Molecular Classification of Low-Grade Diffuse Gliomas

作者：Kim Young Ho; Nobusawa Sumihito; Mittelbronn Michel; Paulus Werner; Brokinkel Benjamin; Keyvani Kathy; Sure Ulrich; Wrede Karsten; Nakazato Yoichi; Tanaka Yuko; Vital Anne; Mariani Luigi; Stawski Robert; Watanabe Takuya; De Girolami Umberto; Kleihues Paul; Ohgaki Hiroko^*

来源：American Journal Of Pathology, 2010, 177(6): 2708-2714.

DOI：10.2353/ajpath.2010.100680

The current World Health Organization classification recognizes three histological types of grade H low grade diffuse glioma (diffuse astrocytoma oligoastrocytoma and oligodendroglioma) However the diagnostic criteria m particular for oligoastrocytoma are highly subjective The aim of our study was to establish genetic profiles for diffuse gliomas and to estimate their predictive impact In this study we screened 360 World Health Organization grade II gliomas for mutations in the IDH1 IDH2 and TP53 genes and for 1p/19q loss and correlated these with clinical outcome Most tumors (86%) were characterized genetically by 77353 mutation plus IDH1/2 muta non (32%) 1p/19q loss plus IDH1/2 mutation (37%) or IDH1/2 mutation only (17%) TP53 mutations only or 1p/19q loss only was rare (2 and 3% respectively) The median survival of patients with TP53 mutation +/- IDH1/2 mutation was significantly shorter than that of patients with 1p/19q loss +/- IDH1/2 mutation (51 8 months vs 587 months respectively P = 0 0037) Multivariate analysis with adjustment for age and treatment confirmed these results (P = 0 0087) and also revealed that TP53 mutation is a significant prognostic marker for shorter survival (P = 0 0005) and 1p/19q loss for longer survival (P = 0 0002) while IDH1/2 mutations are not prognostic (P = 0 8737) The molecular classification on the basis of IDH1/2 mutation TP53 mutation and 1p/19q loss has power similar to histological classification and avoids the ambiguity inherent to the diagnosis of oligoastrocytoma. (Am J Pathol 2010 177 2708-2714 DOI 10 2353/ajpath 2010 100680)

• 出版日期2010-12