The histological representativeness of glioblastoma tissue samples
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ORIGINAL ARTICLE - TUMOR - GLIOMA
The histological representativeness of glioblastoma tissue samples Vilde Elisabeth Mikkelsen 1
&
Ole Solheim 2,3 & Øyvind Salvesen 4 & Sverre Helge Torp 1,5
Received: 27 May 2020 / Accepted: 5 October 2020 # The Author(s) 2020
Abstract Background Glioblastomas (GBMs) are known for having a vastly heterogenous histopathology. Several studies have shown that GBMs can be histologically undergraded due to sampling errors of small tissue samples. We sought to explore to what extent histological features in GBMs are dependent on the amount of viable tissue on routine slides from both biopsied and resected tumors. Methods In 106 newly diagnosed GBM patients, we investigated associations between the presence or degree of 24 histopathological and two immunohistochemical features and the tissue amount on hematoxylin-eosin (HE) slides. The amount of viable tissue was semiquantitatively categorized as “sparse,” “medium,” or “substantial” for each case. Tissue amount was also assessed for associations with MRI volumetrics and the type of surgical procedure. Results About half (46%) of the assessed histological and immunohistochemical features were significantly associated with tissue amount. The significant features were less present or of a lesser degree when the tissue amount was smaller. Among the significant features were most of the features relevant for diffuse astrocytic tumor grading, i.e., small necroses, palisades, microvascular proliferation, atypia, mitotic count, and Ki-67/MIB-1 proliferative index (PI). Conclusion A substantial proportion of the assessed histological features were at risk of being underrepresented when the amount of viable tissue on HE slides was limited. Most of the grading features were dependent on tissue amount, which underlines the importance of considering sampling errors in diffuse astrocytic tumor grading. Our findings also highlight the importance of adequate tissue collection to increase the quality of diagnostics and histological research. Keywords Glioblastoma . Histopathology . Grading . Sampling error . Biopsy . Magnetic resonance imaging
Abbreviations
This article is part of the Topical Collection on Tumor - Glioma * Vilde Elisabeth Mikkelsen [email protected] 1
Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU - Norwegian University of Science and Technology, Erling Skjalgssons gt. 1, 7491 Trondheim, Norway
2
Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, NTNU - Norwegian University of Science and Technology, Trondheim, Norway
3
Department of Neurosurgery, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
4
Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, NTNU - Norwegian University of Science and Technology, Trondheim, Norway
5
Department of Pathology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
FFPE GBM GFAP GTR HE HPF IDH MRI MVD NOS PI T1wGd vWF
Formalin-fix
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