Clinical and histological characteristics of recurrent oligodendroglial tumors: comparison between primary and recurrent
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ORIGINAL ARTICLE
Clinical and histological characteristics of recurrent oligodendroglial tumors: comparison between primary and recurrent tumors in 18 cases Masayuki Kanamori • Toshihiro Kumabe • Ichiyo Shibahara Ryuta Saito • Yoji Yamashita • Yukihiko Sonoda • Hiroyoshi Suzuki • Mika Watanabe • Teiji Tominaga
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Received: 29 May 2012 / Accepted: 17 September 2012 / Published online: 2 October 2012 Ó The Japan Society of Brain Tumor Pathology 2012
Abstract Changes in histological and genetic characteristics were investigated in 18 paired primary and recurrent oligodendroglial tumors, using sequencing analysis for isocitrate dehydrogenase (IDH) 1 and 2 gene mutation, Ki-67 and p53 immunohistochemistry, and fluorescent in situ hybridization for loss of heterozygosity of chromosomes 1p and 19q (1p/19q co-deletion). Malignant transformation occurred in 5 of 8 cases with World Health Organization (WHO) grade II tumors, but in 0 of 10 cases with WHO grade III tumors progressing to glioblastoma. Thirteen of the 18 cases carried IDH1 gene mutation. Tumors with IDH1 mutation tended to survive for longer, even after recurrence, but newly developed microvascular proliferation, tumor necrosis, and elevated Ki-67 labeling index were common. Eleven of the 13 IDH1-mutation tumors had either 1p/19q co-deletion or nuclear expression of p53, but all 5 IDH1/2 wild-type tumors had neither. All cases had the same profile for 1p/19q status at recurrence, but nuclear expression of p53 changed from negative to positive in 2 of 6 cases with IDH1 mutation and 1p/19q co-deletion. WHO grade II oligodendroglial tumors show a high rate of malignant transformation, possibly involving M. Kanamori T. Kumabe (&) I. Shibahara R. Saito Y. Yamashita Y. Sonoda T. Tominaga Department of Neurosurgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan e-mail: [email protected] H. Suzuki Department of Pathology and Laboratory Medicine, Sendai Medical Center, Sendai, Japan M. Watanabe Department of Pathology, Tohoku University Hospital, Sendai, Japan
p53 in tumors with IDH1 mutation and 1p/19q co-deletion. Tumors with IDH1 mutation had a more aggressive histological phenotype despite their better prognosis. Keywords Recurrent oligodendroglial tumor IDH1/2 gene p53 1p/19q co-deletion Ki-67 labeling index
Introduction Oligodendroglial tumors, including oligodendroglioma (OD), oligoastrocytoma (OA), anaplastic oligodendroglioma (AOD), and anaplastic oligoastrocytoma (AOA), account for 6.8 % of all cases of glial tumors in Japan [1]. These entities have better prognoses than astrocytic tumors, but most patients ultimately experience disease progression. The changes in histological diagnosis for the 95 cases treated prospectively in the North Central Cancer Treatment Group study were recently reported [2]. The World Health Organization (WHO) grade increased after recurrence in 51 % of all cases, in 57 % of WHO grade II tumors, and in 13 % of WHO grade III tumors. Additionally, signific
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