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P10.22.A Prognostic role of TCF7L2 in glioblastoma. Neuro Oncol 2022. [DOI: 10.1093/neuonc/noac174.187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Glioblastoma is the most common and devastating brain cancer and despite maximal surgical resection, chemotherapy and radiotherapy, the five-year survival rate is less than 7%. The TCF7L2 gene encodes transcription factor 7-like 2, a main effector of Wnt/β-Catenin signaling pathway involved in cancer development and progression. Aberrant activation of the TCF7L2 gene is one of the primary events in tumorigenesis by maintaining stem-cell characteristics, however its role in glioblastoma is poorly studied.
Material and Methods
The expression of TCF7L2 was analyzed by qRT-PCR in a series of consecutive glioblastoma samples from patients that underwent surgical resection. Secondary or recurrent glioblastomas were excluded from the analysis. All patients underwent radio- and chemotherapy according to the protocol. Housekeeping gene RPL13 was used as reference gene. The 2-ΔCT method was used to calculate the relative expression of TCF7L2 to the reference gene.
Results
A total of 49 glioblastoma samples were included in the study. The mean survival period was 58.2 weeks. The median value of TCF7L2 expression was used as a cut-off point for the survival analysis. There were no statistically significant differences regarding the clinical and histopathological factors between the groups with low and high expression of TCF7L2. By using the Kaplan-Meier analysis, we observed that patients with overexpression of TCF7L2 had a decreased survival rate compared to patients with low levels of TCF7L2 (38.8 weeks vs. 77.34 weeks, p = 0.001).
Conclusion
These results demonstrate that glioblastoma patients with high levels of TCF7L2 have a poorer survival rate and TCF7L2 might be a useful prognostic factor for these patients. However, further studies are needed to elucidate the mechanisms through which TCF7L2 affects the prognosis and its implication as a possible therapeutic target.
This work was supported by an ERA PerMed grant - ERAPERMED2018-270 (PerProGlio).
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P07.02 Robot-assisted stereotactic brain biopsy combined with cortical mapping using navigated transcranial magnetic stimulation. Neuro Oncol 2021. [DOI: 10.1093/neuonc/noab180.085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
BACKGROUND
Frame-based stereotactic biopsy has been for decades the gold-standard method for taking samples of brain tumors for the histopathological diagnostic in cases when surgery was contraindicated. However, novel frameless techniques have been developed in order to facilitate the procedure for the neurosurgeon, and for the patient as well. Preoperative cortical mapping techniques enable the planning of the trajectory with the sparing of eloquent areas.
MATERIAL AND METHODS
A preoperative cortical mapping using navigated transcranial magnetic stimulation was performed in the case of a 37-year-old male that presented with headache. The MRI scan revealed multiple lesions located frontal lobe and temporal lobe on the right hemisphere and frontal and occipital lobes on the left hemisphere. The results of the preoperative cortical mapping were integrated into the neuronavigation system and used for the planning of the frameless based stereotactic brain biopsy. A biopsy procedure was performed using a robotic arm according to the planned trajectory.
RESULTS
The targeted lesion was the right frontal one. The planned trajectory took into account the results from the cortical mapping using nTMS, and the eloquent areas were avoided. The robotic arm guided the procedure and aligned to the entry point and trajectory. According to the histopathological result the lesion was a grade II diffuse astrocytoma. There were no perioperative complications.
CONCLUSION
To our knowledge, this is the first report that describes the use of a robot-guided frameless brain biopsy system combined with the preoperative mapping of the eloquent cortical areas using navigated transcranial magnetic stimulation. This approach is a safe one and carries less burden for the patient as well as for the surgeon.
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P04.17 Differential diagnosis of gliomas using Digital Holographic Microscopy. Neuro Oncol 2019. [DOI: 10.1093/neuonc/noz126.112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
BACKGROUND
The clinical course and prognostic of gliomas depend on the tumor histological and molecular features. The histopathological diagnosis requests well-trained specialists and multi-step operational procedures for sample preparation. Faster and more objective protocols should be implemented in support of pathologists. The Quantitative Phase Imaging based methods are biologically proved to be efficient in revealing, without any labeling, important characteristics of the living specimens having different structural complexity. We used Digital Holographic Microscopy (DHM) to acquire QPIs and to analyze glioma samples in order to discriminate glioma tissues of various malignancy grades.
MATERIAL AND METHODS
Grade II glioma (GM) and grade IV glioblastoma (GBM) tissues were collected from patients who underwent surgery. For each sample, two consecutive slices were fixed with formalin, embedded in paraffin and cut at 4 µm thickness. One slice was stained using hematoxylin and eosin (H&E) and the other slice was left unstained. The pathologist diagnosed H&E slides as GM or GBM and the corresponding unstained slides were accordingly labeled. Holograms of unstained sections were acquired using a LyncéeTec DHM®-R1000 digital holographic microscope (at 664.5 nm). QPIs were reconstructed using the Koala dedicated software, and then the distribution of the phase shift values in the image was characterized by various statistical parameters (mean, variance, kurtosis, skewness, energy, entropy).
RESULTS
A total of 78 images were analyzed, 33 for grade II gliomas and 45 for grade IV glioblastomas, the areas being randomly selected, as the tissue is highly homogeneous. Lower values of Mean, Variance and Energy and higher values of Kurtosis and Entropy were found for GM compared to GBM (Mann-Whitney test was performed for proofing the statistically significance). No statistical difference was observed for Skewness. As the thickness of the samples was constant, variations of these parameters may be attributed to different distributions of the refractive index within the samples, which in turn is directly related to the protein content and structural features of the tissue.
CONCLUSION
The analyze of unstained biopsies of glioma tumors based on DHM could be used for faster and more accurate diagnosis, offering efficient optical markers to distinguish between levels of malignancy with high statistical confidence. Our findings can be further exploited for automatic evaluation and classification of malignant tissues, parameters provided by QPIs being used as classifiers for a supervised machine algorithm. This method can be adapted for fresh samples, being thus a promising method for intraoperative diagnostic.
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