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Mak G, Menon S, Lu JQ. Neurofilaments in neurologic disorders and beyond. J Neurol Sci 2022; 441:120380. [PMID: 36027641 DOI: 10.1016/j.jns.2022.120380] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 08/07/2022] [Accepted: 08/10/2022] [Indexed: 11/17/2022]
Abstract
Many neurologic diseases can initially present as a diagnostic challenge and even when a diagnosis is made, monitoring of disease activity, progression and response to therapy may be limited with existing clinical and paraclinical assessments. As such, the identification of disease specific biomarkers provides a promising avenue by which diseases can be effectively diagnosed, monitored and used as a prognostic indicator for long-term outcomes. Neurofilaments are an integral component of the neuronal cytoskeleton, where assessment of neurofilaments in the blood, cerebrospinal fluid (CSF) and diseased tissue has been shown to have value in providing diagnostic clarity, monitoring disease activity, tracking progression and treatment efficacy, as well as lending prognostic insight into long-term outcomes. As such, this review attempts to provide a glimpse into the structure and function of neurofilaments, their role in various neurologic and non-neurologic disorders, including uncommon conditions with recent knowledge of neurofilament-related pathology, as well as their applicability in future clinical practice.
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Affiliation(s)
- Gloria Mak
- McMaster University, Department of Medicine, Hamilton, Ontario, Canada
| | - Suresh Menon
- McMaster University, Department of Medicine, Hamilton, Ontario, Canada
| | - Jian-Qiang Lu
- McMaster University, Department of Pathology and Molecular Medicine, Hamilton, Ontario, Canada.
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2
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Rong T, Zou W, Qiu X, Cui W, Zhang D, Wu B, Kang Z, Li W, Liu B. A Rare Manifestation of a Presumed Non-Osteophilic Brain Neoplasm: Extensive Axial Skeletal Metastases From Glioblastoma With Primitive Neuronal Components. Front Oncol 2021; 11:760697. [PMID: 34796114 PMCID: PMC8593252 DOI: 10.3389/fonc.2021.760697] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 10/04/2021] [Indexed: 11/13/2022] Open
Abstract
Background Glioblastoma multiforme (GBM) is the most common malignant tumor of the central nervous system. GBM with primitive neuronal component (GBM-PNC) is an aggressive variant identified in 0.5% of GBMs. Extracranial metastasis from GBM-PNC is a rare and challenging situation. Methods A special case of early-onset GBM with systemic bone metastasis was enrolled. Clinical data, including patient characteristics, disease course, and serial radiological images were retrieved and analyzed. Tumor tissues were obtained by surgical resections and were made into formalin-fixed paraffin-embedded sections. Histopathological examinations and genetic testing were performed for both the primary and metastatic tumor specimens. Results A 20-year-old man suffered from GBM with acute intratumoral hemorrhage of the left temporal lobe. He was treated by gross total resection and chemoradiotherapy following the Stupp protocol. Seven months later, he returned with a five-week history of progressive neck pain and unsteady gait. The radiographic examinations identified vertebral collapse at C4 and C6. Similar osteolytic lesions were also observed at the thoracolumbar spine, pelvic, and left femur. Anterior spondylectomy of C4 and C6 was performed. The resected vertebral bodies were infiltrated with greyish, soft, and ill-defined tumor tissue. One month later, he developed mechanical low-back pain and paraplegia caused by thoracolumbar metastases. Another spine surgery was performed, including T10 total en-bloc spondylectomy, T7-9, L2-3, and L5-S1 laminectomy. After the operation, the patient’s neurological function and spinal stability remained stable. However, he finally succumbed to the rapidly increased tumor burden and died 15 months from onset because of cachexia and multiple organ failure. In addition to typical GBM morphology, the histological examinations identified monomorphic small-round cells with positive immunohistochemical staining of synaptophysin and CD99, indicating the coexistence of PNC. The next-generation sequencing detected pathogenic mutations in TP53 and DNMT3A. Based on above findings, a confirmed diagnosis of systemic metastases from GBM-PNC (IDH-wild type, WHO grade IV) was made. Conclusions The present case highlights the occurrence and severity of extensive axial skeletal metastases from GBM-PNC. This rare variant of GBM requires aggressive multimodal treatment including surgery and chemoradiotherapy targeting PNC. The pathological screening of PNC is recommended in patients with early-onset GBM and intratumoral hemorrhage. Surgery for spinal metastasis is appropriate in patients with chemoradioresistance and relatively good general status, with the objectives of restoring spinal stability and relieving spinal cord compression.
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Affiliation(s)
- Tianhua Rong
- Department of Orthopaedic Surgery, Spine Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,National Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation, Beijing, China.,Basic and Translational Medicine Center, China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Wanjing Zou
- Department of Neuropathology, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
| | - Xiaoguang Qiu
- Department of Radiation Oncology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Wei Cui
- Department of Orthopaedic Surgery, Spine Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,National Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation, Beijing, China
| | - Duo Zhang
- Department of Orthopaedic Surgery, Spine Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,National Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation, Beijing, China
| | - Bingxuan Wu
- Department of Orthopaedic Surgery, Spine Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,National Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation, Beijing, China.,Basic and Translational Medicine Center, China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Zhuang Kang
- Department of Neuro-Oncology, Cancer Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Wenbin Li
- Department of Neuro-Oncology, Cancer Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Baoge Liu
- Department of Orthopaedic Surgery, Spine Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,National Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation, Beijing, China.,Basic and Translational Medicine Center, China National Clinical Research Center for Neurological Diseases, Beijing, China
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3
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Glioblastoma with a primitive neuroectodermal component: two cases with implications for glioblastoma cell-of-origin. Clin Imaging 2020; 73:139-145. [PMID: 33406475 DOI: 10.1016/j.clinimag.2020.10.041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 09/22/2020] [Accepted: 10/17/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND Glioblastoma (GBM) is the most common primary brain malignancy, but much remains unknown about the histogenesis of these tumors. In the great majority of cases, GBM is a purely glial tumor but in rare cases the classic-appearing high-grade glioma component is admixed with regions of small round blue cells with neuronal immunophenotype, and these tumors have been defined in the WHO 2016 Classification as "glioblastoma with a primitive neuronal component." METHODS In this paper, we present two cases of GBM-PNC with highly divergent clinical courses, and review current theories for the GBM cell-of-origin. RESULTS AND CONCLUSIONS GBM-PNC likely arises from a cell type competent to give rise to glial or neuronal lineages. The thesis that GBM recapitulates to some extent normal neurodevelopmental cellular pathways is supported by molecular and clinical features of our two cases of GBM-PNC, but more work is needed to determine which cellular precursor gives rise to specific cases of GBM. GBM-PNC may have a dramatically altered clinical course compared to standard GBM and may benefit from specific lines of treatment.
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4
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Shayganfar A, Ebrahimian S, Mahzouni P, Shirani F, Aalinezhad M. A review of glioblastoma tumors with primitive neuronal component and a case report of a patient with this uncommon tumor at a rare location. Clin Case Rep 2020; 8:2600-2604. [PMID: 33363787 PMCID: PMC7752627 DOI: 10.1002/ccr3.3228] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 06/10/2020] [Accepted: 07/17/2020] [Indexed: 11/15/2022] Open
Abstract
Glioblastoma with primitive neuronal component should be considered as a differential diagnosis of infratentorial tumors.
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Affiliation(s)
- Azin Shayganfar
- Department of RadiologyIsfahan University of Medical SciencesIsfahanIran
| | - Shadi Ebrahimian
- Department of RadiologyIsfahan University of Medical SciencesIsfahanIran
| | - Parvin Mahzouni
- Department of PathologyIsfahan University of Medical SciencesIsfahanIran
| | - Fattane Shirani
- Department of RadiologyIsfahan University of Medical SciencesIsfahanIran
| | - Marzieh Aalinezhad
- Department of RadiologyIsfahan University of Medical SciencesIsfahanIran
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Rabadán R, Mohamedi Y, Rubin U, Chu T, Alghalith AN, Elliott O, Arnés L, Cal S, Obaya ÁJ, Levine AJ, Cámara PG. Identification of relevant genetic alterations in cancer using topological data analysis. Nat Commun 2020; 11:3808. [PMID: 32732999 PMCID: PMC7393176 DOI: 10.1038/s41467-020-17659-7] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Accepted: 07/09/2020] [Indexed: 01/05/2023] Open
Abstract
Large-scale cancer genomic studies enable the systematic identification of mutations that lead to the genesis and progression of tumors, uncovering the underlying molecular mechanisms and potential therapies. While some such mutations are recurrently found in many tumors, many others exist solely within a few samples, precluding detection by conventional recurrence-based statistical approaches. Integrated analysis of somatic mutations and RNA expression data across 12 tumor types reveals that mutations of cancer genes are usually accompanied by substantial changes in expression. We use topological data analysis to leverage this observation and uncover 38 elusive candidate cancer-associated genes, including inactivating mutations of the metalloproteinase ADAMTS12 in lung adenocarcinoma. We show that ADAMTS12-/- mice have a five-fold increase in the susceptibility to develop lung tumors, confirming the role of ADAMTS12 as a tumor suppressor gene. Our results demonstrate that data integration through topological techniques can increase our ability to identify previously unreported cancer-related alterations.
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Affiliation(s)
- Raúl Rabadán
- Departments of Systems Biology and Biomedical Informatics, Columbia University, 1130 St. Nicholas Ave., New York, NY, 10032, USA.
| | - Yamina Mohamedi
- Departamento de Bioquimica y Biologia Molecular, Universidad de Oviedo, Oviedo, Asturias, Spain
- IUOPA, Instituto Universitario de Oncologia, Oviedo, Asturias, Spain
| | - Udi Rubin
- Departments of Systems Biology and Biomedical Informatics, Columbia University, 1130 St. Nicholas Ave., New York, NY, 10032, USA
- Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY, 10065, USA
| | - Tim Chu
- Departments of Systems Biology and Biomedical Informatics, Columbia University, 1130 St. Nicholas Ave., New York, NY, 10032, USA
| | - Adam N Alghalith
- Department of Genetics and Institute for Biomedical Informatics, Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Blvd., Philadelphia, PA, 19104, USA
| | - Oliver Elliott
- Departments of Systems Biology and Biomedical Informatics, Columbia University, 1130 St. Nicholas Ave., New York, NY, 10032, USA
| | - Luis Arnés
- Departments of Systems Biology and Biomedical Informatics, Columbia University, 1130 St. Nicholas Ave., New York, NY, 10032, USA
| | - Santiago Cal
- Departamento de Bioquimica y Biologia Molecular, Universidad de Oviedo, Oviedo, Asturias, Spain
- IUOPA, Instituto Universitario de Oncologia, Oviedo, Asturias, Spain
| | - Álvaro J Obaya
- IUOPA, Instituto Universitario de Oncologia, Oviedo, Asturias, Spain
- Departamento de Biologia Funcional, Universidad de Oviedo, Oviedo, Asturias, Spain
| | - Arnold J Levine
- The Simons Center for Systems Biology, Institute for Advanced Study, Princeton, NJ, 08540, USA.
| | - Pablo G Cámara
- Department of Genetics and Institute for Biomedical Informatics, Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Blvd., Philadelphia, PA, 19104, USA.
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Orman G, Mohammed S, Tran HDB, Lin FY, Meoded A, Desai N, Huisman TAGM, Kralik SF. Neuroimaging Appearance of Cerebral Malignant Epithelioid Glioneuronal Tumors in Children. AJNR Am J Neuroradiol 2020; 41:1740-1744. [PMID: 32675339 DOI: 10.3174/ajnr.a6668] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 05/28/2020] [Indexed: 11/07/2022]
Abstract
Malignant epithelioid glioneuronal tumor is a rare high-grade, aggressive brain tumor that shows both glial and neuronal differentiation on histopathology but is not included in the current World Health Organization classification. The neuroimaging appearance is variable but may be secondary to the size of the mass and/or location of the tumor. In our series, all epithelioid glioneuronal tumors were encountered in the supratentorial space and included pineal, temporal, and extratemporal lobar cerebral hemisphere locations. When large, the tumors demonstrate cystic degeneration and necrosis, hemorrhage, contrast enhancement, and regions of low apparent diffusion coefficient scalars consistent with patterns seen with other high-grade pediatric brain tumors. The tumors also have a propensity to spread into the meninges at presentation and for distant CSF spread on follow-up imaging.
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Affiliation(s)
- G Orman
- From the Edward B. Singleton Department of Radiology (G.O., S.M., H.D.B.T., A.M., N.D., T.A.G.M.H., S.F.K.)
| | - S Mohammed
- From the Edward B. Singleton Department of Radiology (G.O., S.M., H.D.B.T., A.M., N.D., T.A.G.M.H., S.F.K.)
| | - H D B Tran
- From the Edward B. Singleton Department of Radiology (G.O., S.M., H.D.B.T., A.M., N.D., T.A.G.M.H., S.F.K.)
| | - F Y Lin
- Department of Oncology (F.Y.L.), Texas Children's Hospital and Baylor College of Medicine, Houston, Texas
| | - A Meoded
- From the Edward B. Singleton Department of Radiology (G.O., S.M., H.D.B.T., A.M., N.D., T.A.G.M.H., S.F.K.)
| | - N Desai
- From the Edward B. Singleton Department of Radiology (G.O., S.M., H.D.B.T., A.M., N.D., T.A.G.M.H., S.F.K.)
| | - T A G M Huisman
- From the Edward B. Singleton Department of Radiology (G.O., S.M., H.D.B.T., A.M., N.D., T.A.G.M.H., S.F.K.)
| | - S F Kralik
- From the Edward B. Singleton Department of Radiology (G.O., S.M., H.D.B.T., A.M., N.D., T.A.G.M.H., S.F.K.)
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7
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Sánchez-Ortega JF, Aguas-Valiente J, Sota-Ochoa P, Calatayud-Pérez J. Glioblastoma with primitive neuronal component: A case report and considerations of fluorescence-guided surgery. Surg Neurol Int 2020; 11:178. [PMID: 32754353 PMCID: PMC7395537 DOI: 10.25259/sni_272_2020] [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: 05/13/2020] [Accepted: 06/14/2020] [Indexed: 11/23/2022] Open
Abstract
Background: Glioblastoma with primitive neuronal components (GB/PNC) is an extremely rare type of glioblastoma characterized by presenting histological and cytogenetic features of both entities. The mixed nature of these tumors limits the imaging diagnosis and supposes a therapeutic dilemma. Case Description: We present the case of a 77-year-old female with a GB/PNC who is treated with surgery and adjuvant radiochemotherapy according to the STUPP protocol, where an abnormal uptake of 5-aminolevulinic acid (5-ALA) is evident during surgery in probable relation to the mixed nature of GB/PNC. Conclusion: GB/PNC is extremely rare tumors. Given its low prevalence, there are no studies that refer to the macroscopic characteristics of the tumor as well as evidence of the effectiveness of adjuvant treatment. Fluorescence-guided resection with 5-ALA is the surgical treatment of choice in surgery for high-grade gliomas; however, in GB/PNC, it may not be as useful since PNC may have less fluorescent marker uptake and be more dimly visualized when excited by light using the surgical microscope.
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Affiliation(s)
| | - Jesús Aguas-Valiente
- Departments of Neurosurgery, Lozano Blesa University Clinical Hospital, Av. San Juan Bosco, nº 15, Zaragoza, Spain
| | - Patricia Sota-Ochoa
- Departments of Pathology, Lozano Blesa University Clinical Hospital, Av. San Juan Bosco, nº 15, Zaragoza, Spain
| | - Juan Calatayud-Pérez
- Departments of Neurosurgery, Lozano Blesa University Clinical Hospital, Av. San Juan Bosco, nº 15, Zaragoza, Spain
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Glioblastoma with Both Oligodendroglioma and Primitive Neuroectodermal Tumor-Like Components in a Case with 9-Year Survival. Case Rep Surg 2018; 2018:1382680. [PMID: 29992076 PMCID: PMC6016224 DOI: 10.1155/2018/1382680] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 05/23/2018] [Indexed: 01/25/2023] Open
Abstract
Introduction Glioblastoma multiforme (GBM), the most common primary malignant brain tumor in adults, is characterized by extensive heterogeneity in its clinicopathological presentation. A primary brain tumor with both astrocytic differentiation and neuronal immunophenotype features is rare. Here, we report a long-term survival patient who presented this rare form of GBM in the disease course. Presentation of Case A 23-year-old woman, presenting with rapidly progressive headache and right-side weakness, was diagnosed with brain tumor over the left basal ganglion. She underwent the first craniectomy for tumor removal, and histopathology revealed classic GBM. Tumor recurrence occurred 8 years later. Another gross total resection was performed and pathology revealed GBM with the oligodendroglioma component (GBM-O). Due to disease progression, she received debulking surgery the following year. The third pathology revealed glioblastoma with primitive neuroectodermal tumor-like component (GBM-PNET). Discussion GBM-PNETs are collision tumors with both neuronal and glial components. They are rare, and a few case reports have suggested that these tumors are associated with favorable outcomes but a higher risk of cerebrospinal fluid dissemination. Conclusion We report a patient who developed the distinct pathologic variants of classic GBM, GBM-O, and GBM-PNET, throughout the disease course. Young age, aggressive surgical resection, and pathologic and genetic features may have contributed to the long-term survival of the patient.
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Prelaj A, Rebuzzi SE, Caffarena G, Giròn Berrìos JR, Pecorari S, Fusto C, Caporlingua A, Caporlingua F, Di Palma A, Magliocca FM, Salvati M, Tomao S, Bianco V. Therapeutic approach in glioblastoma multiforme with primitive neuroectodermal tumor components: Case report and review of the literature. Oncol Lett 2018; 15:6641-6647. [PMID: 29616127 DOI: 10.3892/ol.2018.8102] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2017] [Accepted: 01/16/2018] [Indexed: 01/05/2023] Open
Abstract
Glioblastoma multiforme (GBM) is the most common and aggressive malignant glioma that is treated with first-line therapy, using surgical resection followed by local radiotherapy and concomitant/adjuvant temozolomide (TMZ) treatment. GBM is characterised by a high local recurrence rate and a low response to therapy. Primitive neuroectodermal tumour (PNET) of the brain revealed a low local recurrence rate; however, it also exhibited a high risk of cerebrospinal fluid (CSF) dissemination. PNET is treated with surgery followed by craniospinal irradiation (CSI) and platinum-based chemotherapy in order to prevent CSF dissemination. GBM with PNET-like components (GBM/PNET) is an emerging variant of GBM, characterised by a PNET-like clinical behaviour with an increased risk of CSF dissemination; it also may benefit from platinum-based chemotherapy upfront or following failure of GBM therapy. The results presented regarding the management of GBM/PNET are based on case reports or case series, so a standard therapeutic approach for GBM/PNET is not defined, constituing a challenging diagnostic and therapeutic dilemma. In this report, a case of a recurrent GBM/PNET treated with surgical resection and radiochemotherapy as Stupp protocol, and successive platinum-based chemotherapy due to the development of leptomeningeal dissemintation and an extracranial metastasis, is discussed. A review of the main papers regarding this rare GBM variant and its therapeutic approach are also reported. In conclusion, GBM/PNET should be treated with a multimodal approach including surgery, chemoradiotherapy, and/or the early introduction of CSI and platinum-based chemotherapy upfront or at recurrence.
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Affiliation(s)
- Arsela Prelaj
- Department of Medical Oncology Unit A, Policlinico Umberto I, 'Sapienza' University of Rome, I-00161 Rome, Italy
| | - Sara Elena Rebuzzi
- Department of Medical Oncology Unit 1, IRCCS AOU San Martino-IST, I-16132 Genoa, Italy
| | - Giovanni Caffarena
- Department of Neurosurgery, IRCCS AOU San Martino-IST, I-16132 Genoa, Italy
| | - Julio Rodrigo Giròn Berrìos
- Department of Medical Oncology Unit A, Policlinico Umberto I, 'Sapienza' University of Rome, I-00161 Rome, Italy
| | - Silvia Pecorari
- Department of Medical Oncology Unit A, Policlinico Umberto I, 'Sapienza' University of Rome, I-00161 Rome, Italy
| | - Carmela Fusto
- Department of Medical Oncology Unit A, Policlinico Umberto I, 'Sapienza' University of Rome, I-00161 Rome, Italy
| | - Alessandro Caporlingua
- Department of Neurology and Psychiatry, Neurosurgery, Policlinico Umberto I, 'Sapienza' University of Rome, I-00161 Rome, Italy
| | - Federico Caporlingua
- Department of Neurology and Psychiatry, Neurosurgery, Policlinico Umberto I, 'Sapienza' University of Rome, I-00161 Rome, Italy
| | - Annamaria Di Palma
- Department of Radiotherapy, San Pietro Hospital, Fatebenefratelli, I-00189 Rome, Italy
| | - Fabio Massimo Magliocca
- Department of Gynecology, Obstetrics and Urology, Umberto I, 'Sapienza' University of Rome, I-00161 Rome, Italy
| | - Maurizio Salvati
- Department of Neurosurgery, IRCCS Neuromed, I-86077 Pozzilli, Italy
| | - Silverio Tomao
- Department of Radiological Sciences, Oncology and Pathology, 'Sapienza' University of Rome, I-04100 Latina, Italy
| | - Vincenzo Bianco
- Department of Medical Oncology Unit A, Policlinico Umberto I, 'Sapienza' University of Rome, I-00161 Rome, Italy
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10
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Bouali S, Maatar N, Zehani A, Mahmoud M, Kallel J, Jemel H. A case of adult anaplastic cerebellar ganglioglioma. Surg Neurol Int 2018. [PMID: 29527389 PMCID: PMC5838827 DOI: 10.4103/sni.sni_295_17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Anaplastic posterior fossa ganglioglioma in adults is exceedingly rare. To date, only one case of adult anaplastic posterior fossa ganglioglioma has been reported in the English literature and none has been described at the cerebellum. To our knowledge, this report is the third case of malignant posterior fossa ganglioglioma in adults and the first at the cerebellum. In general, this entity can be misdiagnosed preoperatively as a primary posterior fossa neoplasm, and by reporting our clinical and radiographic observations we want to add to the existing literature on this rare entity. Case Description: A 40-year-old man presented with a history of headaches and dizziness and progressive gait disturbance and was diagnosed with anaplastic ganglioglioma in the posterior fossa. Conclusions: Although rare, our case demonstrates that anaplastic ganglioglioma should be considered in the differential diagnosis of infratentorial tumors in adult patients.
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Affiliation(s)
- Sofiene Bouali
- Department of Neurosurgery, National Institute of Neurology Tunis, Tunisia Faculty of Medicine, University of Tunis el MANAR, Tunisia
| | - Nidhal Maatar
- Department of Neurosurgery, National Institute of Neurology Tunis, Tunisia Faculty of Medicine, University of Tunis el MANAR, Tunisia
| | - Alia Zehani
- Department of Histopathology, la Rabta, Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia
| | - Maha Mahmoud
- Department of Neuroradiology, National Institute of Neurology Tunis, Tunisia Faculty of Medicine, University of Tunis el MANAR, Tunisia
| | - Jalel Kallel
- Department of Neurosurgery, National Institute of Neurology Tunis, Tunisia Faculty of Medicine, University of Tunis el MANAR, Tunisia
| | - Hafedh Jemel
- Department of Neurosurgery, National Institute of Neurology Tunis, Tunisia Faculty of Medicine, University of Tunis el MANAR, Tunisia
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11
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Hashemi F, Naderian M, Kadivar M, Nilipour Y, Gheytanchi E. Expression of neuronal markers, NFP and GFAP, in malignant astrocytoma. Asian Pac J Cancer Prev 2017; 15:6315-9. [PMID: 25124617 DOI: 10.7314/apjcp.2014.15.15.6315] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Immunohistochemical markers are considered as important factors in diagnosis of malignant astrocytomas. The aim of the current study was to investigate the frequency of the immunohistochemical markers neurofilament protein (NFP) and glial fibrillary acidic protein (GFAP) in malignant astrocytoma tumors in Firoozgar and Rasool-Akram hospitals from 2005 to 2010. MATERIALS AND METHODS In this cross-sectional study, immunohistochemical analysis of NFP and GFAP was performed on 79 tissue samples of patients with the diagnosis of anaplastic and glioblastoma multiform (GBM) astrocytomas. RESULTS The obtained results demonstrated that all patients were positive for GFAP and only 3.8% were positive for NFP. There was no significant association between these markers and clinical, demographic, and prognostic features of patients (p>0.05). CONCLUSIONS NFP was expressed only in GBMs and not in anaplastic astrocytomas. It would be crucial to confirm the present findings in a larger number of tumors, especially in high grade gliomas.
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Affiliation(s)
- Forough Hashemi
- Department of Pathology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran E-mail :
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12
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LaBuzetta JN, Mordes D, Arrillaga I, Chi A, Dietrich J. A 34-Year-Old Male with An Intracranial Mass. Brain Pathol 2016; 26:289-90. [PMID: 27000488 DOI: 10.1111/bpa.12358] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Affiliation(s)
| | - Daniel Mordes
- Departments of Pathology, Massachusetts General Hospital, Boston, MA
| | - Isabel Arrillaga
- Departments of Neurology, Massachusetts General Hospital, Boston, MA
| | - Andrew Chi
- Departments of Neurology, Massachusetts General Hospital, Boston, MA
| | - Jorg Dietrich
- Departments of Neurology, Massachusetts General Hospital, Boston, MA
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13
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Kim HR, Lee JJ, Lee JI, Nam DH, Suh YL, Seol HJ. Malignant Glioma with Neuronal Marker Expression : A Clinicopathological Study of 18 Cases. J Korean Neurosurg Soc 2016; 59:44-51. [PMID: 26885285 PMCID: PMC4754586 DOI: 10.3340/jkns.2016.59.1.44] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Revised: 11/24/2015] [Accepted: 12/18/2015] [Indexed: 11/27/2022] Open
Abstract
Objective Malignant gliomas with neuronal marker expression (MGwNM) are rare and poorly characterized. Increasingly diverse types of MGwNM have been described and these reported cases underscore the dilemmas in the classification and diagnosis of those tumors. The aim of this study is to provide additional insights into MGwNM and present the clinicopathological features of 18 patients. Methods We reviewed the medical records of 18 patients diagnosed as MGwNM at our institute between January 2006 and December 2012. Macroscopic total resection was performed in 11 patients (61%). We evaluated the methylation status of O6-methylguanine-DNA methyltransferase (MGMT) and expression of isocitrate dehydrogenase 1 (IDH-1) in all cases, and deletions of 1p and 19q in available cases. Results The estimated median overall survival was 21.2 months. The median progression-free survival was 6.3 months. Six patients (33%) had MGMT methylation but IDH1 mutation was found in only one patient (6%). Gene analysis for 1p19q performed in nine patients revealed no deletion in six, 19q deletion only in two, and 1p deletion only in one. The extent of resection was significantly correlated with progression free survival on both univariate analysis and multivariate analysis (p=0.002 and p=0.013, respectively). Conclusion In this study, the overall survival of MGwNM was not superior to glioblastoma. The extent of resection has a significant prognostic impact on progression-free survival. Further studies of the prognostic factors related to chemo-radio therapy, similar to studies with glioblastoma, are mandatory to improve survival.
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Affiliation(s)
- Hong Rye Kim
- Department of Neurosurgery, Konyang University Hospital, Konyang University School of Medicine, Daejeon, Korea
| | - Jae Jun Lee
- Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jung-Il Lee
- Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Do Hyun Nam
- Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yeon-Lim Suh
- Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ho Jun Seol
- Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Lucas JT, Huang AJ, Mott RT, Lesser GJ, Tatter SB, Chan MD. Anaplastic ganglioglioma: a report of three cases and review of the literature. J Neurooncol 2015; 123:171-7. [PMID: 25862009 DOI: 10.1007/s11060-015-1781-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Accepted: 04/05/2015] [Indexed: 01/22/2023]
Abstract
Gangliogliomas are rare tumors of the central nervous system that are thought to arise from a glioneuronal precursor and consist of both neuronal and glial elements. Grade III, or anaplastic ganglioglioma (AGG), most commonly affects children and young adults, generally arises in a supratentorial location, is highly epileptogenic, and often results in diffuse local and distant failure within the craniospinal axis. Pathologically, these tumors are graded by the degree of malignancy in their glial portion and radiologic diagnosis is difficult due to the wide variation in its degree of solid and cystic components, contrast uptake, and calcification patterns. This report presents three cases of AGG, with initial treatment including subtotal resection followed by conformal radiotherapy. In the case where the AGG developed in the setting of an existent low-grade astrocytoma, the patient received no chemotherapy. Both of the other de novo cases were managed with adjuvant chemoradiotherapy with temozolomide. Recurrence occurred at 6, 16, and 20 months following therapy. Two of the three patients experienced symptomatic decline at recurrence, but experienced Karnofsky performance status (KPS) improvement after salvage therapy, including the reduction of cranial neuropathy and balance. All patients had a significant reduction in presenting symptoms following salvage therapy. Patients died at 23, 20, and 22 months following initial surgical management, respectively. A review of anaplastic and malignant gangliogliomas is presented in the context of these three cases.
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Affiliation(s)
- John Thomas Lucas
- Department of Radiation Oncology, Wake Forest School of Medicine, Winston-Salem, NC, USA,
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15
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16
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Conroy S, Kruyt FAE, Joseph JV, Balasubramaniyan V, Bhat KP, Wagemakers M, Enting RH, Walenkamp AME, den Dunnen WFA. Subclassification of newly diagnosed glioblastomas through an immunohistochemical approach. PLoS One 2014; 9:e115687. [PMID: 25546404 PMCID: PMC4278713 DOI: 10.1371/journal.pone.0115687] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Accepted: 11/26/2014] [Indexed: 01/26/2023] Open
Abstract
Molecular signatures in Glioblastoma (GBM) have been described that correlate with clinical outcome and response to therapy. The Proneural (PN) and Mesenchymal (MES) signatures have been identified most consistently, but others including Classical (CLAS) have also been reported. The molecular signatures have been detected by array techniques at RNA and DNA level, but these methods are costly and cannot take into account individual contributions of different cells within a tumor. Therefore, the aim of this study was to investigate whether subclasses of newly diagnosed GBMs could be assessed and assigned by application of standard pathology laboratory procedures. 123 newly diagnosed GBMs were analyzed for the tumor cell expression of 23 pre-identified proteins and EGFR amplification, together allowing for the subclassification of 65% of the tumors. Immunohistochemistry (IHC)-based profiling was found to be analogous to transcription-based profiling using a 9-gene transcriptional signature for PN and MES subclasses. Based on these data a novel, minimal IHC-based scheme for subclass assignment for GBMs is proposed. Positive staining for IDH1R132H can be used for PN subclass assignment, high EGFR expression for the CLAS subtype and a combined high expression of PTEN, VIM and/or YKL40 for the MES subclass. The application of the proposed scheme was evaluated in an independent tumor set, which resulted in similar subclass assignment rates as those observed in the training set. The IHC-based subclassification scheme proposed in this study therefore could provide very useful in future studies for stratification of individual patient samples.
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Affiliation(s)
- Siobhan Conroy
- Department of Pathology and Medical Biology (Division of Pathology), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- * E-mail:
| | - Frank A. E. Kruyt
- Department of Medical Oncology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Justin V. Joseph
- Department of Medical Oncology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Veerakumar Balasubramaniyan
- Department of Neuroscience, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Krishna P. Bhat
- Department of Pathology, University of Texas, MD Anderson Cancer Center, Houston, Texas, United States of America
| | - Michiel Wagemakers
- Department of Neurosurgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Roelien H. Enting
- Department of Neurology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Annemiek M. E. Walenkamp
- Department of Medical Oncology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Wilfred F. A. den Dunnen
- Department of Pathology and Medical Biology (Division of Pathology), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Garcia C, Dubois LG, Xavier AL, Geraldo LH, da Fonseca ACC, Correia AH, Meirelles F, Ventura G, Romão L, Canedo NHS, de Souza JM, de Menezes JRL, Moura-Neto V, Tovar-Moll F, Lima FRS. The orthotopic xenotransplant of human glioblastoma successfully recapitulates glioblastoma-microenvironment interactions in a non-immunosuppressed mouse model. BMC Cancer 2014; 14:923. [PMID: 25482099 PMCID: PMC4295410 DOI: 10.1186/1471-2407-14-923] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Accepted: 11/26/2014] [Indexed: 12/20/2022] Open
Abstract
Background Glioblastoma (GBM) is the most common primary brain tumor and the most aggressive glial tumor. This tumor is highly heterogeneous, angiogenic, and insensitive to radio- and chemotherapy. Here we have investigated the progression of GBM produced by the injection of human GBM cells into the brain parenchyma of immunocompetent mice. Methods Xenotransplanted animals were submitted to magnetic resonance imaging (MRI) and histopathological analyses. Results Our data show that two weeks after injection, the produced tumor presents histopathological characteristics recommended by World Health Organization for the diagnosis of GBM in humans. The tumor was able to produce reactive gliosis in the adjacent parenchyma, angiogenesis, an intense recruitment of macrophage and microglial cells, and presence of necrosis regions. Besides, MRI showed that tumor mass had enhanced contrast, suggesting a blood–brain barrier disruption. Conclusions This study demonstrated that the xenografted tumor in mouse brain parenchyma develops in a very similar manner to those found in patients affected by GBM and can be used to better understand the biology of GBM as well as testing potential therapies. Electronic supplementary material The online version of this article (doi:10.1186/1471-2407-14-923) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | - Flavia Regina Souza Lima
- Instituto de Ciências Biomédicas, CCS - Bloco F, Universidade Federal do Rio de Janeiro, 21949-590 Rio de Janeiro, Brazil.
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18
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Proteomic and Mitochondrial Genomic Analyses of Pediatric Brain Tumors. Mol Neurobiol 2014; 52:1341-1363. [DOI: 10.1007/s12035-014-8930-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Accepted: 10/07/2014] [Indexed: 11/26/2022]
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Rosette-forming glioneuronal tumour (RGNT) of the fourth ventricle: a highly aggressive case. Brain Tumor Pathol 2014; 32:124-30. [DOI: 10.1007/s10014-014-0195-z] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2014] [Accepted: 06/09/2014] [Indexed: 11/30/2022]
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20
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Yao NW, Chen CCV, Yen CT, Chang C. Promoted Growth of Brain Tumor by the Transplantation of Neural Stem/Progenitor Cells Facilitated by CXCL12. Transl Oncol 2014; 7:S1936-5233(14)00042-4. [PMID: 24862537 PMCID: PMC4145393 DOI: 10.1016/j.tranon.2014.04.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2013] [Revised: 04/10/2014] [Accepted: 04/14/2014] [Indexed: 12/17/2022] Open
Abstract
The targeted migration of neural stem/progenitor cells (NSPCs) is a prerequisite for the use of stem cell therapy in the treatment of pathologies. This migration is regulated mainly by C-X-C motif chemokine 12 (CXCL12). Therefore, promotion of the migratory responses of grafted cells by upregulating CXCL12 signaling has been proposed as a strategy for improving the efficacy of such cell therapies. However, the effects of this strategy on brain tumors have not yet been examined in vivo. The aim of the present study was thus to elucidate the effects of grafted rat green fluorescent protein (GFP)-labeled NSPCs (GFP-NSPCs) with CXCL12 enhancement on a model of spontaneous rat brain tumor induced by N-ethyl-N-nitrosourea. T2-weighted magnetic resonance imaging was applied to determine the changes in tumor volume and morphology over time. Postmortem histology was performed to confirm the tumor pathology, expression levels of CXCL12 and C-X-C chemokine receptor type 4, and the fate of GFP-NSPCs. The results showed that the tumor volume and hypointense areas of T2-weighted images were both significantly increased in animals treated with combined NSPC transplantation and CXCL12 induction, but not in control animals or in those with tumors that received only one of the treatments. GFP-NSPCs appear to migrate toward tumors with CXCL12 enhancement and differentiate uniquely into a neuronal lineage. These findings suggest that CXCL12 is an effective chemoattractant that facilitates exogenous NSPC migration toward brain tumors and that CXCL12 and NSPC can act synergistically to promote tumor progression with severe hemorrhage.
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Affiliation(s)
- Nai-Wei Yao
- Department of Life Science, National Taiwan University, Taipei, Taiwan; Institute of Biomedical Sciences, Academic Sinica, Taipei, Taiwan
| | - Chiao-Chi V Chen
- Institute of Biomedical Sciences, Academic Sinica, Taipei, Taiwan
| | - Chen-Tung Yen
- Department of Life Science, National Taiwan University, Taipei, Taiwan.
| | - Chen Chang
- Institute of Biomedical Sciences, Academic Sinica, Taipei, Taiwan.
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21
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Fève M, Saliou JM, Zeniou M, Lennon S, Carapito C, Dong J, Van Dorsselaer A, Junier MP, Chneiweiss H, Cianférani S, Haiech J, Kilhoffer MC. Comparative expression study of the endo-G protein coupled receptor (GPCR) repertoire in human glioblastoma cancer stem-like cells, U87-MG cells and non malignant cells of neural origin unveils new potential therapeutic targets. PLoS One 2014; 9:e91519. [PMID: 24662753 PMCID: PMC3963860 DOI: 10.1371/journal.pone.0091519] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2013] [Accepted: 02/10/2014] [Indexed: 12/22/2022] Open
Abstract
Glioblastomas (GBMs) are highly aggressive, invasive brain tumors with bad prognosis and unmet medical need. These tumors are heterogeneous being constituted by a variety of cells in different states of differentiation. Among these, cells endowed with stem properties, tumor initiating/propagating properties and particularly resistant to chemo- and radiotherapies are designed as the real culprits for tumor maintenance and relapse after treatment. These cells, termed cancer stem-like cells, have been designed as prominent targets for new and more efficient cancer therapies. G-protein coupled receptors (GPCRs), a family of membrane receptors, play a prominent role in cell signaling, cell communication and crosstalk with the microenvironment. Their role in cancer has been highlighted but remains largely unexplored. Here, we report a descriptive study of the differential expression of the endo-GPCR repertoire in human glioblastoma cancer stem-like cells (GSCs), U-87 MG cells, human astrocytes and fetal neural stem cells (f-NSCs). The endo-GPCR transcriptome has been studied using Taqman Low Density Arrays. Of the 356 GPCRs investigated, 138 were retained for comparative studies between the different cell types. At the transcriptomic level, eight GPCRs were specifically expressed/overexpressed in GSCs. Seventeen GPCRs appeared specifically expressed in cells with stem properties (GSCs and f-NSCs). Results of GPCR expression at the protein level using mass spectrometry and proteomic analysis are also presented. The comparative GPCR expression study presented here gives clues for new pathways specifically used by GSCs and unveils novel potential therapeutic targets.
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Affiliation(s)
- Marie Fève
- Laboratoire d'Innovation Thérapeutique, UMR7200, Laboratoire d'Excellence Medalis, CNRS, Université de Strasbourg, Faculté de Pharmacie, Illkirch, France
| | - Jean-Michel Saliou
- Laboratoire de Spectrométrie de Masse BioOrganique, UMR7178, CNRS, Institut Pluridisciplinaire Hubert Curien, Université de Strasbourg, Strasbourg, France
| | - Maria Zeniou
- Laboratoire d'Innovation Thérapeutique, UMR7200, Laboratoire d'Excellence Medalis, CNRS, Université de Strasbourg, Faculté de Pharmacie, Illkirch, France
| | - Sarah Lennon
- Laboratoire de Spectrométrie de Masse BioOrganique, UMR7178, CNRS, Institut Pluridisciplinaire Hubert Curien, Université de Strasbourg, Strasbourg, France
| | - Christine Carapito
- Laboratoire de Spectrométrie de Masse BioOrganique, UMR7178, CNRS, Institut Pluridisciplinaire Hubert Curien, Université de Strasbourg, Strasbourg, France
| | - Jihu Dong
- Laboratoire d'Innovation Thérapeutique, UMR7200, Laboratoire d'Excellence Medalis, CNRS, Université de Strasbourg, Faculté de Pharmacie, Illkirch, France
| | - Alain Van Dorsselaer
- Laboratoire de Spectrométrie de Masse BioOrganique, UMR7178, CNRS, Institut Pluridisciplinaire Hubert Curien, Université de Strasbourg, Strasbourg, France
| | - Marie-Pierre Junier
- Neuroscience Paris Seine, UMR8246, Inserm U1130, Institut de Biologie Paris Seine, CNRS, Université Pierre et Marie Curie, Paris, France
| | - Hervé Chneiweiss
- Neuroscience Paris Seine, UMR8246, Inserm U1130, Institut de Biologie Paris Seine, CNRS, Université Pierre et Marie Curie, Paris, France
| | - Sarah Cianférani
- Laboratoire de Spectrométrie de Masse BioOrganique, UMR7178, CNRS, Institut Pluridisciplinaire Hubert Curien, Université de Strasbourg, Strasbourg, France
| | - Jacques Haiech
- Laboratoire d'Innovation Thérapeutique, UMR7200, Laboratoire d'Excellence Medalis, CNRS, Université de Strasbourg, Faculté de Pharmacie, Illkirch, France
| | - Marie-Claude Kilhoffer
- Laboratoire d'Innovation Thérapeutique, UMR7200, Laboratoire d'Excellence Medalis, CNRS, Université de Strasbourg, Faculté de Pharmacie, Illkirch, France
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Hervey-Jumper SL, Wang AC, Yates AN, Robertson PL, Muraszko KM, Garton HJL, Blaivas M. 8-year-old boy with progressive headache. Brain Pathol 2013; 23:601-2. [PMID: 23937593 DOI: 10.1111/bpa.12074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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23
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Puget S, Boddaert N, Veillard AS, Garnett M, Miquel C, Andreiuolo F, Sainte-Rose C, Roujeau T, DiRocco F, Bourgeois M, Zerah M, Doz F, Grill J, Varlet P. Neuropathological and neuroradiological spectrum of pediatric malignant gliomas: correlation with outcome. Neurosurgery 2013; 69:215-24. [PMID: 21368704 DOI: 10.1227/neu.0b013e3182134340] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The diagnostic accuracy and reproducibility for glioma histological diagnosis are suboptimal. OBJECTIVE To characterize radiological and histological features in pediatric malignant gliomas and to determine whether they had an impact on survival. METHODS We retrospectively reviewed a series of 96 pediatric malignant gliomas. All histological samples were blindly and independently reviewed and classified according to World Health Organization 2007 and Sainte-Anne classifications. Radiological features were reviewed independently. Statistical analyses were performed to investigate the relationship between clinical, radiological, and histological features and survival. RESULTS Cohort median age was 7.8 years; median follow-up was 4.8 years. Tumors involved cerebral hemispheres or basal ganglia in 82% of cases and brainstem in the remaining 18%. After histopathological review, low-grade gliomas and nonglial tumors were excluded (n = 27). The World Health Organization classification was not able to demonstrate differences between groups and patients survival. The Sainte-Anne classification identified a 3-year survival rate difference between the histological subgroups (oligodendroglioma A, oligodendroglioma B, malignant glioneuronal tumors, and glioblastomas; P = .02). The malignant glioneuronal tumor was the only glioma subtype with specific radiological features. Tumor location was significantly associated with 3-year survival rate (P = .005). Meningeal attachment was the only radiological criteria associated with longer survival (P = .02). CONCLUSION The Sainte-Anne classification was better able to distinguish pediatric malignant gliomas in terms of survival compared with the World Health Organization classification. In this series, neither of these 2 histological classifications provided a prognostic stratification of the patients.
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Affiliation(s)
- Stéphanie Puget
- Department of Neurosurgery, Hôpital Necker Enfants Malades, Université Paris Descartes, Paris, France.
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Prognostic significance of neuronal marker expression in glioblastomas. Childs Nerv Syst 2012; 28:1879-86. [PMID: 22922887 DOI: 10.1007/s00381-012-1883-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2012] [Accepted: 07/30/2012] [Indexed: 12/19/2022]
Abstract
PURPOSE Glioblastomas are the most malignant tumors of central nervous system neoplasms and are well known for their biological heterogeneity. Contrary to the putative hypothesis of purely glial differentiation in glioblastomas, they often demonstrate immunopositivity for neuronal markers. However, the significance of their neuronal marker expression is still controversial. To evaluate the prognostic implication of neuronal expression in glioblastoma, this study investigated the expression of neuronal markers in a large series of glioblastoma patients in terms of patient survival rate. METHODS Expression of synaptophysin, neurofilament protein, and NeuN was explored using immunohistochemistry in 88 cases of glioblastoma. Clinicopathological variables as well as patients' survival data were compared according to the immunopositivity of cases. RESULTS Sixty-one of the 88 tumors (69.3 %) were positive for at least one neuronal marker. Synaptophysin positivity was observed in 43 cases (48.9 %). Neurofilament protein and NeuN were positive in 38 (43.2 %) and 42 cases (47.7 %), respectively. There was no statistically significant difference in overall survival and progression-free survival in association with neuronal marker expression. However, gross total removal or combined radiotherapy and chemotherapy significantly prolonged survival (P=0.041 and 0.044). Cox's proportional hazard model revealed that NeuN expression was the independent prognostic factors in progression-free survival (P=0.012). CONCLUSIONS Although the correlation of neuronal marker expression and clinical outcome in glioblastoma is of considerable interest, the presented data support the limited prognostic value of neuronal marker expression in glioblastoma.
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25
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El Demellawy D, Sur M, Ahmed AD, Provias J. Hemispheric extra-ventricular glioneurocytoma: a clinicopathological review with detailed immunohistochemical profile. Pathol Res Pract 2012; 208:444-51. [PMID: 22710139 DOI: 10.1016/j.prp.2012.04.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2011] [Revised: 10/02/2011] [Accepted: 04/02/2012] [Indexed: 11/19/2022]
Abstract
Glioneuronal tumors have recently been recognized in the WHO Classification of Tumors of the Central Nervous System, 2007 [14]. However, the entities included in this category do not encompass all the glioneuronal tumors encountered during practice. We characterize a new entity called glioneurocytoma (GNC) showing distinct morphology with glial and neuronal differentiation. We reviewed 10 cases of glioneurocytomas diagnosed in our department during 2003 and 2004, with emphasis on clinicopathological features, immunohistochemical profile, genetic aberrations and prognosis. The cases included in the study showed equal gender distribution and age range of 23-40 years and mean age of 34.4 years at the time of initial presentation. Most of the tumors were centered in the frontal lobe. In our study, GFAP was the most sensitive and relatively specific marker for glial differentiation and remains the marker of choice for glial differentiation. CD56 and S100 protein were sensitive but non-specific. Vimentin, CD57 and NF were non-contributory in the immunohistochemical work up of glioneurocytomas. We concluded that the diagnosis of glioneurocytomas requires attention to morphological details and proper immunohistochemical assessment, using a panel of both glial and neuronal markers. Particular attention is recommended to the existence of the intermediate neurocytic cells which may be unique for these tumors. Future implication with full molecular analysis for gene expression profiling is suggested for proper and accurate identifying this entity.
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26
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Thirant C, Galan-Moya EM, Dubois LG, Pinte S, Chafey P, Broussard C, Varlet P, Devaux B, Soncin F, Gavard J, Junier MP, Chneiweiss H. Differential proteomic analysis of human glioblastoma and neural stem cells reveals HDGF as a novel angiogenic secreted factor. Stem Cells 2012; 30:845-53. [PMID: 22331796 DOI: 10.1002/stem.1062] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Presence in glioblastomas of cancer cells with normal neural stem cell (NSC) properties, tumor initiating capacity, and resistance to current therapies suggests that glioblastoma stem-like cells (GSCs) play central roles in glioblastoma development. We cultured human GSCs endowed with all features of tumor stem cells, including tumor initiation after xenograft and radio-chemoresistance. We established proteomes from four GSC cultures and their corresponding whole tumor tissues (TTs) and from human NSCs. Two-dimensional difference gel electrophoresis and tandem mass spectrometry revealed a twofold increase of hepatoma-derived growth factor (HDGF) in GSCs as compared to TTs and NSCs. Western blot analysis confirmed HDGF overexpression in GSCs as well as its presence in GSC-conditioned medium, while, in contrast, no HDGF was detected in NSC secretome. At the functional level, GSC-conditioned medium induced migration of human cerebral endothelial cells that can be blocked by anti-HDGF antibodies. In vivo, GSC-conditioned medium induced neoangiogenesis, whereas HDGF-targeting siRNAs abrogated this effect. Altogether, our results identify a novel candidate, by which GSCs can support neoangiogenesis, a high-grade glioma hallmark. Our strategy illustrates the usefulness of comparative proteomic analysis to decipher molecular pathways, which underlie GSC properties.
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Affiliation(s)
- Cécile Thirant
- INSERM U894, Psychiatry and Neuroscience Center, Glial Plasticity Team, Cochin Institute, Paris Descartes University, Paris, France
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27
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Raffel C. Editorial: glioblastoma subtype. J Neurosurg 2012; 117:474; discussion 475. [PMID: 22725980 DOI: 10.3171/2012.1.jns112254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Pallud J, Dezamis E, Audureau E, Devaux B, Souillard-Scemama R, Sanai N, Page P, Beuvon F, Koziak M, Oppenheim C, Dhermain F, Schlienger M, Meder JF, Roux FX, Varlet P. Neuronal immunoexpression and a distinct subtype of adult primary supratentorial glioblastoma with a better prognosis. J Neurosurg 2012; 117:476-85. [PMID: 22725988 DOI: 10.3171/2012.5.jns111670] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECT In this study, the authors address whether neurofilament protein (NFP) expression can be used as an independent prognostic factor in primary glioblastoma multiformes (GBMs). METHODS Three hundred and two consecutive adult patients with newly diagnosed supratentorial primary GBMs were analyzed (January 2000-August 2008). Detailed data regarding clinical, imaging, and pathological findings, oncological treatments, and outcomes were recorded. Neurofilament protein immunoexpression served to identify NFP-positive tumor cells (normal entrapped neurons and mature ganglion-like cells excluded). RESULTS Neurofilament-positive cells were identified in 177 GBMs (58.6%). Patients with NFP-positive GBMs were younger (p < 0.0001), and their GBMs presented with more temporal lobe tumor localization (p = 0.029) and more cortical involvement (p = 0.0003). Neurofilament-negative GBMs presented with more ventricular contact (p < 0.0001) and more tumor midline crossing (p = 0.03). Median overall survival and progression-free survival (PFS) were 13.0 and 7.6 months, respectively, for NFP-positive GBMs, and 7.0 and 5.1 months, respectively, for NFP-negative GBMs. Multivariate analysis revealed NFP immunoexpression, tumor midline crossing, complete resection, and radiotherapy combined with chemotherapy as independent factors associated with overall survival. Neurofilament protein-positive immunoexpression was associated with longer overall survival (hazard ratio [HR] 0.54, 95% CI 0.40-0.74; p < 0.0001) and longer PFS (HR 0.71, 95% CI 0.53-0.96; p = 0.02). CONCLUSIONS Neurofilament protein-positive immunoexpression represents a strong, therapeutically independent prognostic factor for primary supratentorial GBM clinical outcome among adult patients. Neurofilament protein-GBM's unique pathological features are not only associated with distinct clinical and anatomical behavior, but are also predictive of overall patient survival and PFS. Neurofilament protein immunoexpression may help identify a distinct subgroup of primary GBMs with a favorable prognosis, which should be considered in the design of future targeted therapies.
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Affiliation(s)
- Johan Pallud
- Department of Neurosurgery, Sainte-Anne Hospital, Paris, France.
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DeWire MD, Beltran C, Boop FA, Helton KJ, Ellison DW, McKinnon PJ, Gajjar A, Pai Panandiker AS. Radiation therapy and adjuvant chemotherapy in a patient with a malignant glioneuronal tumor and underlying ataxia telangiectasia: a case report and review of the literature. J Clin Oncol 2012; 31:e12-4. [PMID: 22689803 DOI: 10.1200/jco.2011.40.1430] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Mariko D DeWire
- St. Jude Children's Research Hospital, Memphis, TN 38105-2794, USA.
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30
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Cebrián-Torrejón G, Assad Kahn S, Lagarde N, Castellano F, Leblanc K, Rodrigo J, Molinier-Frenkel V, Rojas de Arias A, Ferreira ME, Thirant C, Fournet A, Figadère B, Chneiweiss H, Poupon E. Antiproliferative activity of trans-avicennol from Zanthoxylum chiloperone var. angustifolium against human cancer stem cells. JOURNAL OF NATURAL PRODUCTS 2012; 75:257-261. [PMID: 22304006 DOI: 10.1021/np2004165] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Zanthoxylum chiloperone var. angustifolium root bark was studied with the aim of finding novel molecules able to overcome cancer stem cell chemoresistance. Purification of a methanol-soluble extract resulted in the isolation of a known pyranocoumarin, trans-avicennol (1). Compound 1 demonstrated antiproliferative activity on glioma-initiating cells, whereas it was inactive on human neural stem cells. trans-Avicennol (1) activated the MAPK/ERK pathway and was also evaluated for its ability to inhibit the enzyme indoleamine-2,3-dioxygenase.
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Affiliation(s)
- Gerardo Cebrián-Torrejón
- Laboratoire de Pharmacognosie Associé au CNRS UMR 8076 BioCIS, LabEx LERMIT, Faculté de Pharmacie, Université Paris-Sud, 5 Rue Jean-Baptiste Clément, 92296 Châtenay-Malabry, France
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Yan T, Skaftnesmo KO, Leiss L, Sleire L, Wang J, Li X, Enger PØ. Neuronal markers are expressed in human gliomas and NSE knockdown sensitizes glioblastoma cells to radiotherapy and temozolomide. BMC Cancer 2011; 11:524. [PMID: 22185371 PMCID: PMC3259117 DOI: 10.1186/1471-2407-11-524] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2011] [Accepted: 12/20/2011] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Expression of neuronal elements has been identified in various glial tumors, and glioblastomas (GBMs) with neuronal differentiation patterns have reportedly been associated with longer survival. However, the neuronal class III β-tubulin has been linked to increasing malignancy in astrocytomas. Thus, the significance of neuronal markers in gliomas is not established. METHODS The expressions of class III β-tubulin, neurofilament protein (NFP), microtubule-associated protein 2 (MAP2) and neuron-specific enolase (NSE) were investigated in five GBM cell lines and two GBM biopsies with immunocytochemistry and Western blot. Moreover, the expression levels were quantified by real-time qPCR under different culture conditions. Following NSE siRNA treatment we used Electric cell-substrate impedance sensing (ECIS) to monitor cell growth and migration and MTS assays to study viability after irradiation and temozolomide treatment. Finally, we quantitated NSE expression in a series of human glioma biopsies with immunohistochemistry using a morphometry software, and collected survival data for the corresponding patients. The biopsies were then grouped according to expression in two halves which were compared by survival analysis. RESULTS Immunocytochemistry and Western blotting showed that all markers except NFP were expressed both in GBM cell lines and biopsies. Notably, qPCR demonstrated that NSE was upregulated in cellular stress conditions, such as serum-starvation and hypoxia, while we found no uniform pattern for the other markers. NSE knockdown reduced the migration of glioma cells, sensitized them to hypoxia, radio- and chemotherapy. Furthermore, we found that GBM patients in the group with the highest NSE expression lived significantly shorter than patients in the low-expression group. CONCLUSIONS Neuronal markers are aberrantly expressed in human GBMs, and NSE is consistently upregulated in different cellular stress conditions. Knockdown of NSE reduces the migration of GBM cells and sensitizes them to hypoxia, radiotherapy and chemotherapy. In addition, GBM patients with high NSE expression had significantly shorter survival than patients with low NSE expression. Collectively, these data suggest a role for NSE in the adaption to cellular stress, such as during treatment.
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Affiliation(s)
- Tao Yan
- Department of Neurosurgery, Qilu Hospital, Shandong University, Jinan, PR China
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Yano H, Nakayama N, Hirose Y, Ohe N, Shinoda J, Yoshimura SI, Iwama T. Intraventricular glioneuronal tumor with disseminated lesions at diagnosis--a case report. Diagn Pathol 2011; 6:119. [PMID: 22145948 PMCID: PMC3251541 DOI: 10.1186/1746-1596-6-119] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2011] [Accepted: 12/06/2011] [Indexed: 01/05/2023] Open
Abstract
A 55-year-old man presented with a large tumor in his lateral ventricles. Magnetic resonance imaging revealed disseminated lesions in the third and fourth ventricles at the time of diagnosis. The patient underwent a partial removal of the tumor in the lateral ventricles. Histologically, the surgical specimens showed glioneuronal differentiation with ganglion or ganglioid cells, Rosenthal fibers, oligodendroglia-like honeycomb appearances, a spongy pattern, perivascular pseudorosettes, and many hyalinized blood vessels. Papillary structure was not observed. The neuronal component showed a moderately high labeling index of Ki-67/MIB-1. We diagnosed this tumor as atypical intraventricular glioneuronal tumor. The disseminated lesions disappeared after chemoradiation therapy with temozolomide, and the residual tumors in the lateral ventricles remained stable for 3 years after the surgery. We discuss the pathological diagnosis, therapy and clinical course with review of the literatures.
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Affiliation(s)
- Hirohito Yano
- Department of Neurosurgery, Gifu University Graduate School of Medicine, Gifu, Japan.
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Can dynamic contrast-enhanced magnetic resonance imaging combined with texture analysis differentiate malignant glioneuronal tumors from other glioblastoma? Neurol Res Int 2011; 2012:195176. [PMID: 22203901 PMCID: PMC3238409 DOI: 10.1155/2012/195176] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2011] [Accepted: 08/29/2011] [Indexed: 11/17/2022] Open
Abstract
An interesting approach has been proposed to differentiate malignant glioneuronal tumors (MGNTs) as a subclass of the WHO grade III and IV malignant gliomas. MGNT histologically resemble any WHO grade III or IV glioma but have a different biological behavior, presenting a survival twice longer as WHO glioblastomas and a lower occurrence of metastases. However, neurofilament protein immunostaining was required for identification of MGNT. Using two complementary methods, dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and texture analysis (MRI-TA) from the same acquisition process, the challenge is to in vivo identify MGNT and demonstrate that MRI postprocessing could contribute to a better typing and grading of glioblastoma. Results are obtained on a preliminary group of 19 patients a posteriori selected for a blind investigation of DCE T1-weighted and TA at 1.5 T. The optimal classification (0/11 misclassified MGNT) is obtained by combining the two methods, DCE-MRI and MRI-TA.
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Alves TR, Lima FRS, Kahn SA, Lobo D, Dubois LGF, Soletti R, Borges H, Neto VM. Glioblastoma cells: A heterogeneous and fatal tumor interacting with the parenchyma. Life Sci 2011; 89:532-9. [DOI: 10.1016/j.lfs.2011.04.022] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2010] [Revised: 04/19/2011] [Accepted: 04/27/2011] [Indexed: 10/25/2022]
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Thirant C, Varlet P, Lipecka J, Le Gall M, Broussard C, Chafey P, Studler JM, Lacombe J, Lions S, Guillaudeau A, Camoin L, Daumas-Duport C, Junier MP, Chneiweiss H. Proteomic analysis of oligodendrogliomas expressing a mutant isocitrate dehydrogenase-1. Proteomics 2011; 11:4139-54. [DOI: 10.1002/pmic.201000646] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2010] [Revised: 07/19/2011] [Accepted: 08/04/2011] [Indexed: 12/17/2022]
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Silvestre DC, Pineda JR, Hoffschir F, Studler JM, Mouthon MA, Pflumio F, Junier MP, Chneiweiss H, Boussin FD. Alternative lengthening of telomeres in human glioma stem cells. Stem Cells 2011; 29:440-51. [PMID: 21425407 DOI: 10.1002/stem.600] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Cancer stem cells are increasingly recognized as major therapeutic targets. We report here the isolation of glioma stem cells (GSCs) maintaining telomere length through a telomerase-independent mechanism known as alternative lengthening of telomeres (ALTs). TG20 cells were isolated from a glioblastoma multiforme, which had the ALT phenotype. They have no detectable telomerase activity and extremely long and heterogeneous telomeres colocalizing with promyelocytic leukemia bodies. The cancer stem cell potential of TG20 cells was confirmed based on their expression of neural stem cell markers, their capacity of in vitro long-term proliferation and to form intracranial tumors in immune-deficient mice. Interestingly, we found that both in vitro and in vivo TG20 cells were significantly more resistant to ionizing radiation than GSCs with telomerase activity. Analysis of DNA damage foci, DNA double-strand breaks repair, and chromosome instability suggest that radiation resistance was related to interference of ALT pathway with DNA damage response. Therefore, our data show for the first time that the ALT pathway can confer to cancer stem cells the capacity to sustain long-term proliferation as telomerase activity and importantly may also affect treatment efficiency. TG20 cells are thus the first cellular model of GSCs displaying ALT and should prove to be useful for the development of specific treatment strategies.
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Affiliation(s)
- David C Silvestre
- Laboratoire de RadioPathologie, Institut de Radiobiologie Cellulaire et Moléculaire, CEA, Fontenay-aux-Roses, France
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Abstract
This review highlights the recent changes to the World Health Organization (WHO) 4th edition of the classification of central nervous system tumours. The mixed glial and neuronal tumour group continues to expand to encompass three new subtypes of glioneuronal tumours. The main diagnostic points differentiating these tumours are covered. Also covered is an update on issues relating to grading of astrocytic, oligodendroglial and pineal tumours and the recent molecular subtypes observed in medulloblastomas. The theme of molecular genetics is continued in the following section where the four subtypes in the molecular subclassification of glioblastoma; classical, mesenchymal, proneural and neural are outlined. The genetic profile of these subtypes is highlighted as is their varying biological responses to adjuvant therapies. The relationship between chromosome 1p and 19q deletions and treatment responsive oligodendrogliomas is discussed, as are the newer advances relating to silencing of the MGMT gene in astrocytomas and mutations in the IDH-1 gene in both astrocytomas and oligodendrogliomas. The final section in this article provides an update on the concept of glioma stem cells.
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Junier MP, Sharif A. [Instability of cell phenotype and tumor initiating cells in gliomas]. Biol Aujourdhui 2011; 205:63-74. [PMID: 21501577 DOI: 10.1051/jbio/2011002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2010] [Indexed: 05/30/2023]
Abstract
Gliomas, the most frequent primitive CNS tumors, have been suggested to originate from astrocytes or from neural progenitors/stem cells. However, the precise identity of the cells at the origin of gliomas remains a matter of debate because no pre-neoplastic state has been yet identified. TGFα, an EGF family member, is frequently over-expressed in the early stages of glioma progression. We questioned whether prolonged TGFα exposure affects the stability of the normal mature astrocyte phenotype and, eventually, their propensity to cancerous transformation. Using mouse astrocyte cultures devoid of residual neural stem cells or progenitors, we demonstrate that several days of TGFα-treatment result in the functional conversion of a population of mature astrocytes into radial glial cells, a population of neural progenitors, without any accompanying sign of cancerous transformation. In contrast, when astrocytes de-differentiated with TGFα were submitted to oncogenic stress using gamma irradiation, they acquired cancerous properties, forming high-grade glioma-like tumors after brain grafting. Gamma irradiation was without effect on astrocytes which were not treated with TGFα. These results suggested that most gliomas should contain tumor cells with stem-like properties (TSCs). Our study of 55 pediatric brain tumors show that tumor cells with stem cell-like or progenitor-like properties can be isolated from a majority of gliomas. Survival analysis showed an association between isolation of TSCs with extended self-renewal capabilities and a patient's higher mortality rate.
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Affiliation(s)
- Marie-Pierre Junier
- Inserm, UMR894, Équipe Plasticité gliale, Université Paris V, 75006 Paris, France.
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Figarella-Branger D, Bouvier C, Moroch J, Michalak S. [Morphological classification of glioblastomas]. Neurochirurgie 2011; 56:459-63. [PMID: 20864138 DOI: 10.1016/j.neuchi.2010.07.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2010] [Accepted: 07/01/2010] [Indexed: 11/19/2022]
Abstract
BACKGROUND AND PURPOSE In the 2007 WHO classification, glioblastomas are classified among the group of astrocytic tumors. They are highly malignant (grade IV). This group of tumors is morphologically heterogeneous. The WHO distinguishes between clinico-pathological entities, variants of entities and histological pattern. Variants are defined as being reliably indentified histologically and having some relevance for clinical outcome but as still being part of a previously defined overarching entity. Patterns of differentiation are identifiable by histological appearances but without clinical or pathological significance. METHODS The description of the histological and immunohistochemical features is based on the 2007 WHO classification. RESULTS In addition to the classic form of glioblastoma, two variants exist: the giant cell GBM and the gliosarcoma. The first but not the second would have a better outcome than the classic glioblastoma. The WHO classification also distinguishes several patterns of differentiation: small cells glioblastoma; glioblastoma with lipidized cells; glioblastoma with oligodendroglioma component; glioblastoma with heterologous differentiation. These patterns have to be recognized because they represent sometimes a diagnostic challenge. GFAP, Olig2 and Mib1/Ki67 are the most relevant immunohistochemical markers. Diagnostic value of neuronal markers is still controversial. EGFR or p53 expression can be detected and their prognosis value is discussed in this chapter. A systematic analysis of some markers in routine, for example IDH1 or internexin-a, could help to define more homogeneous groups of patients.
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Thirant C, Bessette B, Varlet P, Puget S, Cadusseau J, Dos Reis Tavares S, Studler JM, Silvestre DC, Susini A, Villa C, Miquel C, Bogeas A, Surena AL, Dias-Morais A, Léonard N, Pflumio F, Bièche I, Boussin FD, Sainte-Rose C, Grill J, Daumas-Duport C, Chneiweiss H, Junier MP. Clinical relevance of tumor cells with stem-like properties in pediatric brain tumors. PLoS One 2011; 6:e16375. [PMID: 21297991 PMCID: PMC3030582 DOI: 10.1371/journal.pone.0016375] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2010] [Accepted: 12/19/2010] [Indexed: 11/19/2022] Open
Abstract
Background Primitive brain tumors are the leading cause of cancer-related death in children. Tumor cells with stem-like properties (TSCs), thought to account for tumorigenesis and therapeutic resistance, have been isolated from high-grade gliomas in adults. Whether TSCs are a common component of pediatric brain tumors and are of clinical relevance remains to be determined. Methodology/Principal Findings Tumor cells with self-renewal properties were isolated with cell biology techniques from a majority of 55 pediatric brain tumors samples, regardless of their histopathologies and grades of malignancy (57% of embryonal tumors, 57% of low-grade gliomas and neuro-glial tumors, 70% of ependymomas, 91% of high-grade gliomas). Most high-grade glioma-derived oncospheres (10/12) sustained long-term self-renewal akin to neural stem cells (>7 self-renewals), whereas cells with limited renewing abilities akin to neural progenitors dominated in all other tumors. Regardless of tumor entities, the young age group was associated with self-renewal properties akin to neural stem cells (P = 0.05, chi-square test). Survival analysis of the cohort showed an association between isolation of cells with long-term self-renewal abilities and a higher patient mortality rate (P = 0.013, log-rank test). Sampling of low- and high-grade glioma cultures showed that self-renewing cells forming oncospheres shared a molecular profile comprising embryonic and neural stem cell markers. Further characterization performed on subsets of high-grade gliomas and one low-grade glioma culture showed combination of this profile with mesenchymal markers, the radio-chemoresistance of the cells and the formation of aggressive tumors after intracerebral grafting. Conclusions/Significance In brain tumors affecting adult patients, TSCs have been isolated only from high-grade gliomas. In contrast, our data show that tumor cells with stem cell-like or progenitor-like properties can be isolated from a wide range of histological sub-types and grades of pediatric brain tumors. They suggest that cellular mechanisms fueling tumor development differ between adult and pediatric brain tumors.
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Affiliation(s)
- Cécile Thirant
- Inserm, UMR894, Team Glial Plasticity, University Paris Descartes, Paris, France
| | - Barbara Bessette
- Inserm, UMR894, Team Glial Plasticity, University Paris Descartes, Paris, France
| | - Pascale Varlet
- Inserm, UMR894, Team Glial Plasticity, University Paris Descartes, Paris, France
- Department of Neuropathology, Hospital Sainte-Anne, Paris, France
| | - Stéphanie Puget
- Pediatric Neurosurgical Department. Hospital Necker, University Paris Descartes, Paris, France
- CNRS UMR 8203, Vectorology and Anticancer Therapeutics, Gustave Roussy Cancer Institute, Villejuif, France
| | | | | | - Jeanne-Marie Studler
- Inserm, UMR894, Team Glial Plasticity, University Paris Descartes, Paris, France
- Collège de France, Paris, France
| | - David Carlos Silvestre
- Laboratoire de Radiopathologie UMR 967, CEA-INSERM-Université Paris VII, Fontenay-aux-Roses, France
| | - Aurélie Susini
- Laboratoire d'Oncogénétique - INSERM U735, Institut Curie/Hôpital René Huguenin, St-Cloud, France
| | - Chiara Villa
- Inserm, UMR894, Team Glial Plasticity, University Paris Descartes, Paris, France
- Department of Neuropathology, Hospital Sainte-Anne, Paris, France
| | - Catherine Miquel
- Inserm, UMR894, Team Glial Plasticity, University Paris Descartes, Paris, France
- Department of Neuropathology, Hospital Sainte-Anne, Paris, France
| | - Alexandra Bogeas
- Inserm, UMR894, Team Glial Plasticity, University Paris Descartes, Paris, France
| | - Anne-Laure Surena
- Inserm, UMR894, Team Glial Plasticity, University Paris Descartes, Paris, France
| | - Amélia Dias-Morais
- Inserm, UMR894, Team Glial Plasticity, University Paris Descartes, Paris, France
| | - Nadine Léonard
- Inserm, UMR894, Team Glial Plasticity, University Paris Descartes, Paris, France
- Department of Neuropathology, Hospital Sainte-Anne, Paris, France
| | - Françoise Pflumio
- Laboratoire des Cellules Souches Hématopoïétiques et Leucémiques, UMR U967, CEA-INSERM-Université Paris VII, Fontenay-aux-Roses, France
| | - Ivan Bièche
- Laboratoire d'Oncogénétique - INSERM U735, Institut Curie/Hôpital René Huguenin, St-Cloud, France
| | - François D. Boussin
- Laboratoire de Radiopathologie UMR 967, CEA-INSERM-Université Paris VII, Fontenay-aux-Roses, France
| | - Christian Sainte-Rose
- Pediatric Neurosurgical Department. Hospital Necker, University Paris Descartes, Paris, France
| | - Jacques Grill
- CNRS UMR 8203, Vectorology and Anticancer Therapeutics, Gustave Roussy Cancer Institute, Villejuif, France
| | - Catherine Daumas-Duport
- Inserm, UMR894, Team Glial Plasticity, University Paris Descartes, Paris, France
- Department of Neuropathology, Hospital Sainte-Anne, Paris, France
| | - Hervé Chneiweiss
- Inserm, UMR894, Team Glial Plasticity, University Paris Descartes, Paris, France
| | - Marie-Pierre Junier
- Inserm, UMR894, Team Glial Plasticity, University Paris Descartes, Paris, France
- Department of Neuropathology, Hospital Sainte-Anne, Paris, France
- * E-mail:
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Tumori del sistema nervoso centrale. Classificazioni istologiche e topografiche, epidemiologia. Neurologia 2011. [DOI: 10.1016/s1634-7072(11)70627-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Hussein D, Punjaruk W, Storer LCD, Shaw L, Othman R, Ottoman R, Peet A, Miller S, Bandopadhyay G, Heath R, Kumari R, Bowman KJ, Braker P, Rahman R, Jones GDD, Watson S, Lowe J, Kerr ID, Grundy RG, Coyle B. Pediatric brain tumor cancer stem cells: cell cycle dynamics, DNA repair, and etoposide extrusion. Neuro Oncol 2010; 13:70-83. [PMID: 20978004 PMCID: PMC3018909 DOI: 10.1093/neuonc/noq144] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Reliable model systems are needed to elucidate the role cancer stem cells (CSCs) play in pediatric brain tumor drug resistance. The majority of studies to date have focused on clinically distinct adult tumors and restricted tumor types. Here, the CSC component of 7 newly established primary pediatric cell lines (2 ependymomas, 2 medulloblastomas, 2 gliomas, and a CNS primitive neuroectodermal tumor) was thoroughly characterized. Comparison of DNA copy number with the original corresponding tumor demonstrated that genomic changes present in the original tumor, typical of that particular tumor type, were retained in culture. In each case, the CSC component was approximately 3–4-fold enriched in neurosphere culture compared with monolayer culture, and a higher capacity for multilineage differentiation was observed for neurosphere-derived cells. DNA content profiles of neurosphere-derived cells expressing the CSC marker nestin demonstrated the presence of cells in all phases of the cell cycle, indicating that not all CSCs are quiescent. Furthermore, neurosphere-derived cells demonstrated an increased resistance to etoposide compared with monolayer-derived cells, having lower initial DNA damage, potentially due to a combination of increased drug extrusion by ATP-binding cassette multidrug transporters and enhanced rates of DNA repair. Finally, orthotopic xenograft models reflecting the tumor of origin were established from these cell lines. In summary, these cell lines and the approach taken provide a robust model system that can be used to develop our understanding of the biology of CSCs in pediatric brain tumors and other cancer types and to preclinically test therapeutic agents.
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Affiliation(s)
- Deema Hussein
- Children's Brain Tumour Research Centre, School of Clinical Sciences, University of Nottingham, CBTRC, D32 Medical School, QMC, Clifton Boulevard, Nottingham NG7 2UH, UK
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Andreiuolo F, Puget S, Peyre M, Dantas-Barbosa C, Boddaert N, Philippe C, Mauguen A, Grill J, Varlet P. Neuronal differentiation distinguishes supratentorial and infratentorial childhood ependymomas. Neuro Oncol 2010; 12:1126-34. [PMID: 20615923 DOI: 10.1093/neuonc/noq074] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Ependymomas are glial neoplasms occurring in any location throughout the central nervous system and supposedly are derived from radial glia cells. Recent data suggest that these tumors may have different biological and clinical behaviors according to their location. Pediatric supratentorial and infratentorial ependymoma (SE and IE) were compared with respect to clinical and radiological parameters and immunohistochemistry (IHC). Neuronal markers were specifically assessed by IHC and quantitative PCR (qPCR). No single morphological or radiological characteristic was associated with location or any neuronal marker. However, there was a significant overexpression of neuronal markers in SE compared with IE: neurofilament light polypeptide 70 (NEFL)-positive tumor cells were found in 23 of 34 SE and in only 4 of 32 IE (P < .001). Among SE, 10 of 34 exhibited high expression of NEFL, defined as more than 5% positive cells. qPCR confirmed the upregulation of neuronal markers (NEFL, LHX2, FOXG1, TLX1, and NPTXR) in SE compared with IE. In addition, strong NEFL expression in SE was correlated with better progression-free survival (P = .007). Our results support the distinction of SE and IE. SEs are characterized by neuronal differentiation, which seems to be associated with better prognosis.
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Affiliation(s)
- Felipe Andreiuolo
- INSERM UMR 8203 "Vectorology and Anticancer Therapies," Institut Gustave Roussy, 39 Rue Camille Desmoulins, Villejuif 94805, France.
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Tomasello C, Franceschi E, Tosoni A, Brandes A. Gangliogliomas: recent advances in classification and treatment. FUTURE NEUROLOGY 2010. [DOI: 10.2217/fnl.10.26] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Gangliogliomas are uncommon neoplasms of the CNS and, as a consequence, few randomized, clinical trials have been performed, thereby limiting treatment guidelines. The best management of newly diagnosed gangliogliomas entails a complete resection, corroborated by postoperative contrast-enhanced MRI. If an incomplete resection is documented, a second attempt at gross total resection should be considered, given the prognostic significance of complete resection. Small-volume residual disease is best managed with involved-field radiotherapy. The role of chemotherapy is uncertain and, in general, would be reserved for patients having previously failed surgery and radiotherapy. This article summarizes the most important available up-to-date information on clinical, prognostic, radiological, pathological and therapeutic findings for gangliogliomas in order to provide valuable guidance for the diagnosis and management of such uncommon tumors. This information may be considered as possible background for future studies designed to clarify the complex management of these tumors.
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Affiliation(s)
- Chiara Tomasello
- Department of Medical Oncology, Azienda USL Bell aria-Maggiore Hospital, Bologna, Italy
| | - Enrico Franceschi
- Department of Medical Oncology, Azienda USL Bell aria-Maggiore Hospital, Bologna, Italy
| | - Alicia Tosoni
- Department of Medical Oncology, Azienda USL Bell aria-Maggiore Hospital, Bologna, Italy
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Differential distribution of erbB receptors in human glioblastoma multiforme: expression of erbB3 in CD133-positive putative cancer stem cells. J Neuropathol Exp Neurol 2010; 69:606-22. [PMID: 20467331 DOI: 10.1097/nen.0b013e3181e00579] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Glioblastomas are the most common primary central nervous system tumors in adults, and they remain resistant to current treatments. erbB1 signaling is frequently altered in glioblastomas, suggesting thaterbB receptor family members may represent targets for molecular therapy. We performed a comprehensive analysis of erbB receptor and ligand expression profiles in a panel of 9 glioblastomas andcompared them to nonneoplastic cerebral tissue containing neocortex and adjacent white matter. Quantitative reverse transcription-polymerase chain reaction and Western blot analysis showed that erbB1signaling and erbB2 receptors exhibited highly variable deregulation profiles in the tumors, with patterns ranging from underexpression to overexpression; in contrast, erbB3 and erbB4 were downregulated. We next performed immunohistochemistry to determinethe distribution patterns of erbB receptors among the main neuralcell types in the tumors with special reference to the putative tumor stem cell population. Results revealed intertumoral and intratumoral heterogeneity in all 4 erbB expression profiles, but each receptor exhibited a distinct distribution pattern among glial fibrillary acidic protein-, Olig2-, NeuN-, and CD133-positive populations. Although erbB1 immunoreactivity was detected in only small subsets of CD133-positive putative tumor stem cells, erbB3 immunoreactivity was prominent in this population, suggesting that erbB3 may represent a new potential therapeutic target.
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Donev K, Scheithauer BW, Rodriguez FJ, Jenkins S. Expression of diagnostic neuronal markers and outcome in glioblastoma. Neuropathol Appl Neurobiol 2010; 36:411-21. [PMID: 20298476 DOI: 10.1111/j.1365-2990.2010.01078.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND High-grade gliomas featuring giant cells, often demonstrate immunoreactivity for neuronal markers, a finding prognostically significant according to some studies. We investigated this event in glioblastomas (GBM). METHODS Immunoexpression for synaptophysin, neurofilament protein, neuronal nuclear antigen, chromogranin and glial fibrillary acidic protein was analysed in 82 GBM including 11 fibrillary, 8 gemistocytic, 40 giant cell and 23 small cell examples. Survival was compared between tumours exhibiting (GBMpos) or lacking (GBMneg) neuronal markers and also between tumours expressing only one vs. two or more neuronal markers. RESULTS Forty-five of the 82 tumours (54.8%) including 5 fibrillary, 5 gemistocytic, 30 giant cell and 5 small cell GBMs expressed at least one neuronal marker, synaptophysin being the most frequent (96%). There was no statistically significant difference in survival between GBMpos and GBMneg tumours, all cytologic subtypes combined (P = 0.22). The same was true when cytologic categories were compared. When only GBMpos tumours were analysed, there was a marginally significant difference in outcome between tumours positive for one vs. multiple markers (P = 0.05). This difference was influenced primarily by giant cell GBMs among which the survival time was significantly shorter in the multiple vs. single marker category (median 123 vs. 295 days, P = 0.014). This difference was not observed in the other GBM cell types. Ultrastructurally, rare neurosecretory granules in glial filament-rich cells were identified in one of four tumours studied. CONCLUSIONS Neuronal marker expression is a frequent feature of GBM. Its prognostic significance is limited to the giant cell GBMs expressing two or more neuronal markers, these being associated with shorter survival.
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Affiliation(s)
- K Donev
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, USA
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Epithelioid Versus Rhabdoid Glioblastomas Are Distinguished by Monosomy 22 and Immunohistochemical Expression of INI-1 but not Claudin 6. Am J Surg Pathol 2010; 34:341-54. [DOI: 10.1097/pas.0b013e3181ce107b] [Citation(s) in RCA: 79] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Patru C, Romao L, Varlet P, Coulombel L, Raponi E, Cadusseau J, Renault-Mihara F, Thirant C, Leonard N, Berhneim A, Mihalescu-Maingot M, Haiech J, Bièche I, Moura-Neto V, Daumas-Duport C, Junier MP, Chneiweiss H. CD133, CD15/SSEA-1, CD34 or side populations do not resume tumor-initiating properties of long-term cultured cancer stem cells from human malignant glio-neuronal tumors. BMC Cancer 2010; 10:66. [PMID: 20181261 PMCID: PMC2841664 DOI: 10.1186/1471-2407-10-66] [Citation(s) in RCA: 78] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2009] [Accepted: 02/24/2010] [Indexed: 11/15/2022] Open
Abstract
Background Tumor initiating cells (TICs) provide a new paradigm for developing original therapeutic strategies. Methods We screened for TICs in 47 human adult brain malignant tumors. Cells forming floating spheres in culture, and endowed with all of the features expected from tumor cells with stem-like properties were obtained from glioblastomas, medulloblastoma but not oligodendrogliomas. Results A long-term self-renewal capacity was particularly observed for cells of malignant glio-neuronal tumors (MGNTs). Cell sorting, karyotyping and proteomic analysis demonstrated cell stability throughout prolonged passages. Xenografts of fewer than 500 cells in Nude mouse brains induced a progressively growing tumor. CD133, CD15/LeX/Ssea-1, CD34 expressions, or exclusion of Hoechst dye occurred in subsets of cells forming spheres, but was not predictive of their capacity to form secondary spheres or tumors, or to resist high doses of temozolomide. Conclusions Our results further highlight the specificity of a subset of high-grade gliomas, MGNT. TICs derived from these tumors represent a new tool to screen for innovative therapies.
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Affiliation(s)
- Cristina Patru
- Glial Plasticity lab, Inserm UMR 894, University Paris Descartes, Paris, France
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Dagher R, Brière C, Fève M, Zeniou M, Pigault C, Mazars C, Chneiweiss H, Ranjeva R, Kilhoffer MC, Haiech J. Calcium fingerprints induced by calmodulin interactors in eukaryotic cells. BIOCHIMICA ET BIOPHYSICA ACTA 2009; 1793:1068-77. [PMID: 19133300 DOI: 10.1016/j.bbamcr.2008.11.019] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2008] [Revised: 11/19/2008] [Accepted: 11/20/2008] [Indexed: 10/21/2022]
Abstract
Calcium (Ca2+) is a ubiquitous second messenger which promotes cell responses through transient changes in intracellular concentrations. The prominent role of Ca2+ in cell physiology is mediated by a whole set of proteins constituting a Ca2+-signalling toolkit involved in Ca2+-signal generation, deciphering and arrest. The different Ca2+-signalosomes deliver Ca2+-signals with spatial and temporal dynamics to control the function of specific cell types. Among the intracellular proteins involved in Ca2+-signal deciphering, calmodulin (CaM) plays a pivotal role in controlling Ca2+-homeostasis and downstream Ca2+-based signalling events. Due to its ubiquitous expression in eukaryotic cells and the variety of proteins it interacts with, CaM is central in Ca2+-signalling networks. For these reasons, it is expected that disrupting or modifying CaM interactions with its target proteins will affect Ca2+-homeostasis and cellular responses. The resulting calcium response will vary depending on which interactions between CaM and target proteins are altered by the molecules and on the specific Ca2+-toolkit expressed in a given cell, even in the resting state. In the present paper, the effect of six classical CaM interactors (W5, W7, W12, W13, bifonazole and calmidazolium) was studied on Ca2+-signalling in tumor initiating cells isolated from human glioblastoma (TG1) and tobacco cells (BY-2) using the fluorescent Ca2+-sensitive Indo-1 dye and aequorin, respectively. Various Ca2+-fingerprints were obtained depending both on the CaM interactor used and the cell type investigated. These data demonstrate that interaction between the antagonists and CaM results in a differential inhibition of CaM-dependent proteins involved in Ca2+-signal regulation. In addition, the distinct Ca2+-fingerprints in tobacco and human tumor initiating glioblastoma cells induced by a given CaM interactor highlight the specificity of the Ca2+-signalosome in eukaryotic cells.
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Affiliation(s)
- Rania Dagher
- UMR CNRS 7200, Université de Strasbourg, Faculté de Pharmacie 74, route du Rhin, F-67401 Illkirch, France
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Scheithauer BW, Silva AI, Ketterling RP, Pula JH, Lininger JF, Krinock MJ. ROSETTE-FORMING GLIONEURONAL TUMOR: REPORT OF A CHIASMAL-OPTIC NERVE EXAMPLE IN NEUROFIBROMATOSIS TYPE 1. Neurosurgery 2009; 64:E771-2; discussion E772. [DOI: 10.1227/01.neu.0000340979.81362.f3] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Abstract
OBJECTIVE
Rosette-forming glioneuronal tumor is a rare, rather recently described tumor featuring a highly distinctive, biphasic histological pattern, including a cytologically uniform neuronal component of Homer-Wright type pseudorosettes and an accompanying astrocytic element resembling pilocytic astrocytoma. Its occurrence in the posterior fossa and association with the fourth ventricle is stereotypical and a feature of all reported cases.
CLINICAL PRESENTATION
In this article, we describe the first rosette-forming glioneuronal tumor arising outside this site, a histologically classic example involving the anterior visual pathway and associated with neurofibromatosis type 1.
INTERVENTION
Genetic (fluorescent in situ hybridization) studies demonstrated no large deletion in either normal or neoplastic tissue, indicating that the genetic abnormality underlying neurofibromatosis type 1 in this patient is likely a very small deletion or point mutation.
CONCLUSION
The relation of the tumor to the underlying neurofibromatosis type 1 cannot be assessed.
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Affiliation(s)
- Bernd W. Scheithauer
- Departments of Pathology and Laboratory Medicine, Mayo Clinic, Rochester, Minnesota
| | - Ana I. Silva
- Departments of Pathology and Laboratory Medicine, Mayo Clinic, Rochester, Minnesota
- Sao Marcos Hospital, Braga, Portugal
| | - Rhett P. Ketterling
- Departments of Pathology and Laboratory Medicine, Mayo Clinic, Rochester, Minnesota
| | - J. H. Pula
- Department of Neurology, University of Chicago, Chicago, Illinois
| | - James F. Lininger
- Department of Pathology, Borgess Medical Center, Kalamazoo, Michigan
| | - Mark J. Krinock
- Department of Neurosurgery, Borgess Medical Center, Kalamazoo, Michigan
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