial tumours, adding to our understanding of their more indolent clinical evolution and responsiveness to therapy.
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Affiliation(s)
- S Palfi
- INSERM Unité 421, IM3, Faculté de Médecine, 94010 Créteil, France
- Service de Neurochirurgie, Hôpital Henri Mondor, 94010 Créteil, France
| | - K R Swanson
- Departments of Pathology and Applied Mathematics, University of Washington and Laboratory of Neuropathology, Harborview Medical Center, Seattle, Washington 98104-2499, USA
| | - S de Boüard
- INSERM Unité 421, IM3, Faculté de Médecine, 94010 Créteil, France
| | - F Chrétien
- Service de Neuropathologie, Hôpital Henri Mondor, 94010Créteil, France
- INSERM EMI 00.11, IM3, Faculté de Médecine, 94010 Créteil, France
| | - R Oliveira
- INSERM Unité 421, IM3, Faculté de Médecine, 94010 Créteil, France
| | - R K Gherardi
- Service de Neuropathologie, Hôpital Henri Mondor, 94010Créteil, France
- INSERM EMI 00.11, IM3, Faculté de Médecine, 94010 Créteil, France
| | - J M Kros
- Departments of Pathology and Neuro-Oncology, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands
| | - M Peschanski
- INSERM Unité 421, IM3, Faculté de Médecine, 94010 Créteil, France
| | - C Christov
- INSERM Unité 421, IM3, Faculté de Médecine, 94010 Créteil, France
- Service de Neuropathologie, Hôpital Henri Mondor, 94010Créteil, France
- INSERM Unité 421, IM3, Faculté de Médecine, 8 rue du Général Sarrail, 94010 Créteil, France. E-mail:
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