The goal of this work was to demonstrate prospectively that maximal surgical resection of low grade oligodendrogliomas without adjuvant therapy does not reduce life expectancy over that of historical controls. All pat...The goal of this work was to demonstrate prospectively that maximal surgical resection of low grade oligodendrogliomas without adjuvant therapy does not reduce life expectancy over that of historical controls. All patients with surgically accessible grade II oligodendrogliomas underwent maximal resection using stereotactic guidance and/or cortical mapping and were followed with serial MRI scans without adjuvant therapy until either progression or spread into brain regions deemed not surgically resectable. Nineteen patients were treated between 1993 and 2006. Ten patients required reoperation an average of 55 months after their first surgery. Nine patients progressed to anaplastic tumors an average of 42 months after their first surgery: six patients died from their tumors an average of 73 months after diagnosis, two are still alive 76 and 18 months after progression, and one was lost to follow up. Ten patients are alive and progression-free an average of 116 months after diagnosis, one of whom was lost to follow up at 106 months from diagnosis. Four patients are alive and event-free an average of 125 months after diagnosis. All are male and three had tumors in the superior frontal gyrus. The event-free survival, progression-free survival, and overall survival of our patients are not worse than those of patients treated with postoperative adjuvant therapy. Withholding adjuvant therapy at diagnosis appears to be safe. It will be important to establish the molecular differences between the patients who did very well and those who progressed so that adjuvant therapy could be offered to the latter.展开更多
CD44, in its standard form as well in its isoforms, is a cell surface adhesion glycoprotein which occurs in a widevariety of non-neoplastic and neoplastic ceils. CD44 has been considered to be implicated in tumoral gr...CD44, in its standard form as well in its isoforms, is a cell surface adhesion glycoprotein which occurs in a widevariety of non-neoplastic and neoplastic ceils. CD44 has been considered to be implicated in tumoral growth andin metastatic potential. We studied the immunohistochemical expression of CD44 standard in 30 oligodendrogliomas(19 primary lesions and 11 recurrences) in order to verify its possible prognostic role. Twelve primary oligoden-展开更多
The current study investigated correlations between the expression of leucine-rich repeats and immunoglobulin-like domain 1 （LRIG1） and antioxidant enzymes and related proteins, including manganese superoxide dismut...The current study investigated correlations between the expression of leucine-rich repeats and immunoglobulin-like domain 1 （LRIG1） and antioxidant enzymes and related proteins, including manganese superoxide dismutase, glutamate cysteine ligase catalytic or regulatory subunit, thioredoxin and thioredoxin reductase, in both human ependymoma and oligodendroglioma. Results revealed that the cytoplasmic expression of LRIG1 was associated with expression of glutamate cysteine ligase catalytic subunit in the human ependymoma, while the nuclear expression of LRIG1 was associated with expression of thioredoxin reductase. In human oligodendroglioma, the cytoplasmic expression of LRIG1 was associated with expression of the glutamate cysteine ligase catalytic subunit. Both the nuclear and perinuclear expressions of LRIG1 were associated with expression of glutamate cysteine ligase regulatory subunit. These results indicated that several antioxidant enzymes and related proteins contributed to LRIG1 expression, and that these may participate in the antioxidation of the cells.展开更多
Grade II oligodendrogliomas are rare and slow growing tumors, making long-term follow up difficult, but necessary for better understanding. In this retrospective study a review of all grade II oligodendrogliomas encou...Grade II oligodendrogliomas are rare and slow growing tumors, making long-term follow up difficult, but necessary for better understanding. In this retrospective study a review of all grade II oligodendrogliomas encountered in the last 20 years at one institution, was undertaken to determine if specific tumor location and immunohistochemical analysis had any impact on recurrence rate, progression free survival, or life expectancy. Eighty-nine grade II oligodendroglioms cases were reviewed (38 females and 51 males;mean age was 40.3 ± 13.8 years). Tumor location was: frontal lobe (44, 49.4%) and superior frontal gyrus (30, 33.7%). 1p19q data were available in 49 patients. Twenty-nine cases were co-deleted (59.2%). There was no significant difference in the incidence of 1p19q co-deletion between superior frontal gyrus tumors vs. other frontal tumors or extra-frontal tumors (p?= 0.45). Follow up of at least 3 months after diagnosis was available in 79 patients (mean follow up: 93.2 months). In recurrence analysis, recurrence by 1p19q status and recurrence by location revealed no significant differences. In analysis of progression, progression by 1p19q status and progression by location revealed no significant differences. An analysis of deaths for the sample, deaths by 1p19q status and deaths by location revealed no significant differences. There was a higher death rate among patients >50 years of age, however this, too, was not significant.?There did not appear to be any advantage in recurrence rate, progression free survival, or life expectancy for tumors located in the frontal lobe or superior frontal gyrus. 1p19q co-deletion did not appear to confer an advantage as measured by time to recurrence, time to progression, or overall survival. Other than age, eloquent location, Karnofsky status, and overall tumor size as reported by others, tumor location and 1p19q status in low grade oligodendrogliomas are not currently predictive of survival.展开更多
A brain tumor associated with an arteriovenous malformation (AVM) is very rare. A 42-year-old female presented with two separate lesions in her right frontal lobe on MRI. An angiogram diagnosed one of the lesions as a...A brain tumor associated with an arteriovenous malformation (AVM) is very rare. A 42-year-old female presented with two separate lesions in her right frontal lobe on MRI. An angiogram diagnosed one of the lesions as an AVM. The second lesion appeared to be a tumor. Tumor removal was difficult due to bleeding from the nearby AVM, necessitating removal of the AVM and allowing complete excision of the tumor. Histopathological analysis revealed the tumor was an anaplastic oligodendroglioma. There was no recurrence of the tumor 5 year after completion of therapy. We discuss the operative strategy in case of synchronous diseases and provide a review of the literature.展开更多
目的探讨I D H突变和1p/19q共缺失型少突胶质细胞瘤的临床病理特征及预后相关影响因素。方法收集54例IDH突变和1p/19q共缺失型少突胶质细胞瘤病例,分析其临床病理特点,包括年龄、组织学分级和肿瘤部位等因素对无进展生存期和总生存期的...目的探讨I D H突变和1p/19q共缺失型少突胶质细胞瘤的临床病理特征及预后相关影响因素。方法收集54例IDH突变和1p/19q共缺失型少突胶质细胞瘤病例,分析其临床病理特点,包括年龄、组织学分级和肿瘤部位等因素对无进展生存期和总生存期的影响。结果 54例患者中,肿瘤发生于1个脑叶者46例,发生于2个脑叶以上者8例。肿瘤组织学WHO分级2级12例,3级42例。FISH检测显示54例均为1p/19q共缺失;免疫组织化学检测显示Olig2均为弥漫强阳性;GFAP均为阳性;p53有6例强阳性;48例患者ATRX未缺失;Ki-67增殖指数5%~60%。Sanger测序显示54例均发生IDH基因突变(40例为IDH1突变,14例为IDH2突变),33例发生TERT启动子突变。16例在治疗过程中发生复发及转移。单因素分析显示,手术后复发转移间隔时间超过2年可以延长患者无进展生存和总生存期。54例患者平均无进展生存期33.5个月,平均总生存期40.7个月。结论 IDH突变和1p/19q共缺失型少突胶质细胞瘤术后联合精准放化疗降低了进展风险,手术后复发转移间隔时间与该型患者预后相关。展开更多
Gliomas are primary brain tumors derived from glial cells of the central nervous system,afflicting both adults and children with distinct characteristics and therapeutic challenges.Recent developments have ushered in ...Gliomas are primary brain tumors derived from glial cells of the central nervous system,afflicting both adults and children with distinct characteristics and therapeutic challenges.Recent developments have ushered in novel clinical and molecular prognostic factors,reshaping treatment paradigms based on classi-fication and grading,determined by histological attributes and cellular lineage.This review article delves into the diverse treatment modalities tailored to the specific grades and molecular classifications of gliomas that are currently being discussed and used clinically in the year 2023.For adults,the therapeutic triad typically consists of surgical resection,chemotherapy,and radiotherapy.In contrast,pediatric gliomas,due to their diversity,require a more tailored approach.Although complete tumor excision can be curative based on the location and grade of the glioma,certain non-resectable cases demand a chemotherapy approach usually involving,vincristine and carboplatin.Addi-tionally,if surgery or chemotherapy strategies are unsuccessful,Vinblastine can be used.Despite recent advancements in treatment methodologies,there remains a need of exploration in the literature,particularly concerning the efficacy of treatment regimens for isocitrate dehydrogenase type mutant astrocytomas and fine-tuned therapeutic approaches tailored for pediatric cohorts.This review article explores into the therapeutic modalities employed for both adult and pediatric gliomas in the context of their molecular classification.展开更多
Background Our previous study confirmed that oligodendrogliomas had higher frequency of chromosome 1p/19q deletion. In order to improve the diagnostic criteria and to predict the prognosis of oligodendroglioma patient...Background Our previous study confirmed that oligodendrogliomas had higher frequency of chromosome 1p/19q deletion. In order to improve the diagnostic criteria and to predict the prognosis of oligodendroglioma patients, the status of chromosome 1 p/19q deletion, the methylation of O6-methylguanine-DNA methyltransferase （MGMT）, and the expression of p53 protein were evaluated and investigated in relation to patients＇ outcomes.Methods Methylation of MGMT in 73 cases was analyzed by nested methylation-specific PCR （MSP）. The levels of MGMT and p53 protein were tested with immunohistochemistry. Pearson＇s chi-square test and Fisher＇s exact test were used. Multivariate and Kaplan-Meier analysis were performed to determine patients＇ outcomes.Results Both oligodendrogliomas and astrocytic gliomas exhibited frequent methylation of MGMT. However, the results of MSP did not completely correspond to that of the immunohistochemical staining for MGMT. The expression of p53 protein was more frequently observed in patients without a 1 p or 19q deletion in anaplastic oligodendrogliomas （=0.032,0.025）. In low-grade oligodendrogliomas, methylation of MGMT was more frequent in patients with 1 p/19q deletion than in patients with 1p/19q intact （P=0.038）. Patients with oligodendrogliomas with 1p/19q loss of heterozygosity and p53-negative showed a longer progression-free survival.Conclusion Detection of chromosome 1p/19q status combined with p53 protein immunohistochemistry might be beneficial to improve the pathological diagnosis and to determine the prognosis of patients with oligodendrogliomas.展开更多
文摘The goal of this work was to demonstrate prospectively that maximal surgical resection of low grade oligodendrogliomas without adjuvant therapy does not reduce life expectancy over that of historical controls. All patients with surgically accessible grade II oligodendrogliomas underwent maximal resection using stereotactic guidance and/or cortical mapping and were followed with serial MRI scans without adjuvant therapy until either progression or spread into brain regions deemed not surgically resectable. Nineteen patients were treated between 1993 and 2006. Ten patients required reoperation an average of 55 months after their first surgery. Nine patients progressed to anaplastic tumors an average of 42 months after their first surgery: six patients died from their tumors an average of 73 months after diagnosis, two are still alive 76 and 18 months after progression, and one was lost to follow up. Ten patients are alive and progression-free an average of 116 months after diagnosis, one of whom was lost to follow up at 106 months from diagnosis. Four patients are alive and event-free an average of 125 months after diagnosis. All are male and three had tumors in the superior frontal gyrus. The event-free survival, progression-free survival, and overall survival of our patients are not worse than those of patients treated with postoperative adjuvant therapy. Withholding adjuvant therapy at diagnosis appears to be safe. It will be important to establish the molecular differences between the patients who did very well and those who progressed so that adjuvant therapy could be offered to the latter.
文摘CD44, in its standard form as well in its isoforms, is a cell surface adhesion glycoprotein which occurs in a widevariety of non-neoplastic and neoplastic ceils. CD44 has been considered to be implicated in tumoral growth andin metastatic potential. We studied the immunohistochemical expression of CD44 standard in 30 oligodendrogliomas(19 primary lesions and 11 recurrences) in order to verify its possible prognostic role. Twelve primary oligoden-
基金the Swedish Institute, No. 00287/2006210the North Sweden Cancer Foundation, Specialized Research Fund for the Doctoral Program New Teacher of Higher Education by the Chinese Ministry of Education, No. 200804861039the National Natural Science Foundation of China, No. 30973073, 30973072
文摘The current study investigated correlations between the expression of leucine-rich repeats and immunoglobulin-like domain 1 （LRIG1） and antioxidant enzymes and related proteins, including manganese superoxide dismutase, glutamate cysteine ligase catalytic or regulatory subunit, thioredoxin and thioredoxin reductase, in both human ependymoma and oligodendroglioma. Results revealed that the cytoplasmic expression of LRIG1 was associated with expression of glutamate cysteine ligase catalytic subunit in the human ependymoma, while the nuclear expression of LRIG1 was associated with expression of thioredoxin reductase. In human oligodendroglioma, the cytoplasmic expression of LRIG1 was associated with expression of the glutamate cysteine ligase catalytic subunit. Both the nuclear and perinuclear expressions of LRIG1 were associated with expression of glutamate cysteine ligase regulatory subunit. These results indicated that several antioxidant enzymes and related proteins contributed to LRIG1 expression, and that these may participate in the antioxidation of the cells.
文摘Grade II oligodendrogliomas are rare and slow growing tumors, making long-term follow up difficult, but necessary for better understanding. In this retrospective study a review of all grade II oligodendrogliomas encountered in the last 20 years at one institution, was undertaken to determine if specific tumor location and immunohistochemical analysis had any impact on recurrence rate, progression free survival, or life expectancy. Eighty-nine grade II oligodendroglioms cases were reviewed (38 females and 51 males;mean age was 40.3 ± 13.8 years). Tumor location was: frontal lobe (44, 49.4%) and superior frontal gyrus (30, 33.7%). 1p19q data were available in 49 patients. Twenty-nine cases were co-deleted (59.2%). There was no significant difference in the incidence of 1p19q co-deletion between superior frontal gyrus tumors vs. other frontal tumors or extra-frontal tumors (p?= 0.45). Follow up of at least 3 months after diagnosis was available in 79 patients (mean follow up: 93.2 months). In recurrence analysis, recurrence by 1p19q status and recurrence by location revealed no significant differences. In analysis of progression, progression by 1p19q status and progression by location revealed no significant differences. An analysis of deaths for the sample, deaths by 1p19q status and deaths by location revealed no significant differences. There was a higher death rate among patients >50 years of age, however this, too, was not significant.?There did not appear to be any advantage in recurrence rate, progression free survival, or life expectancy for tumors located in the frontal lobe or superior frontal gyrus. 1p19q co-deletion did not appear to confer an advantage as measured by time to recurrence, time to progression, or overall survival. Other than age, eloquent location, Karnofsky status, and overall tumor size as reported by others, tumor location and 1p19q status in low grade oligodendrogliomas are not currently predictive of survival.
文摘A brain tumor associated with an arteriovenous malformation (AVM) is very rare. A 42-year-old female presented with two separate lesions in her right frontal lobe on MRI. An angiogram diagnosed one of the lesions as an AVM. The second lesion appeared to be a tumor. Tumor removal was difficult due to bleeding from the nearby AVM, necessitating removal of the AVM and allowing complete excision of the tumor. Histopathological analysis revealed the tumor was an anaplastic oligodendroglioma. There was no recurrence of the tumor 5 year after completion of therapy. We discuss the operative strategy in case of synchronous diseases and provide a review of the literature.
文摘目的探讨I D H突变和1p/19q共缺失型少突胶质细胞瘤的临床病理特征及预后相关影响因素。方法收集54例IDH突变和1p/19q共缺失型少突胶质细胞瘤病例,分析其临床病理特点,包括年龄、组织学分级和肿瘤部位等因素对无进展生存期和总生存期的影响。结果 54例患者中,肿瘤发生于1个脑叶者46例,发生于2个脑叶以上者8例。肿瘤组织学WHO分级2级12例,3级42例。FISH检测显示54例均为1p/19q共缺失;免疫组织化学检测显示Olig2均为弥漫强阳性;GFAP均为阳性;p53有6例强阳性;48例患者ATRX未缺失;Ki-67增殖指数5%~60%。Sanger测序显示54例均发生IDH基因突变(40例为IDH1突变,14例为IDH2突变),33例发生TERT启动子突变。16例在治疗过程中发生复发及转移。单因素分析显示,手术后复发转移间隔时间超过2年可以延长患者无进展生存和总生存期。54例患者平均无进展生存期33.5个月,平均总生存期40.7个月。结论 IDH突变和1p/19q共缺失型少突胶质细胞瘤术后联合精准放化疗降低了进展风险,手术后复发转移间隔时间与该型患者预后相关。
文摘Gliomas are primary brain tumors derived from glial cells of the central nervous system,afflicting both adults and children with distinct characteristics and therapeutic challenges.Recent developments have ushered in novel clinical and molecular prognostic factors,reshaping treatment paradigms based on classi-fication and grading,determined by histological attributes and cellular lineage.This review article delves into the diverse treatment modalities tailored to the specific grades and molecular classifications of gliomas that are currently being discussed and used clinically in the year 2023.For adults,the therapeutic triad typically consists of surgical resection,chemotherapy,and radiotherapy.In contrast,pediatric gliomas,due to their diversity,require a more tailored approach.Although complete tumor excision can be curative based on the location and grade of the glioma,certain non-resectable cases demand a chemotherapy approach usually involving,vincristine and carboplatin.Addi-tionally,if surgery or chemotherapy strategies are unsuccessful,Vinblastine can be used.Despite recent advancements in treatment methodologies,there remains a need of exploration in the literature,particularly concerning the efficacy of treatment regimens for isocitrate dehydrogenase type mutant astrocytomas and fine-tuned therapeutic approaches tailored for pediatric cohorts.This review article explores into the therapeutic modalities employed for both adult and pediatric gliomas in the context of their molecular classification.
文摘Background Our previous study confirmed that oligodendrogliomas had higher frequency of chromosome 1p/19q deletion. In order to improve the diagnostic criteria and to predict the prognosis of oligodendroglioma patients, the status of chromosome 1 p/19q deletion, the methylation of O6-methylguanine-DNA methyltransferase （MGMT）, and the expression of p53 protein were evaluated and investigated in relation to patients＇ outcomes.Methods Methylation of MGMT in 73 cases was analyzed by nested methylation-specific PCR （MSP）. The levels of MGMT and p53 protein were tested with immunohistochemistry. Pearson＇s chi-square test and Fisher＇s exact test were used. Multivariate and Kaplan-Meier analysis were performed to determine patients＇ outcomes.Results Both oligodendrogliomas and astrocytic gliomas exhibited frequent methylation of MGMT. However, the results of MSP did not completely correspond to that of the immunohistochemical staining for MGMT. The expression of p53 protein was more frequently observed in patients without a 1 p or 19q deletion in anaplastic oligodendrogliomas （=0.032,0.025）. In low-grade oligodendrogliomas, methylation of MGMT was more frequent in patients with 1 p/19q deletion than in patients with 1p/19q intact （P=0.038）. Patients with oligodendrogliomas with 1p/19q loss of heterozygosity and p53-negative showed a longer progression-free survival.Conclusion Detection of chromosome 1p/19q status combined with p53 protein immunohistochemistry might be beneficial to improve the pathological diagnosis and to determine the prognosis of patients with oligodendrogliomas.
